IM Inspection Worksheet_20-12-2023_15-16-06INSPECTION WORKSHEET (SEP-029522-2023)
SEP-0601-2023Case Number:Case Module:Permit Management
12/20/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:103 Assembly Point Rd
Lake George, NY 12845
239.12-2-33
Company Name NameContact Type
Agent Hutchins Engineering
Applicant Kara Haraden
Contractor Nims Outdoor Services Inc.
Engineer Lucas Dobie
Granted Permission Kara Haraden
Primary Owner JEANNE AUSTIN
Checklist Item CommentsPassed
Building Inspector Notes True Due to weather conditions, no one on site. Will need to verify inlet
baffle, floats, alarm, water shut off and final electrical. 12/18/23
12/20/23 returned to site, verified placement of (2) 2000 gallon
precast / traffic rated holding tanks, with floats, alarm and water
shut off. CMD
Soil Type: Sand True
Final Electrical False please provide final electrical inspection
Waterline separation distance True
Building to Tank True 4" SCHD 40
[Provide extension collar if Yes]False
Tank to Distribution Box False N/A
Opening Sealed:True
Soil Type: Clay False
90% alarm level activates True
End Cap False N/A
Absorbtion Fields: Total Length False N/A
Foundation to Tank True 10 ft
Engineer Report and As-Built False please provide engineer asbuilt
Water shut off activates at 90% full True
Location of system on property True see specs
Inlet & Outlet manholes 12"+ below grade False
Type of Water: Municipal / Well Water True lake
Locations / Separations True
Depth of Trenches False N/A
Length of Each Trench False N/A
System Use Status True
Conforms as per Plot Plan True
Size of tank True (2) 2000 gallon holding tanks
Distribution box to Field / Pit False N/A
December 20, 2023 Page 1 of 2
INSPECTION WORKSHEET (SEP-029522-2023)
Checklist Item CommentsPassed
Foundation to Absorption False N/A
InletOutlet Pipes & Baffles True inlet baffle
50% alarm level activates True
Soil Type: Loam True
December 20, 2023 Page 2 of 2