IM Inspection Worksheet_07-09-2023_13-38-33INSPECTION WORKSHEET (SEP-027577-2023)
SEP-0394-2023Case Number:Case Module:Permit Management
09/07/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:18 Ashley Pl
Queensbury, NY 12804
302.14-1-20
Company Name NameContact Type
Applicant RICHARD BOUTELLE
Contractor Sanitary Sewer Service
Engineer Center Project Services
Granted Permission RICHARD BOUTELLE
Primary Owner RICHARD BOUTELLE
Checklist Item CommentsPassed
Soil Type: Sand True
Size of Stone True #2
Waterline separation distance True
Building to Tank True 4" SCHD 40
Tank to Distribution Box True 4" SDR 35
Opening Sealed:True
End Cap True lines are looped
Absorbtion Fields: Total Length True 15wx30L stone absorption bed
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
Type of Water: Municipal / Well Water True municipal
Locations / Separations True
Depth of Trenches True bed is roughly 20+"
Length of Each Trench True each line is 25ft x 3 and looped 5ft=85 ft
System Use Status True
Conforms as per Plot Plan True
Size of tank True 1000 gallon
Distribution box to Field / Pit True 4" sewer and drain perforated
Foundation to Absorption True 20 ft / behind garage
InletOutlet Pipes & Baffles True concrete
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