IM Inspection Worksheet_13-10-2023_15-28-25INSPECTION WORKSHEET (SEP-028203-2023)
SEP-0632-2023Case Number:Case Module:Permit Management
10/13/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:95 Mason Rd
Queensbury, NY 12804
226.12-1-27
Company Name NameContact Type
Applicant Morning Star Excavation & Septic
Contractor Morning Star Excavation & Septic
Engineer Kevin Hastings
Granted Permission Morning Star Excavation & Septic
Primary Owner Janet Stasio
Checklist Item CommentsPassed
Building Inspector Notes False
Soil Type: Sand True Eljen matts atop washed sand
ETU Maintenance Contract provided False
Size of Stone False N/A
Final Electrical False N/A
Waterline separation distance True
Building to Tank True 2" force main SCHD 40
[Provide extension collar if Yes]False
Tank to Distribution Box True 4" SDR 35
Opening Sealed:True
90% alarm level activates False
End Cap True
Absorbtion Fields: Total Length True 80 ft
Foundation to Tank True 43+ft
Engineer Report and As-Built False engineer onsite, to provide engineer asbuilt report
Location of system on property True see asbuilt
Inlet & Outlet manholes 12"+ below grade False
Type of Water: Municipal / Well Water False lake George
Locations / Separations True
Length of Each Trench True Eljen B43 GSF modules lines @ 40 ft=80ft
System Use Status True
Conforms as per Plot Plan True
Distribution box to Field / Pit True 4" SDR 35 perforated
Foundation to Absorption True 30ft
InletOutlet Pipes & Baffles True outlet is of effulent filter
50% alarm level activates False
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