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SR0082388
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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SR0082388
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Last modified
10/27/2020 3:28:05 PM
Creation date
10/27/2020 3:08:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082388
PE
4211
FACILITY_NAME
17053 S VICTORY RD
STREET_NUMBER
17053
Direction
S
STREET_NAME
VICTORY
STREET_TYPE
RD
City
OAKDALE
Zip
95361
APN
22921017
ENTERED_DATE
7/29/2020 12:00:00 AM
SITE_LOCATION
17053 S VICTORY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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SEPTIC SYSTEM INSPECTION CHECK LIST <br /> ADDRESS: PERMIT# ,SiQoo 2 f1 <br /> Check box ACTUAL MEETS SJC <br /> PARAMETER if inspected MEASUREMENT STANDARDS? COMMENTS <br /> SEPTIC TANK: <br /> CORRECT TANK CAPACITY? / iv N <br /> DISTANCE TO FOUNDATION? v t ® N <br /> DISTANCE TO PROPERTY LINE? /00 N <br /> DISTANCE TO ANY WELLS? N <br /> TANK LEVEL AND ORIENTED CORRECTLY? ® N <br /> SANITARY TEES CORRECTLY INSTALLED? ® N <br /> CORRECT TYPE OF PIPING? f &z- IC> N <br /> TANK VENTED? %/ N <br /> ANY TANK ABNORMALITIES NOTED? W N <br /> OTHER Y N <br /> DISTRIBUTION BOX: <br /> DISTANCE FROM TANK? G r `� N <br /> DISTANCE TO NEAREST LEACH LINE? N <br /> DOES SYSTEM HAVE EQUAL DISTRIBUTION? L/ i- Et N <br /> IS D-BOX LEVEL? m N <br /> OTHER Y N <br /> LEACH FIELD: (LL=LEACH LINES) <br /> DISTANCE TO PROPERTY LINE? /4d N <br /> DISTANCE TO ANY WATER WELLS? ^3 ® N <br /> DISTANCE TO NEAREST FOUNDATION? `d 4 N <br /> DISTANCE OF SOIL BARRIER BETWEEN LL'S? le N <br /> CORRECT DEPTH OF LL TRENCHES? 4yb tjX N <br /> CORRECT DEPTH AND TYPE OF ROCK? / a N <br /> CORRECT WIDTH OF LL TRENCHES? Z 'M N <br /> CORRECT LENGTH OF LL TRENCHES? /® N <br /> CORRECT TYPE OF PIPING? wiL3,f Y N <br /> OTHER Y N <br /> SEEPAGE PITS: <br /> DISTANCE TO PROPERTY LINE? �� m N <br /> DISTANCE TO ANY WATER WELLS? /qs 2P N <br /> DISTANCE TO NEAREST FOUNDATION? 1p N <br /> DISTANCE OF SOIL BARRIER TO PITS? q/ t� N <br /> CORRECT DEPTH AND TYPE OF ROCK? ??os N <br /> CORRECT WIDTH? N <br /> OTHER F�lY 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: DATE: Z 0- Zr-)2,0 <br />
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