IM Inspection Worksheet_15-08-2023_14-02-03INSPECTION WORKSHEET (SEP-027231-2023)
SEP-0485-2023Case Number:Case Module:Permit Management
08/15/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:4 Richardson St
Queensbury, NY 12804
309.10-2-52
Company Name NameContact Type
Applicant IBS Septic
Contractor IBS Septic
Granted Permission IBS Septic
Primary Owner Barbara Woodard
Checklist Item CommentsPassed
Soil Type: Sand True
Size of Stone True #2
Waterline separation distance True
Building to Tank True manufactured home 4" SCHD 40
[Provide extension collar if Yes]True
Tank to Distribution Box True 4" SDR 35
End Cap True
Absorbtion Fields: Total Length True 150 ft
Septic system field above flood plain True
Foundation to Tank False
Engineer Report and As-Built True as built provided by installer
Location of system on property True see asbuilt
Inlet & Outlet manholes 12"+ below grade True
Type of Water: Municipal / Well Water True municipal
Locations / Separations True
Depth of Trenches True 18-20 inches
Length of Each Trench True 50 ft
System Use Status True good for use
Conforms as per Plot Plan True
Size of tank True 1000 gallon
Distribution box to Field / Pit True 4" SDR 35 perforated
Foundation to Absorption True manufactured home on piers
InletOutlet Pipes & Baffles True Effulent filter at outlet
August 15, 2023 Page 1 of 1