IM Inspection Worksheet_15-09-2023_13-46-32INSPECTION WORKSHEET (PTI-027572-2023)
PT-0545-2023Case Number:Case Module:Permit Management
09/15/2023 PassedInspection Status:Inspection Date:
Property Transfer InspectionsInspection Type:Inspector:Mark Smith
Job Address:Parcel Number:358 Cleverdale Rd
Queensbury, NY 12804
226.12-1-66
Company Name NameContact Type
Contractor IBS Septic
Primary Owner SHERRY FAMILY IRREVOCABLE LIVING TRUST
Checklist Item CommentsPassed
Building Inspector Notes False 9/15/23 property transfer inspection approved.
- septic system was recently replaced and is functioning as
designed.
Capacity in gallons True 1250 gallon tank
Is there a high water alarm?True
Roof gutters don't discharge over leach field True
Concrete tank True
Temperature (Fahrenheit)True 60 degrees
D-box material: concrete or plastic True pre cast concrete
Baffle & D-box or 45° angle True
Septic inlet cover ext - Req 12"+ below grade True
Visible scum layer True
Septic tank (include # of tanks)True 1250 gallon septic tank, with a 50 gallon grinder pump tank
Plumbing fixtures tested & confirmed True
Speed levers in D-box True
Is there evidence of surface water infiltrating True negative
Septic tank for bdrms/whrlpl/grndr w/in 250 gal True 1250 gallon septic tank for a four bedroom home
Tank cover True steel
System appears to have functioned adequately True
System passes all function testing True
Does the pump(s) appear to be operating properly?True
Roof runoff True
Septic outlet cover ext - Req 12"+ below grade True
Depth below grade to top of tank True 12/14"
Access riser? (if yes, depth to cover)True covers for septic tank pump tank and D box at grade
Inlet baffle True
As-built provided is accurate True
Test each fixture flow to septic tank True
Liquid level AT/ABOVE/BELOW (one) discharge invert True at discharge level
Are both switch and alarm operable?True
Solids in D-box True negative
Ejector or grinder pump sealed True
Outlet baffle True
September 15, 2023 Page 1 of 2
INSPECTION WORKSHEET (PTI-027572-2023)
Checklist Item CommentsPassed
Weather True sunny
Main tank cleanout size and location True man hole cover at driver way
Absorption field True
Pump station extention - Reg 12"+ below grade True
Leaking water fixtures True negative
Water tight tank True
Are there any obvious electrical shortcomings?True negative
September 15, 2023 Page 2 of 2