IM Inspection Worksheet_08-01-2024_12-46-14INSPECTION WORKSHEET (SEP-000064-2024)
RC-0653-2022Case Number:Case Module:Permit Management
01/08/2024 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:105 Rockhurst Rd
Queensbury, NY 12804
227.9-1-4
Company Name NameContact Type
Applicant WD Williams Construction, Inc.
Contractor WD Williams Construction, Inc.
Designer Williams & Williams Designers Inc.
Granted Permission Frank Sinatra Jr
Primary Owner Laura Sinatra
Frank Sinatra Jr
Checklist Item CommentsPassed
Building Inspector Notes True To verify placement of Fuji tank (ETU) 1,000 gallon pump chamber
/ floats/alarm and flow along with 15'x31' absorption bed.
Soil Type: Sand True
ETU Maintenance Contract provided False Please provide copy of maintenance contract
Size of Stone True #2
Final Electrical True to be provided / received
Waterline separation distance True
Building to Tank True 4" SCHD 40
[Provide extension collar if Yes]True
Tank to Distribution Box True 2" force main to manifold
Opening Sealed:True
Soil Type: Clay False
90% alarm level activates True
End Cap True
Absorbtion Fields: Total Length True (3) 2" force main lines at 29 ft=87
Foundation to Tank True see specs
Engineer Report and As-Built False to be provided
Water shut off activates at 90% full False
Well Casing Length: 50ft +/-False
Location of system on property True see specs
Inlet & Outlet manholes 12"+ below grade True
Septic tanks & pump station anchored in flood zone False
Water softener not connected to septic system False
Type of Water: Municipal / Well Water True lake
Locations / Separations True
Well separation distance False
Length of Each Trench True 15'x31' absorption bed
System Use Status True
Conforms as per Plot Plan True
January 08, 2024 Page 1 of 2
INSPECTION WORKSHEET (SEP-000064-2024)
Checklist Item CommentsPassed
Size of tank True Fuji ETU to 1000 gallon pump chamber (precast)
Distribution box to Field / Pit False
Foundation to Absorption True see specs
InletOutlet Pipes & Baffles True
50% alarm level activates True
Soil Type: Loam False
January 08, 2024 Page 2 of 2