INSPECTION WORKSHEET 04242024
INSPECTION WORKSHEET
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number: PT-0764-2023 Case Module: Permit
Inspection Date: April 24, 2024 Inspection Status: Passed
Inspector: Charles Dyer Inspection Type: Property Transfer
Job Address: 256 Lake Pkwy
, Parcel Number:
Contact Type Company Name Name
Agent N/A George Pensel
Primary Owner Patricia A Pensel Revocable Trust
Checklist Item
Status
Building Inspector notes
Need to witness operation of pump fllow to distribution box.
Verified 4/24/24
PASS
Weather
PASS
Temperature (Fahrenheit)
PASS
Test each fixture flow to septic tank
PASS
Septic tank for bedrooms, whirlpool,
garbage grinder within 250 gallons
PASS
Leaking water fixtures
PASS
Plumbing fixtures tested and confirmed
PASS
Excavate 18 inches around to verify no
leach field is connected
PASS
Watertight
PASS
Septic tank; include number of tanks
PASS
Concrete tank
PASS
Access riser; if yes, what is depth to
cover PASS
Depth below grade to top of tank
PASS
Tank cover
PASS
Septic outlet cover extension, required 12
inches or more below grade
PASS
Pump station extension, required 12
inches or more below grade
PASS
Septic inlet cover extension, required 12
inches or more below grade
PASS
Inlet baffle
PASS
Outlet baffle
PASS
Effluent filter
PASS
Liquid level at, above or below discharge
invert
At
PASS
Number of tank compartments
two
PASS
Visible scum layer
PASS
Main tank cleanout size and location
PASS
Capacity in gallons
1250 gallon
PASS
Water tight tank
PASS
Dosing or pump tank sealed
PASS
Capacity of pump tank, in gallons
1000
PASS
Ejector or grinder pump sealed
PASS
Does the pumps appear to be operating
properly
PASS
Is there a high water alarm
PASS
Are both switch and alarm operable
PASS
Is there evidence of surface water
infiltrating
PASS
Are there any obvious electrical
shortcomings
PASS
D-box material: concrete or plastic
PASS
Baffle and d-box or 45 degree angle
PASS
Cracked, corroded or deformed
PASS
Speed levers in d-box
PASS
Solids in d-box
PASS
Number of drop boxes
PASS
Outflow line invert above leach line
inverts
PASS
Evidence of liquid above outlet inverts
PASS
Absorption field
PASS
System appears to have functioned
adequately
Need to witness operation of pump fllow to distribution box.
verified 4/24/24
PASS
As built provided is accurate
PASS
System passes all function testing
Need to witness operation of pump fllow to distribution box.
Verified 4/24/24
PASS
Charles Dyer
Code Enforcement Officer