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SR0082890
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082890
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Last modified
4/14/2021 9:51:47 AM
Creation date
4/14/2021 9:22:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082890
PE
4213
FACILITY_NAME
12455 N CURRY AVE
STREET_NUMBER
12455
Direction
N
STREET_NAME
CURRY
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
06114083
ENTERED_DATE
11/16/2020 12:00:00 AM
SITE_LOCATION
12455 N CURRY AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />ADDRESS: \ -.2._ *-\ t_ v.. '----'•-\ A ,.... ,c-.._ . PERMIT # 5 (2-. b 2. ?D s. 0 <br />< Check box ACTUAL MEETS SJC <br />PARAMETER if if inspected MEASUREMENT STANDARDS? COMMENTS <br />SEPTIC TANK: <br />CORRECT TANK CAPACITY? <br />DISTANCE TO FOUNDATION? <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WELLS? <br />TANK LEVEL AND ORIENTED CORRECTLY? <br />SANITARY TEES CORRECTLY INSTALLED?..„g <br />CORRECT TYPE OF PIPING? <br />TANK VENTED? <br />ANY TANK ABNORMALITIES NOTED? <br />OTHER <br />\kot:0 <br />f 0 N J <br />.1 \n_._. N <br />J \ -5.. ' N TV 6G1-'5 r <br />J <br />-5 \\ N <br />\-ç- N <br />'ie.-5 N <br />J L,0 t\ - S_S N <br />J, \\v-- & N 1)I-VI-de-- <br />J o Q) N <br />N I ',' Y N <br />DISTRIBUTION BOX: <br />DISTANCE FROM TANK? <br />DISTANCE TO NEAREST LEACH LINE? <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION? <br />IS D-BOX LEVEL? <br />OTHER <br />(9 t N it <br />..1 c) N —; <br />J4 \il $CCJ7 0 N <br />vi ,k 't5 Z N <br />— V / IN Y N <br />LEACH FIELD: (LL = LEACH LINES) <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER WELLS? <br />DISTANCE TO NEAREST FOUNDATION? <br />DISTANCE OF SOIL BARRIER BETVVEEN LL'S? <br />CORRECT DEPTH OF LL TRENCHES? <br />CORRECT DEPTH AND TYPE OF ROCK? <br />CORRECT WIDTH OF LL TRENCHES? <br />CORRECT LENGTH OF LL TRENCHES? <br />CORRECT TYPE OF PIPING? <br />OTHER <br />c Y N -x-c3 •11::---S "CT- 3 <br />J ,,,c4,--, 6 N <br />J -z,..-12 b N <br />..1 \\6, 62) N <br />rzw, e N <br />ii.. \-C '% N '‘\\ k,1,\S- e, N "ils.) ,i- 7.---A----c c?...._ ecl-o ‘e--- 1 <br />N <br />J ,3,C %c \' e_Ac/4 P N <br />si 1-S2 q-. ') U9 N <br />-- r--1 / P.. Y N <br />SEEPAGE PITS: <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WATER WELLS? <br />DISTANCE TO NEAREST FOUNDATION? <br />DISTANCE OF SOIL BARRIER TO PITS? <br />CORRECT DEPTH AND TYPE OF ROCK?11 <br />CORRECT WIDTH? <br />OTHER <br />c-,( T N J <br />%.,- t<DI V N <br />\!3•Adi N <br />)( -1 1 F N \ .1---1 6 --.K- L,-, ---..N- e cA5 <br />/LS \,], ,,,,(A, v N <br />J \\I" 12)' N <br />v) i Pc Y N <br />MISCELLANEOUS: <br />DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? (0 N <br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? 0 N <br />ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br />COMMENTS: <br />- F-17 0 Ai I) Fr FU s) .11`) PGFrcfc- I ,jtr6 T e`A/1 AVO mi g e„P -VD rcl,trys A rr,t <br />-1--(. 1....> c-7 LA_ - Li 6-- I- <br />' M D V' ,C) c- F E-0 (•13 663FC--g-kl -#2 . <br />INSPECTED BY: DATE: (
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