IM Inspection Worksheet_28-11-2023_15-08-39INSPECTION WORKSHEET (SEP-029118-2023)
SEP-0693-2023Case Number:Case Module:Permit Management
11/28/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:215 Aviation Rd
Queensbury, NY 12804
295.19-2-24
Company Name NameContact Type
Applicant Sanitary Sewer Service
Contractor Sanitary Sewer Service
Granted Permission Sanitary Sewer Service
Primary Owner CHRISTOPHER BROWN
Checklist Item CommentsPassed
Building Inspector Notes False
Soil Type: Sand True
Size of Stone True #2
Waterline separation distance True
Building to Tank True existing line
[Provide extension collar if Yes]False
Tank to Distribution Box True 4" SDR 35
Opening Sealed:True
End Cap False lines are looped
Absorbtion Fields: Total Length True 20x25 absorbtion bed / 95 ft
Foundation to Tank True 24 ft
Engineer Report and As-Built False asbuilt provided by installer
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 depth of bed is roughly 20+"
Length of Each Trench True each line is 20 ft then looped at 5 ft 95 ft
System Use Status True
Conforms as per Plot Plan True
Size of tank True existing 1000 gallon
Distribution box to Field / Pit True 4" sewer and drain perforated
Foundation to Absorption True 32 ft
InletOutlet Pipes & Baffles True existing concrete
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