IM Inspection Worksheet_27-10-2023_15-59-37INSPECTION WORKSHEET (SEP-028578-2023)
SEP-0402-2023Case Number:Case Module:Permit Management
10/27/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:180 Lake Pkwy
Lake George, NY 12845
226.19-1-92
Company Name NameContact Type
Applicant Kevin Cioffi
Contractor Mountain Top Septic
Engineer Brett Steenburgh
Granted Permission 180 LAKE PARKWAY, LLC
Primary Owner 180 LAKE PARKWAY, LLC
Checklist Item CommentsPassed
Building Inspector Notes False
ETU Maintenance Contract provided False N/A
Size of Stone True # 2
Final Electrical True
Roof gutters don't discharge over leach field False
Waterline separation distance True
Building to Tank True 4" SCHD 40
Public Sewer Sign-Off False
[Provide extension collar if Yes]True
Tank to Distribution Box True 2" force main to manifold
Opening Sealed:True
90% alarm level activates True
End Cap True
Absorbtion Fields: Total Length True absorption bed 2 lines 2" at 17 ft Tee'd off @ 17 1/2 ft=36
Foundation to Tank True 15 ft
Engineer Report and As-Built False please provide engineer asbuilt report
Location of system on property True see specs
Inlet & Outlet manholes 12"+ below grade True
Type of Water: Municipal / Well Water True Lake George
Locations / Separations True
Depth of Trenches False absorption bed / see specs
Length of Each Trench True 2" lines are roughly 36 ft in length
System Use Status True
Conforms as per Plot Plan True
Size of tank True 1500 gallon plastic / fiber
Distribution box to Field / Pit True 2"
Foundation to Absorption True see specs
InletOutlet Pipes & Baffles True
50% alarm level activates True
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