INSPECTION WORKSHEET
INSPECTION WORKSHEET
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number: SEP-0684-2023 Case Module: Permit
Inspection Date: March 01, 2024 Inspection Status: Reinspect
Inspector: John O'Brien Inspection Type: Septic
Job Address: 9 Duncan Cv
, Parcel Number:
Contact Type Company Name Name
Contractor Ellsworth & Son Excavation
Owner N/A SALLY GIFFORD
Engineer Hutchins Engineering PLLC
Checklist Item
Status
Building Inspector notes
3/1/24 Septic System Partial Inspection - Installed 2-2000 gallon holding
tanks including pipe to residence. Also installed access cover extensions.
Ok to backfill. Lucas Dobie from Hutchins Engineering and took photos. I
also took photos. Ok to backfill. Follow up inspection scheduled for
3/8/24.
Items Remaining:
1) Install complete holding tank alarm system with domestic water
shutoff.
2) Provide a final electrical inspection for complete alarm system.
3) Witness function test of alarm system and water shut off.
4) Submit final approval letter and certified septic as-built from design
engineer.
5) Verify installation of 4” house sewer line from garage bathroom.
FAIL
Soil type: loam
PASS
Type of water: municipal or well water
lake domestic water supply
PASS
Waterline separation distance
PASS
Septic tanks and pump station anchored
in flood zone
PASS
System use status
FAIL
Distance from building to tank
PASS
Opening sealed
PASS
Inlet outlet pipes and baffles, provide
extension collar if yes
N/O
Locations and separations
PASS
Distance from foundation to tank
PASS
Size of tank
PASS
50 percent alarm level activates
N/O
90 percent alarm level activates
N/O
Water shut off activates at 90 percent full
N/O
Final electrical
N/O
Conforms as per plot plan
FAIL
Engineer report and as-built
FAIL
Location of system on property
PASS
Well separation distance
PASS
John O'Brien
Director of Building & Codes