IM Inspection Worksheet_11-01-2024_14-40-24INSPECTION WORKSHEET (SEP-000209-2024)
SEP-0074-2023Case Number:Case Module:Permit Management
01/11/2024 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:11 Duncan Cv
Queensbury, NY 12804
226.16-1-5
Company Name NameContact Type
Applicant Deborah Purcell
Contractor Crandall Excavating
Engineer Environmental Design Partnership (EDP)
Granted Permission Barbara D'Agostino
Primary Owner Barbara D'Agostino
Checklist Item CommentsPassed
Building Inspector Notes True partial inspection / 4 rows ELJEN bio matts / returned 10/26 for
completion of system, please provide engineer report and final
electric.
Final electric received / please provide engineer as built
Soil Type: Sand True
ETU Maintenance Contract provided False N/A
Size of Stone False N/A
Final Electrical True provide final electrical / received
Waterline separation distance True
Building to Tank True 4" SCHD 40
[Provide extension collar if Yes]False
Tank to Distribution Box True 2" force main to 4" SDR 35
Opening Sealed:True
90% alarm level activates True
End Cap True
Absorbtion Fields: Total Length True 132ft
Septic system field above flood plain True
Foundation to Tank True crawl area 11ft
Engineer Report and As-Built False please provide engineer asbuilt report / received
Sump pump not connected to septic system True
Location of system on property True see specs
Type of Water: Municipal / Well Water True Lake
Locations / Separations True
Depth of Trenches True matts sit atop washed sand / see specs
Length of Each Trench True ELJEN matts 4 rows @ 32 ft
System Use Status True
Conforms as per Plot Plan True placement of tanks
Size of tank True 1250 gallon
Distribution box to Field / Pit True 4" sewer and drain perforated
Foundation to Absorption True 28+ft
January 11, 2024 Page 1 of 2
INSPECTION WORKSHEET (SEP-000209-2024)
Checklist Item CommentsPassed
InletOutlet Pipes & Baffles True effluent filter
50% alarm level activates True
January 11, 2024 Page 2 of 2