IM Inspection Worksheet_27-11-2023_14-34-48INSPECTION WORKSHEET (PTI-028846-2023)
PT-0726-2023Case Number:Case Module:Permit Management
11/27/2023 PassedInspection Status:Inspection Date:
Property Transfer InspectionsInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:76 Reardon Rd
Queensbury, NY 12804
289.11-1-35
Company Name NameContact Type
Primary Owner SHARON STEPHENSON
Checklist Item CommentsPassed
Building Inspector Notes True system consisted of 6x8 dry well with 1,000 gallon precast septic
tank
Weather/lack of information/inaccessibility False
Capacity in gallons True 1000
Is there a high water alarm?False
Concrete tank True
Temperature (Fahrenheit)True 40+-
D-box material: concrete or plastic False N/A
Baffle & D-box or 45° angle False N/A
Apparent structural damage False
Effluent filter False
Visible scum layer True
Septic tank (include # of tanks)True one
Number of tank compartments False none
Capacity of pump tank (gallons)False
Plumbing fixtures tested & confirmed True
Evidence of a pipe bypassing tank False
System appears undersized/undersized components False
Tank cover True
System appears to have functioned adequately True
System passes all function testing True
Outlet pipe (automatic failure, if yes)False
Does the pump(s) appear to be operating properly?True
Roof runoff False
System needs repairs False
Sump pump not connected to septic system False
Sand filter False
Absorption bed False
Depth below grade to top of tank True 6"-8"
Evidence of prolonged high liquid level False
Access riser? (if yes, depth to cover)False N/A
Inlet baffle True concrete
No treatment tank/other critical component(s)False
As-built provided is accurate True
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INSPECTION WORKSHEET (PTI-028846-2023)
Checklist Item CommentsPassed
Mound system False
Test each fixture flow to septic tank True
Water softener not connected to septic system False
Is tank pumped more than 4x/year?False
On-site as-built req'd before insp is complete True
Ejector or grinder pump sealed True
Outlet baffle True
Weather True partly cloudy
Main tank cleanout size and location True 8"-12" inlet and oulet
Seepage Pits: Number True one
Dosing or pump tank sealed False
Absorption field False
Leaking water fixtures False
Water tight tank True
Other False
Other False
Are there any obvious electrical shortcomings?False
Raised system False
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