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SR0079506
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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SR0079506
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Last modified
9/11/2018 4:27:46 PM
Creation date
9/11/2018 4:27:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0079506
PE
4214
STREET_NUMBER
10808
Direction
E
STREET_NAME
WOODBRIDGE
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
01723009
ENTERED_DATE
8/14/2018 12:00:00 AM
SITE_LOCATION
10808 E WOODBRIDGE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br />ADDRESS: _ r E� %ice/` �• ;duck(&, <br />�rC <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N <br />PERMIT # S CeX:) <br />Check box <br />ACTUAL <br />MEETS SJC <br />PARAMETER <br />if inspected <br />MEASUREMENT <br />STANDARDS? COMMENTS <br />SEPTIC TANK: <br />CORRECT TANK CAPACITY? <br />Y <br />N <br />DISTANCE TO FOUNDATION? <br />Y <br />N <br />DISTANCE TO PROPERTY LINE? <br />Y <br />N <br />DISTANCE TO ANY WELLS? <br />Y <br />N <br />TANK LEVEL AND ORIENTED CORRECTLY? <br />Y <br />N <br />SANITARY TEES CORRECTLY INSTALLED? <br />Y <br />N <br />CORRECT TYPE OF PIPING? <br />Y <br />N <br />TANK VENTED ? <br />Y <br />N <br />ANY TANK ABNORMALITIES NOTED? <br />Y <br />N <br />OTHER <br />L�d <br />Y <br />N <br />DISTRIBUTION BOX: <br />f <br />DISTANCE FROM TANK? <br />V <br />N <br />DISTANCE TO NEAREST LEACH LINE? <br />✓ <br />7 ! <br />V <br />N <br />DOES SYSTEM HAVE EQUAL DISTRIBUTION? <br />,/ <br />d9' <br />N <br />IS D -BOX LEVEL? <br />0' <br />N <br />OTHER <br />Y <br />N <br />LEACH FIELD: (LL = LEACH LINES) <br />DISTANCE TO PROPERTY LINE? <br />i <br />117 <br />N <br />DISTANCE TO ANY WATER WELLS? <br />N <br />DISTANCE TO NEAREST FOUNDATION? <br />�(n i <br />Z5 <br />N <br />DISTANCE OF SOIL BARRIER BETWEEN LUS? <br />Y <br />N <br />CORRECT DEPTH OF LL TRENCHES? <br />0 <br />N <br />CORRECT DEPTH AND TYPE OF ROCK? <br />69 <br />N <br />CORRECT WIDTH OF LL TRENCHES? <br />-4> <br />N <br />CORRECT LENGTH OF LL TRENCHES? <br />2P <br />N <br />CORRECT TYPE OF PIPING? <br />�/ <br />S�� t <br />'0 <br />N <br />OTHER <br />Y <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 />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? N <br />DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? N <br />ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br />COMMENTS: <br />INSPECTED BY: , wd ���„� /ryG DATE: yll-tell <br />e <br />
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