inspections,VL)
TOWN OF QUEENSBURY
BUILDING &CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
ate-Minute/Inch.
:Total raat 00Lengthofeach
Depth of trenchesSizeofstone
SEEPAGE PITS:Number-Size -or.0 ittyStonesize__PIPING:ize TypeBldg.to Tank
Tank to Dist.BoxDist.Box to Field/P:
Openings Sealed?lo aLOCATION/SEPARATIONS~NeFoundationtoTank feetFoundationtoAbsorption—7O feetSeparationofPitseetConformsasperPlotrianfe)No.
JCATION OF SYSTEM ON
eft Side -Right SideliddleRear
Wo
COMMENTS :
SYSTEM USE APPROVED: