inspectionsels of Cutenberp
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road,R.D.1 Box 98
Queensbury,New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME_lo lo
2:
ad permit no.FAI
SOIL TYPE -Sand -Loam -Clay ~
Percolation Test Required?YES
Percolation rate -Min/Inch _
TYPE of SYSTEM:
Absorption field,total length Ave
Length of each trench_fcDepthoftrenches_/.3'Size of gravel_#3
SEEPAGE PITS{Number of)_Size-Fuax'4Gravelsize
PIPING:
Bldg.to tank
Tank to dist.box
Dist.box to field/pi
Openings sealed?Le ah
Wo Partial
LOCATION/SEPARATIONS.
Foundation to tank fut do ft.Foundation to absorytion \_Yo ft.Absorption to lot line Ya.ft.
Separation of pits Deut:
LOCATION OF SYSTEM ON PROPERTY (circle one)
Front -Rear>Left side -Right side -
COMMENTS ——
Building Inspector
01/86 md v1
63dTownofQueensburyqrBUILDINGandZONINGDEPARTMENT
Bay and Haviland Road,R.D.1 Box 98
Queensbury,New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION.
nate Racy Pall
LOCATION.di
pare 4/24 /2 permit no.92-SES”
SOIL TYPE -Sand -Loam -Clay -Percolation Test Required?YES -NO
Percolation rate -Min/Inch _
TYPE of SYSTEM:
Absorption field,total length
Length of each trench
Depth of trenchesSizeofgravel_
SEEPAGE PITS¢Number of)_Size-SEex a eet d
Gravel size
PIPIN Size Type
Bldg.to tank
Tank to dist.box
Dist.box to field/pit
Openings sealed?YES NO Partial
LOCATION/SEPARATIONS :
Foundation to tank teFoundationtoabsorptionft.Absorption to lot line fer
Separation of pits aes
LOCATION OF SYSTEM ON PROPERTY (circle one)
Front -Rear -Left side -Right side -
COMMENTS:
Dove BP 5s
EARL he
SYSTEM USE APPROVED
1220
01/86 md v1