INSPECTION WORKSHEET 05102024
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: May 10, 2024 Inspection Status: Passed
Inspector: John O'Brien Inspection Type: Septic
Job Address: 9 Duncan Cv
, Parcel Number: 226.16-1-4
Contact Type Company Name Name
Owner N/A Sally Gifford
Engineer Hutchins Engineering PLLC null null
Contractor Ellsworth & Son Excavating null null
Checklist Item
Status
Building Inspector notes
3/12/24 Septic System Partial Approval.
Item remaining:
1) Submit engineer's report and as-built!
5/10/24 Received Record As-built septic plot plan and verification from
engineer that the tanks risers were resealed and regasketed and ground
water pumped out of tanks .
PASS
Soil type: sand
PASS
Soil type: loam
PASS
Type of water: municipal or well water
PASS
Waterline separation distance
Potable water from Lake George
PASS
Septic tanks and pump station anchored
in flood zone
PASS
System use status
PASS
Distance from building to tank
As per variance
PASS
Opening sealed
PASS
Inlet outlet pipes and baffles, provide
extension collar if yes
PASS
Locations and separations
PASS
Distance from foundation to tank
PASS
Size of tank
As per variance
PASS
50 percent alarm level activates
PASS
90 percent alarm level activates
PASS
Water shut off activates at 90 percent full
PASS
Final electrical
PASS
Conforms as per plot plan
PASS
Engineer report and as-built
PASS
Location of system on property
PASS
Well separation distance
PASS
John O'Brien
Director of Building & Codes