inspectionINSPECTION WORKSHEET (SEP-003355-2019)
SEP-0051-2019Permit Management
Case Number:Case Module:
06/06/2019Passed
Inspection Date:Inspection Status:
Charles DyerSeptic
Inspector:Inspection Type:
240.6-1-32
Job Address:Parcel Number:
2464 Ridge Rd
Queensbury, NY 12804
Contact TypeCompany NameName
ApplicantDL Dickinson Associates
ContractorChris Crandall
Granted PermissionMICHAEL CHRYS
Primary OwnerMICHAEL CHRYS
Checklist ItemPassedComments
Building Inspector NotesFalseFor placement of 1250 gallon septic tank only 6/6/19
Soil Type: SandFalse
ETU Maintenance Contract providedFalse
Size of StoneFalse
Waterline separation distanceFalse
Building to TankTrue10+ ft
Public Sewer Sign-OffFalse
[Provide extension collar if Yes]False
Tank to Distribution BoxFalse
Size:False
Opening Sealed:False
Soil Type: ClayFalse
End CapFalse
Absorbtion Fields: Total LengthFalse
Septic system field above flood plainFalse
Foundation to TankFalse
Engineer Report and As-BuiltFalse
Well Casing Lengt: 50ft +/-False
Location of system on propertyFalse
Manholes 12 or less below gradeFalse
Septic tanks & pump station anchored in flood zoneFalse
Type of Water: Municipal / Well WaterFalse
Locations / SeparationsFalse
Well separation distanceFalse
Depth of TrenchesFalse
Separation of PitsFalse
Stone Size:False
Seepage Pits: NumberFalse
Length of Each TrenchFalse
Soil Type: LoamFalse
Conforms as per Plot PlanFalse
December 06, 2019Page 1 of 2
INSPECTION WORKSHEET (SEP-003355-2019)
Checklist ItemPassedComments
InletOutlet Pipes & BafflesTrue
Distribution box to Field / PitFalse
System Use StatusFalse
Foundation to AbsorptionFalse
December 06, 2019Page 2 of 2