IM Inspection Worksheet_23-10-2023_14-51-37INSPECTION WORKSHEET (SEP-028457-2023)
RC-0612-2022Case Number:Case Module:Permit Management
10/23/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:7 Mountainview Ter
Lake George, NY 12845
289.6-1-7.1
Company Name NameContact Type
Applicant John Hughes
Designer Gary Hughes
Granted Permission John Hughes
Primary Owner John M. Hughes Trust
Checklist Item CommentsPassed
Building Inspector Notes False
Soil Type: Sand True
ETU Maintenance Contract provided False
Size of Stone True #2
Waterline separation distance True
Building to Tank True 4" SCHD 40
[Provide extension collar if Yes]False
Tank to Distribution Box True 4" SDR 35
Opening Sealed:True
End Cap False lines are looped
Absorbtion Fields: Total Length True 160 ft
Septic system field above flood plain True
Foundation to Tank True 11+ft
Engineer Report and As-Built False please provide engineer asbuilt
Well Casing Length: 50ft +/-True
Location of system on property True rear of home
Inlet & Outlet manholes 12"+ below grade False to be provided
Type of Water: Municipal / Well Water True well
Locations / Separations True
Well separation distance True
Depth of Trenches True 12-16"
Length of Each Trench True 50ft then looped @ 5ft
System Use Status True
Conforms as per Plot Plan False
Size of tank True 1250
Distribution box to Field / Pit True 4" SDR 35 perforated
Foundation to Absorption True 37+ft
InletOutlet Pipes & Baffles False
Soil Type: Loam True
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