IM Inspection Worksheet_29-09-2023_15-08-06INSPECTION WORKSHEET (SEP-028012-2023)
SEP-0540-2023Case Number:Case Module:Permit Management
09/29/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Mark Smith
Job Address:Parcel Number:32 Mohawk Trl
Queensbury, NY 12804
301.13-1-76
Company Name NameContact Type
Applicant IBS Septic
Contractor IBS Septic
Granted Permission IBS Septic
Primary Owner GARY BLASKO
Checklist Item CommentsPassed
Building Inspector Notes True 9/29/23 alterations to septic system approved.
- existing 1250 gallon septic tank with a replacement absorbtion
field of 200' of pipe and stone
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 existing
[Provide extension collar if Yes]True
Tank to Distribution Box True 4" SDR 35
Opening Sealed:True
End Cap True
Absorbtion Fields: Total Length True 4 laterals at 50' each, 200' total
Foundation to Tank True 12"
Engineer Report and As-Built True
Location of system on property True front 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 16/18"
Length of Each Trench True 4 laterals at 50' each, 200' total
System Use Status True system approved for use
Conforms as per Plot Plan True
Size of tank True 1250 gallon
Distribution box to Field / Pit True 4" SDR 35 perforated
Foundation to Absorption True 20'
InletOutlet Pipes & Baffles True filter at outlet baffle
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