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SR0078483
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0078483
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Entry Properties
Last modified
1/31/2022 1:14:37 PM
Creation date
1/31/2022 1:08:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0078483
PE
4216
STREET_NUMBER
6610
Direction
E
STREET_NAME
COLLIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00525057
ENTERED_DATE
12/11/2017 12:00:00 AM
SITE_LOCATION
6610 E COLLIER RD
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: <br />PERMIT # <br />Check box ACTUAL <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 />1 <br />is 00 <br />1 <br />Ove r 2S <br />toe,, <br />yQS <br />q <br />�� <br />\Y/ <br />© <br />® <br />Y <br />® <br />Q <br />�YJ <br />Y <br />N <br />N <br />N <br />N <br />N <br />N Ova j rtSFa. jt& oh O t,*(e4. p(& -W ct4.(* <br />N Ca1QA- <br />N e�Lir.a1 1y►Sy,((�an <br />N <br />N <br />✓ <br />V/' <br />DISTRIBUTIOlf 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 />CJS <br />1 <br />jlZS <br />y 5 <br />Q <br />YO <br />® <br />© <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 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 />aQA' f�- <br />�Y <br />Y <br />Y <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 />N <br />N <br />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 />CORRECTWIDTH? <br />OTHER <br />QvW <br />(�(r(�j I <br />16 <br />s <br />I <br />® <br />N <br />N <br />N <br />N <br />N <br />N <br />N <br />✓ <br />✓ <br />✓ <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 />1N <br />INSPECTED BY: A! DATE: • 19-1 LAI 14- <br />:o <br />114 - <br />;a r <br />
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