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PTI-004907-2020 09232020INSPECTION WORKSHEET (PTI-004907-2020) PT-0676-2019Permit Management Case Number:Case Module: 09/23/2020Failed Inspection Date:Inspection Status: John O'BrienProperty Transfer Inspections Inspector:Inspection Type: 239.8-1-33 Job Address:Parcel Number: 23 Cayuga Dr Queensbury, NY 12804 Contact TypeCompany NameName ApplicantDenise Clairmont Trust ContractorIBS Septic Checklist ItemPassedComments WatertightFalse Weather/lack of information/inaccessibilityFalse Service contract (required)False Holding tank (if yes, include capacity)False Capacity in gallonsFalse System/components indicate unacceptableFalse Is there a high water alarm?False Roof gutters don't discharge over leach fieldFalse Concrete tankFalse Temperature (Fahrenheit)False D-box materialFalse Apparent structural damageFalse Septic inlet cover ext - Reg 12"+ below gradeFalse Visible scum layerFalse Septic tank (include # of tanks)False Number of tank compartmentsFalse Plumbing fixtures tested & confirmedFalse Evidence of a pipe bypassing tankFalse Holding Tank:verify level risescap. w/in 250 galFalse Metal septic or leech tank or cesspoolFalse System appears undersized/undersized componentsFalse Foundation drain(s)False Is there evidence of surface water infiltratingFalse StormwaterFalse Tank coverFalse System appears to have functioned adequatelyFalse System passes all function testingFalse Outlet pipe (automatic failure, if yes)False Metal tank (automatic failure)False Does the pump(s) appear to be operating properly?False Surface discharge? (if yes, to where?)False Roof runoffFalse Septic outlet cover ext - Reg 12"+ below gradeFalse October 23, 2020Page 1 of 3 INSPECTION WORKSHEET (PTI-004907-2020) Checklist ItemPassedComments System needs repairsFalse Sump pump not connected to septic systemFalse Sand filterFalse Leaching bedFalse Outflow line invert above leach line invert(s)?False Overflow pipe (automatic failure)False Depth below grade to top of tankFalse Evidence of prolonged high liquid levelFalse Access riser? (if yes, depth to cover)False CesspoolFalse Inlet baffleFalse Recommend upgrade/expand/replace 1+ componentsFalse Plastic tankFalse Are both switch and alarm operable?False Evidence of liquid above outlet inverts?False No treatment tank/other critical component(s)False Outlet baffleFalse As-built provided is accurateFalse OtherFalse Excavate 18" around,no leach field connectedFalse Mound systemFalse On-site as-built req'd before insp is completeFalse Sump pump(s)False ManufacturerFalse OtherFalse Water softener not hooked to septic systemFalse Liquid level AT/ABOVE/BELOW (one) discharge invertFalse Raised systemFalse Is tank pumped more than 4x/year?False Pump station extention - Reg 12"+ below gradeFalse Main tank cleanout size and locationFalse Solids in D-boxFalse ModelFalse Water tight tankFalse OtherFalse Absorption fieldFalse Leaking water fixturesFalse Are there any obvious electrical shortcomings?False Seepage Pits: NumberFalse TypeFalse Cracked, corroded or deformed?False Number of drop box(es)False October 23, 2020Page 2 of 3 INSPECTION WORKSHEET (PTI-004907-2020) Checklist ItemPassedComments Aerobic systemFalse OtherFalse Test each fixture flow to septic tankFalse Ejector or grinder pump sealedFalse Cracked, corroded or deformed?False WeatherFalse Dosing or pump tank sealedFalse October 23, 2020Page 3 of 3