PTI-006591-2019 10292019INSPECTION WORKSHEET (PTI-006591-2019)
PT-0676-2019Permit Management
Case Number:Case Module:
10/29/2019Failed
Inspection Date:Inspection Status:
Dave HatinProperty 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
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 rises cap. 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
System needs repairsFalse
Sump pump not connected to septic systemFalse
October 23, 2020Page 1 of 3
INSPECTION WORKSHEET (PTI-006591-2019)
Checklist ItemPassedComments
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
Aerobic systemFalse
No treatment tank/other critical component(s)False
Dosing or pump tank sealedFalse
Sump pump(s)False
Absorption fieldFalse
ModelFalse
TypeFalse
On-site as-built req'd before insp is completeFalse
Water softener not hooked to septic systemFalse
As-built provided is accurateFalse
Evidence of liquid above outlet inverts?False
Test each fixture flow to septic tankFalse
Cracked, corroded or deformed?False
Main tank cleanout size and locationFalse
OtherFalse
ManufacturerFalse
Seepage Pits: NumberFalse
Water tight tankFalse
Outlet baffleFalse
Number of drop box(es)False
WeatherFalse
Is tank pumped more than 4x/year?False
Leaking water fixturesFalse
Ejector or grinder pump sealedFalse
Raised systemFalse
Plastic tankFalse
OtherFalse
OtherFalse
Solids in D-boxFalse
Cracked, corroded or deformed?False
Mound systemFalse
Liquid level AT/ABOVE/BELOW (one) discharge invertFalse
October 23, 2020Page 2 of 3
INSPECTION WORKSHEET (PTI-006591-2019)
Checklist ItemPassedComments
Excavate 18" around,no leach field connectedFalse
Are there any obvious electrical shortcomings?False
OtherFalse
Are both switch and alarm operable?False
October 23, 2020Page 3 of 3