IM Inspection Worksheet_16-11-2023_15-59-34INSPECTION WORKSHEET (SEP-028959-2023)
RC-0296-2023Case Number:Case Module:Permit Management
11/16/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:98 West Mountain Rd
Queensbury, NY 12804
315.6-1-18
Company Name NameContact Type
Applicant Cerrone Builders Inc
Contractor Cerrone Builders Inc
Engineer Vision Engineering
Granted Permission Cerrone Builders Inc
Primary Owner Cerrone Builders Inc
Checklist Item CommentsPassed
Building Inspector Notes True See inspection report dated 11/15/23 for details. This report is to
signify that home has a 1250 gallon septic tank, not a 1000 gallon
septic tank. 11/16/23
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 250 ft
Foundation to Tank True 11 ft
Engineer Report and As-Built False N/A
Location of system on property True right side of home
Inlet & Outlet manholes 12"+ below grade False
Type of Water: Municipal / Well Water True municipal
Locations / Separations True
Depth of Trenches True 18"-20"
Length of Each Trench True 50 ft
System Use Status True
Conforms as per Plot Plan False
Size of tank True (1) TWELEVE HUNDRED FIFTY (1250) Gallon septic tank of
precast concrete
Distribution box to Field / Pit True 4" sewer and drain perforated
Foundation to Absorption True 20+ ft
InletOutlet Pipes & Baffles True
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