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Signed Inspection Report (Thu May 6, 2021 at 1029 AM)INSPECTION WORKSHEET (SEP-010178-2021) Town of Queensbury - Building and Codes - Fire Marshal 742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal Case Number:CC-0144-2020 Case Module:Permit Inspection Date:Thu May 6, 2021 Inspection Status:Partial Pass Inspector:O'Brien, John Inspection Type:Septic Job Address:Parcel Number:409 DIX AVE Queensbury, NY, 12804 303.16-1-6 Contact Type Company Name Name Contractor Rozell Industries Inc. Primary Owner South Queensbury Volunteer Fire Co Granted Permission Rozell Industries Inc. Engineer Schoder Rivers Associates, PC Sandblom, Erik Checklist Item Status Building Inspector Notes Failed 1/8/21 Septic System Partial Approval - Absorption Beds Only! NOTE: Where water line and 1.5" sch40 pvc sanitary force main cross the force main needs to be sleeved in 4" sch40 pvc 10' passed the waterline each way(20' sleeve). Ok to backfill beds! 5/5/21 Septic System Partial Approval - Operation of alarm and pumps have been verified. Engineer on site. Remaining Items: - Submit Certified Septic As-Built Plan & Engineer's Report. - Install sanitary line from building to new tank. - Final Electrical Inspection for pumps and alarm. 5/6/21 Septic System Partial Approval - verified sanitary line from building to septic tank and baffle. Remaining Items: - Submit Certified Septic As-Built Plan & Engineer's Report. - Final Electrical Inspection for pumps and alarm. - Verify water shut off(solenoid) on high alarm. May 06, 2021 Page (1) INSPECTION WORKSHEET (SEP-010178-2021) Checklist Item Status Soil Type: Sand Passed Soil Type: Loam Passed Soil Type: Clay Passed Clay at 72" Type of Water: Municipal / Well Water Passed Municipal Waterline separation distance Passed NOTE: Where water line and 1.5" sch40 pvc sanitary force main cross the force main needs to be sleeved in 4" sch40 pvc 10' passed the waterline each way. Absorbtion Fields: Total Length Passed 2 - 15' x 60' Pressure Absorption Beds 330' of 1.5" sch40 pvc absorption lines Length of Each Trench Passed 2 Absorption Beds with 3 lines in each at 55' long. Depth of Trenches Passed 18" - 24" May 06, 2021 Page (2) INSPECTION WORKSHEET (SEP-010178-2021) Checklist Item Status System Use Status Failed 1/8/21 Septic System Partial Approval - Absorption Beds Only! NOTE: Where water line and 1.5" sch40 pvc sanitary force main cross the force main needs to be sleeved in 4" sch40 pvc 10' passed the waterline each way(20' sleeve). 5/5/21 Septic System Partial Approval - Operation of alarm and pumps have been verified. Engineer on site. Remaining Items: - Submit Certified Septic As-Built Plan & Engineer's Report. - Install sanitary line from building to new tank. - Final Electrical Inspection for pumps and alarm. 5/6/21 Septic System Partial Approval - verified sanitary line from building to septic tank and baffle. Remaining Items: - Submit Certified Septic As-Built Plan & Engineer's Report. - Final Electrical Inspection for pumps and alarm. - Verify water shut off(solenoid) on high alarm. Size of Stone Passed #2 Building to Tank Passed 4" sch40 pvc from building to septic tank 4" sch40 pvc from septic tank to pumpstation. Tank to Distribution Box Passed (2) 1-1/2" pvc forcemains to absorption bed manifolds Distribution box to Field / Pit Passed Manifold to absorption bed lines 1.5" sch40 pvc Opening Sealed:Passed - Cap ends of absorption bed lines May 06, 2021 Page (3) INSPECTION WORKSHEET (SEP-010178-2021) Checklist Item Status End Cap Passed - Cap ends of absorption bed lines InletOutlet Pipes & Baffles Passed Manholes 12 or less below grade Passed Locations / Separations Passed Foundation to Tank Passed 10' Foundation to Absorption Passed As per plan Conforms as per Plot Plan Failed - Submit Certified Septic As-Built Plan & Engineer's Report. Engineer Report and As-Built Failed - Submit Certified Septic As-Built Plan & Engineer's Report. Location of system on property Failed - Submit Certified Septic As-Built Plan & Engineer's Report. May 06, 2021 Page (4) O'Brien, John