IM Inspection Worksheet_19-07-2023_08-36-29INSPECTION WORKSHEET (SEP-026676-2023)
SEP-0093-2023Case Number:Case Module:Permit Management
07/19/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:10 Duncan Cv
Queensbury, NY 12804
227.13-2-1
Company Name NameContact Type
Applicant Matthew Parisi
Contractor Ellsworth & Son Excavation
Engineer Hutchins Engineering
Granted Permission Matthew Parisi
Primary Owner Matthew Parisi
Checklist Item CommentsPassed
Building Inspector Notes True Partial inspection for placement of 1250 precast septic tank and
pump chamber only 7/7/23
Soil Type: Sand True
Size of Stone True #2
Final Electrical True provide final electric / received
Waterline separation distance True
Building to Tank True 4" SCHD 40 / 4" SDR 35 to pump chamber
[Provide extension collar if Yes]True
Tank to Distribution Box True 2" SCHD 40 force main to manifold
Opening Sealed:True
90% alarm level activates True
End Cap True
Absorbtion Fields: Total Length True 15x45 pipe in stone absorpition bed
Septic system field above flood plain True
Foundation to Tank True 10 ft
Engineer Report and As-Built False please provide engineer asbuilt / received
Location of system on property True
Inlet & Outlet manholes 12"+ below grade True
Type of Water: Municipal / Well Water True lake George
Locations / Separations True
Depth of Trenches True bed is 18"-20"+
Length of Each Trench True bed is 45 ft length (3) 2" SCHD 40 with 5/16" holes 4ft oc
System Use Status True
Conforms as per Plot Plan True
Size of tank True 1250 pre cast to 500 gallon pre cast pump chamber
Distribution box to Field / Pit True 2" SCHD 40
Foundation to Absorption True see specs
InletOutlet Pipes & Baffles True
50% alarm level activates True
July 19, 2023 Page 1 of 1