SEP-002369-2020 05262020INSPECTION WORKSHEET (SEP-002369-2020)
RC-0058-2020Permit Management
Case Number:Case Module:
05/26/2020Passed
Inspection Date:Inspection Status:
Mark SmithSeptic
Inspector:Inspection Type:
308.18-2-58.3
Job Address:Parcel Number:
11 Kimberly Ln
Queensbury, NY 12804
Contact TypeCompany NameName
ApplicantMonsour Enterprises, LLC
ContractorMonsour Enterprises, LLC
Granted PermissionMonsour Enterprises, LLC
Primary OwnerMonsour Enterprises, LLC
Checklist ItemPassedComments
Building Inspector NotesFalse5/26/20 as built received
Soil Type: SandFalse
ETU Maintenance Contract providedFalse
Size of StoneFalse
Roof gutters don't discharge over leach fieldFalse
Waterline separation distanceFalse
Building to TankFalse
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
Sump pump not connected to septic systemFalse
Well Casing Lengt: 50ft +/-False
Location of system on propertyFalse
Manholes 12 or less below gradeFalse
Septic tanks & pump station anchored in flood zoneFalse
Water softener not hooked to septic systemFalse
Type of Water: Municipal / Well WaterFalse
Locations / SeparationsFalse
Well separation distanceFalse
Depth of TrenchesFalse
Separation of PitsFalse
Stone Size:False
Seepage Pits: NumberFalse
December 10, 2020Page 1 of 2
INSPECTION WORKSHEET (SEP-002369-2020)
Checklist ItemPassedComments
Length of Each TrenchFalse
System Use StatusFalse
Conforms as per Plot PlanFalse
Distribution box to Field / PitFalse
Foundation to AbsorptionFalse
InletOutlet Pipes & BafflesFalse
Soil Type: LoamFalse
December 10, 2020Page 2 of 2