IM Inspection Worksheet_08-08-2023_13-46-27INSPECTION WORKSHEET (SEP-027056-2023)
RC-0180-2023Case Number:Case Module:Permit Management
08/08/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:1 Juniper Dr
Queensbury, NY 12804
278.20-1-16
Company Name NameContact Type
Applicant CERRONE BUILDERS, INC.
Contractor CERRONE BUILDERS, INC.
Granted Permission Fred Champagne
Primary Owner Fred Champagne
Checklist Item CommentsPassed
Building Inspector Notes False
Soil Type: Sand True
Size of Stone True #2
Waterline separation distance True
Building to Tank True 4" SCHD 40
[Provide extension collar if Yes]False
Tank to Distribution Box True 4"sewer and drain
Opening Sealed:True
End Cap True
Absorbtion Fields: Total Length True 140 ft
Septic system field above flood plain True
Foundation to Tank True 10+ ft
Engineer Report and As-Built False please provide engineer asbuilt
Sump pump not connected to septic system False
Well Casing Length: 50ft +/-True
Location of system on property True
Inlet & Outlet manholes 12"+ below grade False
Water softener not connected to septic system False
Type of Water: Municipal / Well Water True well
Locations / Separations True
Well separation distance True 104 ft to D box
Depth of Trenches True 18+"
Length of Each Trench True 35 ft
System Use Status True
Conforms as per Plot Plan True tank is rotated from what is on plot plan
Size of tank True 1000 gallon
Distribution box to Field / Pit True 4" sewer and drain perforated
Foundation to Absorption True 60+
InletOutlet Pipes & Baffles True
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