IM Inspection Worksheet_01-08-2023_08-16-56INSPECTION WORKSHEET (SEP-026924-2023)
SEP-0628-2020Case Number:Case Module:Permit Management
08/01/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:61 Knox Rd
Lake George, NY 12845
239.7-1-12
Company Name NameContact Type
Applicant ROBERTA KAHAN TRUST
Contractor Crandall Excavating
Engineer Dennis MacElroy
Granted Permission ROBERTA KAHAN TRUST
Primary Owner ROBERTA KAHAN TRUST
Checklist Item CommentsPassed
Building Inspector Notes True 5/15/23 verified placement of pump station only
5/18/23 verified first run of Eljen Matt's with (24ft of perforated
sewer and drain)between one story camp and shed with washing
machine.
Remainder of system verified 6/13/23 / verified floats, alarm and
flow to septic tank
Soil Type: Sand True With loam
Final Electrical True Received
Waterline separation distance True
Building to Tank True 4" SCHD 40 to ejector pump station, then 1 1/2" force main to 4"
SDR 35 inlet baffle
[Provide extension collar if Yes]False No
Tank to Distribution Box True 4" SDR 35 to 3 drop boxes with speed levers
Opening Sealed:True
90% alarm level activates True
End Cap True
Absorbtion Fields: Total Length True 96 ft
Septic system field above flood plain True Yes
Foundation to Tank True See specs
Engineer Report and As-Built True Please provide engineer asbuilt report / received 7/31/23
Location of system on property True See specs
Inlet & Outlet manholes 12"+ below grade False No
Type of Water: Municipal / Well Water True Lake
Locations / Separations True See specs
Depth of Trenches True 18"-24"
Stone Size:True Concrete sand
Length of Each Trench True 24 ft
System Use Status True
Conforms as per Plot Plan True
Size of tank True 1500 gallon precast concrete
Distribution box to Field / Pit True 4" SDR 35
August 01, 2023 Page 1 of 2
INSPECTION WORKSHEET (SEP-026924-2023)
Checklist Item CommentsPassed
Foundation to Absorption True See specs
InletOutlet Pipes & Baffles True Outlet with effluent filter
50% alarm level activates True
August 01, 2023 Page 2 of 2