IM Inspection Worksheet_25-08-2023_14-02-51INSPECTION WORKSHEET (SEP-027427-2023)
SEP-0690-2022Case Number:Case Module:Permit Management
08/25/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Mark Smith
Job Address:Parcel Number:20 Burnt Ridge Rd
Lake George, NY 12845
239.16-1-19
Company Name NameContact Type
Applicant Environmental Design Partnership (EDP)
Contractor Moss Capital Group LLC
Engineer Environmental Design Partnership (EDP)
Granted Permission DAN SLOTE
Primary Owner DAN SLOTE
Checklist Item CommentsPassed
Building Inspector Notes False 8/25/23 partial approval for septic system.
-placement of 1250 gallon poly septic tank verified
-placement of 1000 gallon pump tank verified..
- placement of 20' x30' raised absorption bed verified.
2' forced main from pump tank verified.
items remaining
- verify baffles at septic tank.
-verify alarm and pump floats at pump tank.
- verify grinder pump and alarms at grinder pump are operational.
-provide proof of final electrical inspection.
-provide final as built drawing from design engineer.
- verify final grading at raised bed.
Soil Type: Sand False
ETU Maintenance Contract provided False
Size of Stone False
Final Electrical False
Roof gutters don't discharge over leach field False
Waterline separation distance False
Building to Tank False
Public Sewer Sign-Off False
[Provide extension collar if Yes]False
Tank to Distribution Box False
Size False
Opening Sealed:False
Soil Type: Clay False
90% alarm level activates False
End Cap False
Absorbtion Fields: Total Length False
Septic system field above flood plain False
Foundation to Tank False
Engineer Report and As-Built False
Sump pump not connected to septic system False
August 25, 2023 Page 1 of 2
INSPECTION WORKSHEET (SEP-027427-2023)
Checklist Item CommentsPassed
Water shut off activates at 90% full False
Well Casing Length: 50ft +/-False
Location of system on property False
Inlet & Outlet manholes 12"+ below grade False
Septic tanks & pump station anchored in flood zone False
Water softener not connected to septic system False
Type of Water: Municipal / Well Water False
Locations / Separations False
Well separation distance False
Depth of Trenches False
Separation of Pits False
Stone Size:False
Seepage Pits: Number False
Length of Each Trench False
System Use Status False
Conforms as per Plot Plan False
Size of tank False
Distribution box to Field / Pit False
Foundation to Absorption False
InletOutlet Pipes & Baffles False
50% alarm level activates False
Soil Type: Loam False
August 25, 2023 Page 2 of 2