IM Inspection Worksheet_25-08-2023_12-43-06INSPECTION WORKSHEET (PTI-027448-2023)
PT-0098-2023Case Number:Case Module:Permit Management
08/25/2023 PassedInspection Status:Inspection Date:
Property Transfer InspectionsInspection Type:Inspector:John O'Brien
Job Address:Parcel Number:377 Cleverdale Rd
Queensbury, NY 12804
226.12-1-56
Company Name NameContact Type
Applicant Jeanne Rollins
Primary Owner Chuck Rollins
Checklist Item CommentsPassed
Building Inspector Notes True 3/22/23 property transfer inspection not approved.
- met on site with septic hauler IBS. A camera was ran down the
outlet side of the septic tank. No D box was observed, there is only
one lateral of perforated pipe which appeared to be in poor
condition as roots have infiltrated the perforated pipe. This system
will need to be replaced with an engineered on site waste water
system.
6/1/23 Property Transfer Inspection Not Approved
- Septic variance and septic permit application are approved and
issued, replacement system has not been installed as of today.
6/2/23 property transfer inspection approved
- a new system has been installed and approved.
- provide as built drawing from design engineer
8/25/23 Property Transfer Approved - Received certified septic
as-built from engineer.
Capacity in gallons True 1500 gallon septic tanks
Roof gutters don't discharge over leach field True
Concrete tank True
Temperature (Fahrenheit)True 88 degrees
D-box material: concrete or plastic True Precast concrete
Baffle & D-box or 45° angle True
Effluent filter True
Septic tank (include # of tanks)True One 1500 gallon septic tank
Plumbing fixtures tested & confirmed True
Speed levers in D-box True
Stormwater True Negative
Septic tank for bdrms/whrlpl/grndr w/in 250 gal True 1500 gallon septic tank
Tank cover True Concrete
System appears to have functioned adequately True
System passes all function testing True 8/25/23 Property Transfer Approved - Received certified septic
as-built from engineer.
Roof runoff True Negative
Depth below grade to top of tank True 8/ 10"
Access riser? (if yes, depth to cover)True Not required
Inlet baffle True
Number of drop box(es)True 2
August 25, 2023 Page 1 of 2
INSPECTION WORKSHEET (PTI-027448-2023)
Checklist Item CommentsPassed
As-built provided is accurate True 8/25/23 Property Transfer Approved - Received certified septic
as-built from engineer.
Test each fixture flow to septic tank True
Liquid level AT/ABOVE/BELOW (one) discharge invert True New tank and system
Outlet baffle True With filter
Weather True Cloudy
Main tank cleanout size and location True 1500 gallon septic tanks
Absorption field True Eldjen mats, 2 laterals at 40' each
Leaking water fixtures True Negative
August 25, 2023 Page 2 of 2