IM Inspection Worksheet_15-11-2023_15-24-54INSPECTION WORKSHEET (SEP-028882-2023)
RC-0458-2023Case Number:Case Module:Permit Management
11/15/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:29 Revere Rd
Queensbury, NY 12804
308.18-1-45.2
Company Name NameContact Type
Applicant Cerrone Builders Inc
Contractor Cerrone Builders Inc
Engineer Vision Engineering
Granted Permission Cerrone Builders Inc
Primary Owner BRIAN LITTLE
Checklist Item CommentsPassed
Building Inspector Notes False
Soil Type: Sand True
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" sewer and drain
Opening Sealed:True
End Cap True
Absorbtion Fields: Total Length True 165 ft
Foundation to Tank True 11 ft
Engineer Report and As-Built False provide engineer asbuilt
Location of system on property True rear of home
Inlet & Outlet manholes 12"+ below grade False
Type of Water: Municipal / Well Water True municipal
Locations / Separations False
Depth of Trenches True 30+-"
Length of Each Trench True 55 ft
System Use Status True
Conforms as per Plot Plan False
Size of tank True 1000
Distribution box to Field / Pit True 4" sewer and drain perforated
Foundation to Absorption True 28 ft
InletOutlet Pipes & Baffles True concrete
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