IM Inspection Worksheet_02-08-2023_08-34-04INSPECTION WORKSHEET (SEP-026975-2023)
RC-0900-2021Case Number:Case Module:Permit Management
08/02/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:25 Otter Track
Queensbury, NY 12804
316.14-1-9
Company Name NameContact Type
Applicant Mario Profita
Architect Blackbird Group Architect LLC
Contractor Superior Walls of Upstate NY
Wittig Construction
Granted Permission Wittig Construction
Primary Owner Mario Profita
Maria Lasala
Checklist Item CommentsPassed
Building Inspector Notes True 8/1/23 verified floats / alarm / flow to D box, T Hutchins onsite
Soil Type: Sand True
Size of Stone True #2
Final Electrical False please provide electrical inspection when completed
Roof gutters don't discharge over leach field False
Waterline separation distance True
Building to Tank True 4" SCHD 40
Public Sewer Sign-Off False
[Provide extension collar if Yes]True
Tank to Distribution Box True SDR 11 force main
Opening Sealed:True
90% alarm level activates True not installed at time of inspection
End Cap True
Absorbtion Fields: Total Length True 200 ft
Septic system field above flood plain True
Foundation to Tank True 10 ft
Engineer Report and As-Built False please provide engineer asbuilt
Location of system on property True see engineer specs
Inlet & Outlet manholes 12"+ below grade True
Type of Water: Municipal / Well Water True municipal
Locations / Separations True
Depth of Trenches True 12"-16"
Length of Each Trench True 50ft
System Use Status True
Conforms as per Plot Plan True
Size of tank True 1500 / 1000 gallon precast pump chamber
Distribution box to Field / Pit True 4" sewer and drain perforated
Foundation to Absorption True see engineer specs
August 02, 2023 Page 1 of 2
INSPECTION WORKSHEET (SEP-026975-2023)
Checklist Item CommentsPassed
InletOutlet Pipes & Baffles True
50% alarm level activates True
Soil Type: Loam True
August 02, 2023 Page 2 of 2