IM Inspection Worksheet_14-07-2023_12-20-13INSPECTION WORKSHEET (SEP-026580-2023)
SEP-0304-2023Case Number:Case Module:Permit Management
07/14/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:6 Gregwood Cir
Queensbury, NY 12804
308.14-1-52
Company Name NameContact Type
Applicant Stone Installations
Contractor Stone Installations
Granted Permission FOREST PARK MHC, LLC
Primary Owner FOREST PARK MHC, LLC
Checklist Item CommentsPassed
Building Inspector Notes False
Soil Type: Sand True
Size of Stone False N/A gravelless trench
Waterline separation distance True
Building to Tank True 4" SCHD 40
[Provide extension collar if Yes]True at outlet only / less than 12"
Tank to Distribution Box True 4" sewer and drain
Opening Sealed:False to be hooked int manufactured home
End Cap True
Absorbtion Fields: Total Length True 110 ft infiltrators / ADS Hancor ARC 24 chamber model
Septic system field above flood plain True
Foundation to Tank True see specs
Engineer Report and As-Built False please provide engineer asbuilt report
Location of system on property True see specs
Inlet & Outlet manholes 12"+ below grade False
Type of Water: Municipal / Well Water True municipal
Locations / Separations True
Depth of Trenches True 16"-18"
Length of Each Trench True 55 ft
System Use Status True to be hooked into manufactured home
Conforms as per Plot Plan True
Size of tank True 1000 gallon
Distribution box to Field / Pit True 4" sewer and drain
Foundation to Absorption True see specs
InletOutlet Pipes & Baffles True effluent filter at outlet
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