INSPECTION WORKSHEET 05012024
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-0705-2023 Case Module: Permit
Inspection Date: May 01, 2024 Inspection Status: Reinspect
Inspector: Charles Dyer Inspection Type: Property Transfer
Job Address: 27 ANTIGUA RD
, Parcel Number: 239.17-1-8
Contact Type Company Name Name
Antigua Resort LLC
Owner Antigua Resort LLC
Checklist Item
Status
Building Inspector notes
not ready / Mr Brown will call to reschedule
PASS
Weather
N/O
Temperature (Fahrenheit)
N/O
Test each fixture flow to septic tank
N/O
Whirlpool tub, add 250 gallons
N/O
Garbage grinder, add 250 gallons
N/O
Septic tank for bedrooms, whirlpool,
garbage grinder within 250 gallons
N/O
Leaking water fixtures
N/O
Stormwater
N/O
Sump pumps
N/O
Foundation drains
N/O
Roof gutters don't discharge over leach
field
N/O
Roof runoff
N/O
Other
N/O
Plumbing fixtures tested and confirmed
N/O
Holding tank; if yes, include capacity
N/O
Holding tank, verify level rises
N/O
Verify 50 percent and 90 percent floats
N/O
Excavate 18 inches around to verify no
leach field is connected
N/O
Watertight
N/O
Outlet pipe; automatic failure, if yes
N/O
Cesspool; automatic failure, if yes
N/O
Overflow pipe; automatic failure, if yes
N/O
Septic tank; include number of tanks
N/O
Concrete tank
N/O
Metal tank; automatic failure, if yes
N/O
Plastic tank
N/O
Tank Other
N/O
Engineer's report on ETU
N/O
Aerobic system
N/O
Type
N/O
Manufacturer
N/O
Model
N/O
Maintenance agreement or service
contract; required
N/O
Access riser; if yes, what is depth to
cover
N/O
Depth below grade to top of tank
N/O
Tank cover
N/O
Septic outlet cover extension, required 12
inches or more below grade
N/O
Pump station extension, required 12
inches or more below grade
N/O
Septic inlet cover extension, required 12
inches or more below grade
N/O
Inlet baffle
N/O
Outlet baffle
N/O
Effluent filter
N/O
Liquid level at, above or below discharge
invert
N/O
Number of tank compartments
N/O
Visible scum layer
N/O
Main tank cleanout size and location
N/O
Capacity in gallons
N/O
Water tight tank
N/O
Evidence of a pipe bypassing the tank
N/O
Is the tank being pumped more than 4x a
year
N/O
Dosing or pump tank sealed
N/O
Capacity of pump tank, in gallons
N/O
Ejector or grinder pump sealed
N/O
Does the pumps appear to be operating
properly
N/O
Is there a high water alarm
N/O
Are both switch and alarm operable
N/O
Is there evidence of surface water
infiltrating
N/O
Are there any obvious electrical
shortcomings
N/O
D-box material: concrete or plastic
N/O
Baffle and d-box or 45 degree angle
N/O
Cracked, corroded or deformed
N/O
Speed levers in d-box
N/O
Solids in d-box
N/O
Number of drop boxes
N/O
Outflow line invert above leach line
inverts
N/O
Evidence of liquid above outlet inverts
N/O
Sump pump not connected to septic
system
N/O
Water softener not connected to septic
system
N/O
Surface discharge; if yes, to where
N/O
Absorption field
N/O
Absorption bed
N/O
Raised system
N/O
Sand filter
N/O
Mound system
N/O
Seepage pits; how many
N/O
Apparent structural damage
N/O
Seepage Pit Other
N/O
Weather, lack of information,
inaccessibility
N/O
System appears to have functioned
adequately
N/O
System appears undersized or have
undersized components
N/O
System or components are unacceptable
N/O
No treatment tank or other critical
components
N/O
Recommend upgrade, expand or replace
1 or more components
N/O
As built provided is accurate
N/O
On site as built required before inspection
is complete
N/O
Evidence of prolonged high liquid level
N/O
System needs repais
N/O
System passes all function testing
N/O
Charles Dyer
Code Enforcement Officer