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SEPTIC SYSTEM INSPECTION CHECK LIST ADDRESS: II 4-1-- At ----r-v -.E _+/-tewc.y r<=c1._ PERMIT # ifc)C4(?' 3-66 St I , 4 Check box AC1UAL MEETS SJC PARAMETER *...4. if inspected MEASUREMENT STANDARDS? COMMENTS SEPTIC TANK: CORRECT TANK CAPACITY? 't -' 120(0 (.0-I Z3 N DISTANCE TO FOUNDATION? 't/- G ._5 N DISTANCE TO PROPERTY LINE? k . > 1 0 -1- Y N DISTANCE TO ANY WELLS? ‘• 1 3 9. 5" -F-1- Y N TANK LEVEL AND ORIENTED CORRECTLY? N SANITARY TEES CORRECTLY INSTALLED? L - N l/l/ C4: -E1 lot e4:11-- -47- 1-(10,fr— CORRECT TYPE OF PIPING? 59 e-3 S' Y N TANK VENTED? ‘.../.-- Y N ANY TANK ABNORMALITIES NOTED? Y N OTHER ‘-'-- I,- 7S-ex'S Y N DISTRIBUTION BOX: -K,'?c S'"--•‘ DISTANCE FROM TANK? 1 ‘..----- . --1- $ -(---j- Y N DISTANCE TO NEAREST LEACH LINE? Y N DOES SYSTEM HAVE EQUAL DISTRIBUTION? Y N IS D-BOX LEVEL? Y N OTHER N... K i5e-le- i l>-11elY N LEACH FIELD: (LL = LEACH LINES' DISTANCE TO PROPERTY LINE? r -tiSG"' Y N DISTANCE TO ANY WATER WELLS? Y N DISTANCE TO NEAREST FOUNDATION? Y N DISTANCE OF SOIL BARRIER BETWEEN LIS? Y N CORRECT DEPTH OF LL TRENCHES? Y N CORRECT DEPTH AND TYPE OF ROCK? Y N CORRECT WIDTH OF LL TRENCHES? Y N CORRECT LENGTH OF LL TRENCHES? Y N CORRECT TYPE OF PIPING? Y N OTHER Y N SEEPAGE PITS: DISTANCE TO PROPERTY LINE? Y N DISTANCE TO ANY WATER WELLS? Y N DISTANCE TO NEAREST FOUNDATION? Y N DISTANCE OF SOIL BARRIER TO PITS? Y N CORRECT DEPTH AND TYPE OF ROCK? Y N CORRECT WIDTH? Y N OTHER Y N MISCELLANEOUS: DOES PERMIT DRAWING REFLECT ACCURATE LOCATION OF SYSTEM? CO DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? N ANY NO ANSWER ABOVE REQUIRES PERMIT TO Pc R EDR AWN /00 tb COMMENTS: 44w A ‘,/ ci itieyM 0.4,K ,,ped 46/ 4 i4. 4-0 1 s 00 CLVI */f + INSPECTED BD AP-3 DATE: