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SEPTIC SYSTEM INSPECTION CHECK LIST
<br />ADDRESS: \\D A '),,N ,‘__c,„„, ,, _ ,_, k.,„„A, , c,,, ,cLt,,,,cm PERMIT #
<br />
<br />' Check box ACTUAL MEETS SJC ...,
<br />PARAMETER ,. 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?
<br />CORRECT TYPE OF PIPING?
<br />TANK VENTED?
<br />ANY TANK ABNORMALITIES NOTED?
<br />OTHER
<br />Y N
<br />Y N
<br />Y N
<br />Y N
<br />Y N
<br />Y N
<br />Y N
<br />Y N
<br />Y N
<br />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 />Y N
<br />Y N
<br />Y N
<br />Y N
<br />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 BETWEEN 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 />\o '
<br /> 6? N WA
<br />RI \ --2-131 2 N
<br />MI \3'd h- N in \o I z N
<br />NE stC)" - -1 'L i' Y 119 0 QActi-Nc-,' (.,11-bi'l e'itA--Ob144J
<br />KM 1-,Q' - Vb' Y 03-_) \Y'L" epi12.:Au‘ FNO 0 i 2- h (1-qy_
<br />1111 '1,-.0 \ ." G N
<br />KM c-)-s' Y % - C 1 -•'\1,i-0 Tv. t, T._..N.- il< a_ R-T- --
<br />1E11 -,,e_A-- -2.,s N
<br />— 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?
<br />CORRECT WIDTH?
<br />OTHER
<br />Y N
<br />Y N
<br />Y N
<br />Y N
<br />Y N
<br />Y N
<br />Y N
<br />MISCELLANEOUS:
<br />DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? Y N
<br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? Y N
<br />ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN.
<br />COMMENTS:
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<br />- \1 1P' q- - 'C' A. - . c • r k- ‘.....c-_- -c- --4,-._ -V-- .ci--v4,--...( ,I.../c,--„,k ,k (--si)
<br />- Cx,cIL-.A 9 V (-) A-- V c(.- ci-c-- 'S) "---c2 V.-'-, ) 4 ee'r / t2 0 r-c,e-r
<br />- 0 .---,. -Q:,iN-c_.- v..__s---,-LA_.. 1 4---4.0 \--1 .0. L._r_.,._ t--3 , V cl- 5 ik)6.-,,,f) Ti) 13I
<br />INSPECTEDBY: lb -t)q-c.‹.- .__ A
<br /> DATE:
<br /> /-1 1, "un- \
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