IM Inspection Worksheet_11-10-2023_11-28-53INSPECTION WORKSHEET (SEP-028210-2023)
SEP-0435-2023Case Number:Case Module:Permit Management
10/11/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:12 Queens Ln
Queensbury, NY 12804
301.5-1-34
Company Name NameContact Type
Applicant IBS Septic
Contractor IBS Septic
Granted Permission Rick Davidson
Primary Owner Rick Davidson
Checklist Item CommentsPassed
Building Inspector Notes True partial inspection only / placement of 1250 gallon fiber / plastic
tank
Soil Type: Sand True
Size of Stone False N/A
Waterline separation distance True
Building to Tank True 4" SCHD 40
[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 not installed at time of inspection 7/20/23. Verified 10/11/23 - 150
ft / Infiltrators ARC 24
Foundation to Tank True 25+ ft
Engineer Report and As-Built True As-built provided by installer
Sump pump not connected to septic system True
Location of system on property True Rear of garage / patio
Inlet & Outlet manholes 12"+ below grade True
Type of Water: Municipal / Well Water True municipal
Locations / Separations True new tank off of patio behind garage
Depth of Trenches True 4+ ft with vent
Length of Each Trench True 50ft
System Use Status True
Conforms as per Plot Plan True
Size of tank True 1250 gallon / plastic
Distribution box to Field / Pit True 4" SDR 35 to Infiltrators
Foundation to Absorption True 28+- ft
InletOutlet Pipes & Baffles True only inlet at time of inspection / yes- effulent filter at outlet
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