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SR0083223
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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SR0083223
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Last modified
6/15/2021 10:18:00 AM
Creation date
6/15/2021 9:41:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0083223
PE
4210
STREET_NUMBER
13688
STREET_NAME
GRASSLAND
STREET_TYPE
RD
City
LODI
Zip
95240
APN
06526002
ENTERED_DATE
2/1/2021 12:00:00 AM
SITE_LOCATION
13688 GRASSLAND 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: I -36g g /**D,--551(10-(-1 re_cf PERMIT # S4:20 ?Z2.3 <br />-.1 Check box ACTUAL <br />. PARAMETER if inspected MEASUREMENT <br />MEETS SJC <br />STANDARDS? COMMENTS <br />SEPTIC TANK: <br />CORRECT TANK CAPACITY?6-?5•Mtly <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 9 <br />ANY TANK ABNORMALITIES NOTED? <br />OTHER <br />Y N <br />Y N <br />Y N <br />Y N <br />Y N <br />YN <br />\." sr,' e.,3 0 N <br />Y N <br />Y N <br />Y N <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 />- -F-, / / 3 8 N i ....- <br />L.'''. 6 -c 4 N <br />— c.-epo..4--e- Y N <br />\..---- CDI N <br />Y 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 />> 1 0 -Ft Y N t . <br />%...- / 0 a 4 Y N <br />i/- ..› to F -, Y N <br />-- VW 0.4c- Y N <br />N• "ii .2 4 q i h. Y N <br />%/ 1 9 - 27-1 t., . 0 N j — 2- 'i il • CO C-V-5 <br />\--"-- 2 N <br />1,--- Y N <br />1. 5 D p.---)1 N <br />Y 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 />p---2.....i -14- N _ L---- <br />v-- I 4 -1 ft-Y N <br />tr-- N <br />V.-- .. 40 N <br />1./- V -e N 6 N .../- 3 6 io- <br />Y 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 />N <br />Y N <br />INSPECTED BY: DATE: <br />Z/l 67702-1
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