IM Inspection Worksheet_09-08-2023_12-13-13INSPECTION WORKSHEET (SEP-027120-2023)
SEP-0179-2022Case Number:Case Module:Permit Management
08/09/2023 PassedInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:7 Fieldview Rd
Queensbury, NY 12804
289.8-1-75
Company Name NameContact Type
Applicant IBS Septic
Contractor IBS Septic
Engineer Wales Engineering
Granted Permission JOSEPH GETZ
Primary Owner JOSEPH GETZ
Checklist Item CommentsPassed
Building Inspector Notes False
Size of Stone True #2
Roof gutters don't discharge over leach field True No
Waterline separation distance True
Building to Tank True Existing tank
Public Sewer Sign-Off False
[Provide extension collar if Yes]True
Tank to Distribution Box True 4" SDR 35
Opening Sealed:True
Soil Type: Clay True
End Cap True
Absorbtion Fields: Total Length True 175 ft with lines being looped
Septic system field above flood plain False
Foundation to Tank True Existing tank 10 ft
Engineer Report and As-Built True Provide engineer asbuilt report / received 8/9/23
Sump pump not connected to septic system True No
Well Casing Length: 50ft +/-False
Location of system on property True Rear of home, back right corner
Inlet & Outlet manholes 12"+ below grade True
Water softener not connected to septic system True No
Type of Water: Municipal / Well Water False
Locations / Separations True
Well separation distance False
Depth of Trenches True 4+ft
Length of Each Trench True 40 ft lines looped
System Use Status True
Conforms as per Plot Plan True
Size of tank True Existing 1000 gallon
Distribution box to Field / Pit True 4" SDR 35 perforated
August 09, 2023 Page 1 of 2
INSPECTION WORKSHEET (SEP-027120-2023)
Checklist Item CommentsPassed
Foundation to Absorption True 28+ ft
InletOutlet Pipes & Baffles True
Soil Type: Loam True
Permit Card Visible From Road False
August 09, 2023 Page 2 of 2