IM Inspection Worksheet_05-10-2023_15-41-22INSPECTION WORKSHEET (SEP-028100-2023)
SEP-0743-2022Case Number:Case Module:Permit Management
10/05/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:23 Connecticut Ave
Queensbury, NY 12804
309.13-1-55
Company Name NameContact Type
Applicant Sanitary Sewer Service
Contractor Sanitary Sewer Service
Granted Permission Brian Cassant
Primary Owner Brian Cassant
Checklist Item CommentsPassed
Building Inspector Notes False
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 False lines are looped
Absorbtion Fields: Total Length True 65 ft
Foundation to Tank True 10ft
Engineer Report and As-Built True asbuilt from installer
Location of system on property True see asbuilt
Type of Water: Municipal / Well Water True
Locations / Separations True
Depth of Trenches True bed is 20"+-
Length of Each Trench True 30 ft bed system
System Use Status True
Conforms as per Plot Plan True
Size of tank True 1000
Distribution box to Field / Pit True 4" sewer and drain perforated
Foundation to Absorption True 20 ft
InletOutlet Pipes & Baffles True concrete
October 05, 2023 Page 1 of 1