IM Inspection Worksheet_27-10-2023_15-46-57INSPECTION WORKSHEET (SEP-028581-2023)
RC-0235-2023Case Number:Case Module:Permit Management
10/27/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:35 Mountainview Ter
Lake George, NY 12845
289.6-1-7.4
Company Name NameContact Type
Applicant John Hoffman
Architect Gary Hughes
Contractor Top Notch Builders
Granted Permission John Hoffman
Primary Owner John Hoffman
Checklist Item CommentsPassed
Building Inspector Notes False
Soil Type: Sand True
ETU Maintenance Contract provided False
Size of Stone True #2
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
Tank to Distribution Box True 4" SCHD 40
Opening Sealed:True
Soil Type: Clay False
End Cap True
Absorbtion Fields: Total Length True 150 ft
Foundation to Tank True 11+ft 1000 gallon precast
Engineer Report and As-Built False please provide engineer asbuilt report
Well Casing Length: 50ft +/-True
Location of system on property True see site plan
Inlet & Outlet manholes 12"+ below grade False N/A
Type of Water: Municipal / Well Water True well
Locations / Separations True
Well separation distance True
Depth of Trenches True 20+"
Length of Each Trench True 50 ft
System Use Status False
Conforms as per Plot Plan True
Distribution box to Field / Pit True 4" sewer and drain perforated
Foundation to Absorption True 26+- ft
InletOutlet Pipes & Baffles True
Soil Type: Loam False
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