IM Inspection Worksheet_17-07-2023_13-15-13INSPECTION WORKSHEET (SEP-026627-2023)
SEP-0430-2023Case Number:Case Module:Permit Management
07/17/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:133 Tee Hill Rd
Queensbury, NY 12804
289.7-1-50
Company Name NameContact Type
Applicant IBS Septic
Contractor IBS Septic
Granted Permission MATTHEW EBERLEIN
Primary Owner MATTHEW EBERLEIN
Checklist Item CommentsPassed
Building Inspector Notes True for placement of new D-box and 2 lines of SDR 35 to seepage
pitts
Soil Type: Sand True
Size of Stone True #3 around existing pitts
Waterline separation distance True
Building to Tank True existing 4" SCHD 40
[Provide extension collar if Yes]True
Tank to Distribution Box True 4" SDR 35
Size True 6x8
Opening Sealed:True
Septic system field above flood plain True
Foundation to Tank True 10 ft
Engineer Report and As-Built True asbuilt provided by installer
Sump pump not connected to septic system False
Well Casing Length: 50ft +/-True
Location of system on property True
Inlet & Outlet manholes 12"+ below grade True inlet baffle with effluent filter at oulet
Water softener not connected to septic system False
Type of Water: Municipal / Well Water True well
Locations / Separations True
Well separation distance True 100+ ft
Separation of Pits True
Stone Size:True #3
Seepage Pits: Number True 2
System Use Status True
Conforms as per Plot Plan True
Size of tank True existing 1000 gallon
Distribution box to Field / Pit True 4" SDR 35
Foundation to Absorption True
Soil Type: Loam True
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