IM Inspection Worksheet_19-07-2023_15-31-10INSPECTION WORKSHEET (SEP-026677-2023)
SEP-0753-2022Case Number:Case Module:Permit Management
07/19/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:169 Haviland Rd
Queensbury, NY 12804
289.20-1-5
Company Name NameContact Type
Applicant Bay West Associates LLC
Contractor Sanitary Sewer Service
Engineer Hutchins Engineering
Granted Permission Bay West Associates LLC
Primary Owner Bay West Associates LLC
Checklist Item CommentsPassed
Building Inspector Notes True 7/19/23 verified placement of 1250 gallon septic tank / 1,000
gallon pump chamber / D-box / absorption bed. System not
completed due to pump / floats / alarm system not hooked up,
please call when ready to verify. Provide electrical inspection when
completed.
Soil Type: Sand True
ETU Maintenance Contract provided False
Size of Stone True #2
Final Electrical False
Waterline separation distance True
Building to Tank True 4" SCHD 40
[Provide extension collar if Yes]True
Tank to Distribution Box True from pump chamber 1 1/2" force main to 4"SDR 35
Opening Sealed:True
90% alarm level activates False
End Cap True line are looped perforated
Absorbtion Fields: Total Length True 15x40 absorption bed with 3 lines @ 35 ft looped @ 5 ft= 115 ft
Septic system field above flood plain True
Foundation to Tank True 10+ ft
Engineer Report and As-Built False please provide asbuilt report
Location of system on property True
Inlet & Outlet manholes 12"+ below grade True
Type of Water: Municipal / Well Water True municipal
Locations / Separations True
Depth of Trenches True bed @ 18"-20" in depth
Length of Each Trench True 15x40 absorption bed with 3 lines @ 35 ft looped @ 5 ft= 115 ft
System Use Status True
Conforms as per Plot Plan False
Size of tank True 1250 septic tank to 1,000 gallon pump chamber
Distribution box to Field / Pit True 4" SDR 35 perforated
July 19, 2023 Page 1 of 2
INSPECTION WORKSHEET (SEP-026677-2023)
Checklist Item CommentsPassed
Foundation to Absorption True 20+ ft
InletOutlet Pipes & Baffles True
50% alarm level activates False
Soil Type: Loam True
July 19, 2023 Page 2 of 2