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SR0082166
EnvironmentalHealth
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4200 – Liquid Waste Program
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SR0082166
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Entry Properties
Last modified
6/14/2021 3:35:20 PM
Creation date
6/14/2021 3:19:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
SR0082166
PE
4214
FACILITY_NAME
18393 S PARADISE AVE
STREET_NUMBER
18393
Direction
S
STREET_NAME
PARADISE
STREET_TYPE
AVE
City
TRACY
Zip
95304
APN
21310017
ENTERED_DATE
6/8/2020 12:00:00 AM
SITE_LOCATION
18393 S PARADISE AVE
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\dsedra
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />ADDRESS: I e 3q -)) pth-ad it.,e 2d. To c , (1.1, PERMIT # 3 g O() ii 21 L6 <br />-t Check box AC AL <br />PARAMETER if inspected MEASUREMENT <br />MEETS SJC <br />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 />VadiA , 0 <br />6 <br />(y) <br />Y <br />0 <br />0 0 <br />0 <br />Y <br />Y <br />N i/'-- <br />s - 2-5' J N <br />V I S t N <br />4- ( oo F4-- . N <br />V N <br />t./. N <br />1„--- tPie -3-5- N <br />1.--- N <br />N <br />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 />45 t 0 <br />(D <br />sa) 0 <br />Y <br />N i"----- <br />1/-• 5 N <br />L.---- N <br />t-. N <br />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 />I 0 Y <br />Y <br />? <br />Y <br />Y <br />Y <br />0 <br />Y <br />Y <br />N t./- <br />4- ( COt N <br />1.---- 1 "5 1 N <br />1../ I 7-` N __ <br />,A. '-' k N _ <br />^- 031 N — <br />-'‘.. 2.A' N , • <br />‘. I MI N <br />'5VQ.- ''J N <br />N <br />SEEPAGE PITS: <br />DISTANCE TO PROPERTY LINE? <br />DISTANCE TO ANY WA I ER 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 <br />Y <br />Y <br />Y <br />Y <br />Y <br />Y <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />MISCELLANEOUS: <br />DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? <br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? <br />ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br />COMMENTS: <br />ef ,) <br />Y <br />N <br />0 <br />INSPECTED BY: DATE: \ TOA k
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