IM Inspection Worksheet_03-01-2024_11-20-57INSPECTION WORKSHEET (SEP-000010-2024)
RC-0433-2023Case Number:Case Module:Permit Management
01/03/2024 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:10 Michaels Dr
Queensbury, NY 12804
308.6-1-37
Company Name NameContact Type
Applicant CHAD WARNER
Architect Dreamscapes Unlimited
Contractor Amken Construction
Granted Permission CHAD WARNER
Primary Owner CHAD WARNER
Checklist Item CommentsPassed
Building Inspector Notes False 10/4/23 As per my site visit today to 10 Michaels Drive I met with
the contractor and the engineer Bob Flansburg to layout new
location of septic tank and new absorption area due to the
neighbor's well location. Bob Flansburg will be submitting a
revised septic plan showing the neighbor's well location and
required 50' distance from the septic tank and required 100'
distance to the absorption area.
Soil Type: Sand True
ETU Maintenance Contract provided True
Size of Stone False N/A
Waterline separation distance True
Building to Tank True 4" SCHD 40
[Provide extension collar if Yes]False
Tank to Distribution Box True 4" SCHD 40
Opening Sealed:True
End Cap True
Absorbtion Fields: Total Length True 24 ft Eljen matts
Septic system field above flood plain False
Foundation to Tank True Home is slab on grade / within 10 ft
Engineer Report and As-Built True received
Sump pump not connected to septic system False no basement
Well Casing Length: 50ft +/-True
Location of system on property True see asbuilt
Inlet & Outlet manholes 12"+ below grade False
Type of Water: Municipal / Well Water True munincipal / there is a neighboring well (point)
Locations / Separations True
Well separation distance True
Depth of Trenches True 16"
Length of Each Trench True 24 ft
System Use Status True
Conforms as per Plot Plan True
January 03, 2024 Page 1 of 2
INSPECTION WORKSHEET (SEP-000010-2024)
Checklist Item CommentsPassed
Size of tank True 1000 gallon fiber plastic
Distribution box to Field / Pit True 4" sewer and drain perforated
Foundation to Absorption True 2-6 ft
InletOutlet Pipes & Baffles True with effluent filter at outlet
January 03, 2024 Page 2 of 2