IM Inspection Worksheet_14-09-2023_12-10-41INSPECTION WORKSHEET (SEP-027673-2023)
SEP-0547-2023Case Number:Case Module:Permit Management
09/14/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Mark Smith
Job Address:Parcel Number:13 Arbutus Dr
Queensbury, NY 12804
302.17-1-1
Company Name NameContact Type
Applicant Sanitary Sewer Service
Contractor Sanitary Sewer Service
Granted Permission Sanitary Sewer Service
Primary Owner James Ralston
Checklist Item CommentsPassed
Building Inspector Notes True 9/14/23 septic system approved.
- a new 1000 gallon septic tank with a 20' x25' absorption bed was
installed
Soil Type: Sand True
Size of Stone True # 2
Roof gutters don't discharge over leach field True
Waterline separation distance True
Building to Tank True 4" sch 40
[Provide extension collar if Yes]True
Tank to Distribution Box True 4" SDR 35
Opening Sealed:True
End Cap True ends are looped
Absorbtion Fields: Total Length True 20' x 25' a
Septic system field above flood plain True
Foundation to Tank True 10'
Engineer Report and As-Built True
Location of system on property True back yard
Inlet & Outlet manholes 12"+ below grade True
Type of Water: Municipal / Well Water True municipal water supply
Locations / Separations True
Depth of Trenches True 18/20"
Length of Each Trench True 20' x 25' absorption bed
System Use Status True system approved 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 31"
InletOutlet Pipes & Baffles True a filter was installed at outlet baffle
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