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SR0082202
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082202
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Entry Properties
Last modified
1/31/2022 1:48:56 PM
Creation date
12/30/2021 11:21:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082202
PE
4231
STREET_NUMBER
9375
Direction
W
STREET_NAME
SUGAR
STREET_TYPE
LN
City
TRACY
Zip
95304
APN
21216017
ENTERED_DATE
6/16/2020 12:00:00 AM
SITE_LOCATION
9375 W SUGAR LN
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />INSPECTED BY: <br />Pe►.�lfj j <br />dudiu/vises <br />n 4�LG'�T aw <br />DATE: <br />ADDRESS: cS <br />a <br />PERMIT <br />PARAMETER <br />"'Check box <br />if inspected <br />ACTUAL <br />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 />' a <br />`"TWO <br />(�� <br />© <br />Y <br />l� <br />Y <br />Y <br />N <br />N <br />N <br />N 0/dj/ ON <br />N <br />N <br />N <br />N <br />N <br />N <br />(i1 <br />vo*� <br />— <br />�/ <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 />�/ <br />S� <br />'D <br />1 <br />Y <br />N <br />N <br />N <br />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 LUS? <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 />EK <br />gED <br />3��-/ <br />171 <br />ff -- <br />®® <br />ZO � 21" <br />2I <br />S L{� <br />Y� <br />Y <br />G) <br />Y <br />(l� <br />Y <br />N <br />N Nh AAJ <br />N <br />N <br />N <br />N +erk 6cI0 W ninL <br />N <br />N <br />N <br />N <br />rpr y (¢tl <br />. S��yDC6c, 4bdv1� n�'pdr <br />✓ <br />�/ <br />i/ <br />a/ <br />�/ <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 />LEI <br />—� <br />Y <br />Y_ <br />Y _ <br />Y <br />Y <br />Y <br />Y <br />N <br />_-NL <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 />Y <br />Y <br />N <br />N <br />l% I' A I ZYIS ecti OAS <br />¢pY (d/ t S (, <br />s <br />Cwau <br />WWA <br />v� "Ts <br />s <br />Ono, <br />20 <br />re& <br />W <br />14"! � I i <br />V\,Lxsl <br />W <br />c WU + . l 20 <br />- S <br />INSPECTED BY: <br />Pe►.�lfj j <br />dudiu/vises <br />n 4�LG'�T aw <br />DATE: <br />
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