SEP-000100-2019 01042019INSPECTION WORKSHEET (SEP-000100-2019)
RC-0686-2018Permit Management
Case Number:Case Module:
01/04/2019Partial Pass
Inspection Date:Inspection Status:
Charles DyerSeptic
Inspector:Inspection Type:
302.14-3-47
Job Address:Parcel Number:
9 Park View Ave
Queensbury, NY 12804
Contact TypeCompany NameName
ApplicantGammon Construction LLC
ContractorGammon Construction LLC
Granted PermissionGammon Construction LLC
Primary OwnerGammon Construction LLC
Checklist ItemPassedComments
Building Inspector NotesFalse
Soil Type: SandTrue
ETU Maintenance Contract providedFalse
Size of StoneTrueMatt's sit on washed sand
Waterline separation distanceFalse
Building to TankTrue4" schd 40
Public Sewer Sign-OffFalse
Tank to Distribution BoxTrueSewer and drain
Size:False
Opening Sealed:True
Soil Type: ClayFalse
End CapTrue
Absorbtion Fields: Total LengthTrue
72 ft
Eljen Matt's 36"
Septic system field above flood plainTrue
Foundation to TankTrue10 ft
Engineer Report and As-BuiltFalsePlease provide architect asbuilt
Well Casing Lengt: 50ft +/-False
Location of system on propertyTrueRear
Manholes 12 or less below gradeFalse
Septic tanks & pump station anchored in flood zoneFalse
Type of Water: Municipal / Well WaterTrueMunicipal
Locations / SeparationsTrue
Well separation distanceFalse
Depth of TrenchesTrue18"
Separation of PitsFalse
Stone Size:False
Seepage Pits: NumberFalse
Length of Each TrenchTrue24 ft of Eljen matts
System Use StatusTrue
Conforms as per Plot PlanFalse
December 28, 2020Page 1 of 2
INSPECTION WORKSHEET (SEP-000100-2019)
Checklist ItemPassedComments
Distribution box to Field / PitTrue4" sewer and drain perforated
Foundation to AbsorptionTrue27 ft
InletOutlet Pipes & BafflesTrue
Soil Type: LoamFalse
December 28, 2020Page 2 of 2