IM Inspection Worksheet_17-07-2023_13-25-09INSPECTION WORKSHEET (SEP-026615-2023)
SEP-0301-2023Case Number:Case Module:Permit Management
07/17/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:134 Adirondack St
Queensbury, NY 12804
309.9-2-1
Company Name NameContact Type
Applicant Sanitary Sewer Service
Contractor Sanitary Sewer Service
Engineer Environmental Design Partnership (EDP)
Granted Permission Sanitary Sewer Service
Primary Owner Homestead Acres CP LLC
Checklist Item CommentsPassed
Building Inspector Notes True This inspection was for the installation of (2) conventional stone
and pipe systems, one of them with new precast 1000 gallon
septic tank at LOT 134 located at manufactured home park /
Homestead village.
Soil Type: Sand True
Size of Stone True #2
Waterline separation distance True
Building to Tank True Manufactured homes / 4" SCHD 40
[Provide extension collar if Yes]True No
Tank to Distribution Box True 4" sewer and drain
End Cap True
Absorbtion Fields: Total Length True Each field with 3 lines @ 50 ft X 2 = 300 ft
Foundation to Tank True Manufactured homes / 10 ft see specs
Engineer Report and As-Built True Provide engineer asbuilt report / received 7/14/23
Location of system on property True See specs
Inlet & Outlet manholes 12"+ below grade True No
Type of Water: Municipal / Well Water True Municipal
Locations / Separations True
Depth of Trenches True 2 ft +-
Length of Each Trench True 50 ft
System Use Status True
Conforms as per Plot Plan True
Size of tank True LOT 134 new precast concrete 1000 gallon
LOT 135 existing 1000 gallon precast
Distribution box to Field / Pit True 4" sewer and drain perforated
Foundation to Absorption True Manufactured homes / 10 ft / see specs
InletOutlet Pipes & Baffles True Concrete
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