IM Inspection Worksheet_03-08-2023_14-24-10INSPECTION WORKSHEET (SEP-026915-2023)
SEP-0386-2023Case Number:Case Module:Permit Management
08/03/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:52 Sara Jen Dr
Queensbury, NY 12804
295.11-1-29
Company Name NameContact Type
Applicant CHRISTIAN MONROE
Contractor Sanitary Sewer Service
Engineer Hutchins Engineering
Granted Permission CHRISTIAN MONROE
Primary Owner CHRISTIAN MONROE
Checklist Item CommentsPassed
Building Inspector Notes True 20x30 bed system
Soil Type: Sand True
Size of Stone True #2
Waterline separation distance True
Building to Tank True existing 4" SCHD 40 4"
[Provide extension collar if Yes]False
Tank to Distribution Box True 4" SDR 35
Opening Sealed:True
End Cap True lines are looped at 5 ft / perforated
Absorbtion Fields: Total Length True 115 ft
Septic system field above flood plain True
Foundation to Tank True 10 ft
Engineer Report and As-Built False please provide engineer asbuilt report
Location of system on property True see engineer specs
Inlet & Outlet manholes 12"+ below grade False
Type of Water: Municipal / Well Water True municipal
Locations / Separations True
Depth of Trenches True bed at depth of 20"
Length of Each Trench True 20x30 bed / 4 lines at 25 ft, looped on ends
System Use Status True
Conforms as per Plot Plan True
Size of tank True existing 1250
Distribution box to Field / Pit True 4" sewer and drain
Foundation to Absorption True 22 ft
InletOutlet Pipes & Baffles True
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