IM Inspection Worksheet_15-09-2023_15-46-46INSPECTION WORKSHEET (SEP-027639-2023)
SEP-0746-2022Case Number:Case Module:Permit Management
09/15/2023 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Mark Smith
Job Address:Parcel Number:22 Ward Ln
Queensbury, NY 12804
240.6-1-6
Company Name NameContact Type
Applicant David Barlow
Engineer Hutchins Engineering
Granted Permission David Barlow
Primary Owner David Barlow
Checklist Item CommentsPassed
Building Inspector Notes False 4/27/23 partial approval for septic system
- placement of two 1500 gallon poly holding tank approved, ok to
back fill.
Call for recheck when remaining components of septic system
are installed.
5/26/23 partial approval for septic system
-connection of 2" forced main at holding tank verified
- connection of the two holding tanks with 4" SDR 35 verified.
Ok to back fill holding tanks.
Items remaining
- verify pump tank and alarms are operational.
- verify alarms and water shut off solenoid are operational at
holding tank.
-provide as built drawing from design engineer at completion of
installation of septic system.
- provide proof of final electrical inspection ( at completion of
project)
9/15/23 partial approval of septic system
- alarms and shut off solenoid verified.
-alarms at grinder pump verified.
-proof of final electric verified.
items remaining- submit as built drawing from design engineer
ETU Maintenance Contract provided False
Final Electrical True commonwealth
Waterline separation distance True
Building to Tank False
[Provide extension collar if Yes]False
Opening Sealed:False
90% alarm level activates True
Foundation to Tank False
Engineer Report and As-Built False
Water shut off activates at 90% full True
Location of system on property False
Inlet & Outlet manholes 12"+ below grade False
September 15, 2023 Page 1 of 2
INSPECTION WORKSHEET (SEP-027639-2023)
Checklist Item CommentsPassed
Type of Water: Municipal / Well Water True Lake water supply
Separation of Pits False
System Use Status False
Conforms as per Plot Plan False
Size of tank True 2 1500 gallon holding tanks
Foundation to Absorption False
InletOutlet Pipes & Baffles True
50% alarm level activates True
September 15, 2023 Page 2 of 2