IM Inspection Worksheet_11-08-2023_13-20-38INSPECTION WORKSHEET (SEP-027162-2023)
SEP-0403-2023Case Number:Case Module:Permit Management
08/11/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:36 Russell Harris Rd
Queensbury, NY 12804
239.8-1-2
Company Name NameContact Type
Applicant IBS Septic
Contractor IBS Septic
Engineer Wales Engineering
Granted Permission JOHN MCDOUGALL
Primary Owner JOHN MCDOUGALL
Checklist Item CommentsPassed
Building Inspector Notes True
Soil Type: Sand True
ETU Maintenance Contract provided False
Size of Stone False N/A
Final Electrical True
Waterline separation distance True
Building to Tank True 4" SCHD 40
[Provide extension collar if Yes]True
Tank to Distribution Box True 2" SCHD 80 force main to 4" SDR 35
Opening Sealed:True
90% alarm level activates True
End Cap True
Absorbtion Fields: Total Length True Eljen matts / 3 rows at 36 ft = 108 ft
Septic system field above flood plain True
Foundation to Tank True Summer camp sits on piers
Engineer Report and As-Built True please provide engineer asbuilt
Location of system on property True
Inlet & Outlet manholes 12"+ below grade True
Type of Water: Municipal / Well Water True Lake George
Locations / Separations True See Engineer specs
Depth of Trenches True roughly 7+inches atop 12 inches washed sand
Length of Each Trench True 36 ft
System Use Status True
Conforms as per Plot Plan False septic / pump tank placed different from site plan / D box on south
end of field other then north end according to site plan.
Size of tank True 1500 gallon septic plastic fiber tank / 500 gallon plastic fiber pump
tank
Distribution box to Field / Pit True 4 " SDR 35 perforated
Foundation to Absorption True See specs
InletOutlet Pipes & Baffles True
August 11, 2023 Page 1 of 2
INSPECTION WORKSHEET (SEP-027162-2023)
Checklist Item CommentsPassed
50% alarm level activates True
August 11, 2023 Page 2 of 2