IM Inspection Worksheet_06-12-2023_15-21-26INSPECTION WORKSHEET (PTI-029235-2023)
PT-0766-2023Case Number:Case Module:Permit Management
12/06/2023 FailedInspection Status:Inspection Date:
Property Transfer InspectionsInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:12 Chelsie Ln
Lake George, NY 12845
279.13-1-18
Company Name NameContact Type
Agent Patrick Burke
Primary Owner David Prehoda
Checklist Item CommentsPassed
Building Inspector Notes True inspection was for 2 dwellings on one parcel. The barn dwelling is
in need of new D box, field lines appeared to be in good shape.
The lakeside dwelling is a failure, due to 4" line with a 90 just lying
on top of tank as inlet line, tank was observed to be in good
shape. A engineer will have to be hired to redesign system, the
septic tank for this system will have to be equipped with "mafia
blocks" due to being in a flood zone. 12/6/23
Weather/lack of information/inaccessibility False
Capacity in gallons True 1000 gallon
System/components indicate unacceptable True at lakeside dwelling
Roof gutters don't discharge over leach field False
Concrete tank True
Temperature (Fahrenheit)True 32+
D-box material: concrete or plastic False
Baffle & D-box or 45° angle False
Apparent structural damage False
Effluent filter False
Septic inlet cover ext - Req 12"+ below grade False
Visible scum layer False
Septic tank (include # of tanks)True 2
Number of tank compartments False
Plumbing fixtures tested & confirmed True
Evidence of a pipe bypassing tank False
System appears undersized/undersized components False
Foundation drain(s)False
Speed levers in D-box False
Tank cover False yes on barn dwelling / no on lakeside dwelling
System appears to have functioned adequately False
System passes all function testing False
Outlet pipe (automatic failure, if yes)False
Metal tank (automatic failure)False
Surface discharge? (if yes, to where?)False
Roof runoff False
Septic outlet cover ext - Req 12"+ below grade False
System needs repairs True
December 06, 2023 Page 1 of 2
INSPECTION WORKSHEET (PTI-029235-2023)
Checklist Item CommentsPassed
Sand filter False
Absorption bed False
Outflow line invert above leach line invert(s)?False
Overflow pipe (automatic failure)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
Cesspool (automatic failure, if yes)False
Inlet baffle True
Recommend upgrade/expand/replace 1+ components True
No treatment tank/other critical component(s)False
Number of drop box(es)False
As-built provided is accurate False
Mound system False
Test each fixture flow to septic tank True
Liquid level AT/ABOVE/BELOW (one) discharge invert False
Is tank pumped more than 4x/year?False
On-site as-built req'd before insp is complete False
Solids in D-box False
Outlet baffle True
Weather True cloudy
Main tank cleanout size and location False
Evidence of liquid above outlet inverts?False
Other False
Cracked, corroded or deformed?True need of replacement at barn dwelling
Sump pump(s)False
Plastic tank False
Raised system False
Pump station extention - Reg 12"+ below grade False
Cracked, corroded or deformed?False
Leaking water fixtures False
Other False
Absorption field True at barn dwelling
Water tight tank True
Seepage Pits: Number False
Other False
December 06, 2023 Page 2 of 2