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SR0079707
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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SR0079707
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Last modified
11/19/2024 3:48:03 PM
Creation date
11/15/2018 2:09:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0079707
PE
4211
STREET_NUMBER
11136
Direction
E
STREET_NAME
STATE ROUTE 12
City
LOCKEFORD
Zip
95237
APN
05114054
ENTERED_DATE
10/1/2018 12:00:00 AM
SITE_LOCATION
11136 E HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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DAfonskaia
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EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADD 11 Q rf t /2 L c 1 PERMIT#t` S C o 77 <br /> box ACTUAL MEETS SJC <br /> PARAMETER ifinspecfed MEASUREMENT STANDARDS? CQMMENTS <br /> SEPTIC TANK: ff <br /> CORRECT TANK CAPACITY? f j_ ,00A Q N <br /> DISTANCE TO FOUNDATION? / �j N <br /> DISTANCE TO PROPERTY LINE? (l� N <br /> DISTANCE TO ANY WELLS? �(1. =� N <br /> TANKLEVEL AND ORIENTED CORRECTLY? N <br /> SANITARY TEES CORRECTLY INSTALLED? (P� N , <br /> CORRECT TYPE OF PIPING? S N <br /> TANK VENTED? `/ N <br /> ANY.TANK ABNORMALITIES NOTED? Y N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROMTANK7 C3 N <br /> DISTANCETONEARESTLEACHLINE? �/ (� N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? N <br /> ISD-BOX LEVEL? GV N <br /> OTHER Y N <br /> LEACH FIELD: (LL.=LF�CH LINES) ' <br /> DISTANCE TO PROPERTY LINE? �CT (TJ N <br /> DISTANCE TO ANY WATER WELLS? a N <br /> DISTANCE TO NEAREST FOUNDATION? L (3� N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? Y N <br /> CORRECT DEPTI I OF LLTRENCHES? ✓ ��-, N <br /> CORRECT DEPTH AND TYPE OF ROCK? ✓)C j ® N <br /> CORRECT WIDTH OF LL TRENCHES? - N <br /> CORRECT LENGTH OF LL TRENCHES? �S�j N <br /> CORRECT TYPE OF PIPING? E�zS 3�j US N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE-? � )�L (S� N <br /> DISTANCE TO ANY WATER WELLS? ✓ Cl N <br /> DISTANCE TO NEAREST FOUNDATION? ✓ N <br /> DISTANCE OF SOIL BARRIER TO PITS? V IT` {"t CYC N <br /> CORRECT DEPTH AND TYPE OF ROCK? V 2 lj N <br /> CORRECTWIDTH? LI tC I l(d S N <br /> OTHER Y N <br /> MISCELLANEOUS: <br /> DOES PERMIT DRAWING REFLECTACCURATE LOCATION OF SYSTEM? Y N <br /> DOES PERMIT DRAWING SHOW SUFFICIENT DETAIL TO LOCATE IN FUTURE? Y N <br /> ANY NO ANSWER ABOVE REQUIRES PERMIT TO BE REDRAWN. <br /> COMMENTS: <br /> INSPECTED BY: DATE: <br />
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