Signed Inspection Worksheet (03-07-2018) I III III I... III I I �
Town of Queensbury-Building and Codes-Fire Marshal
742 Bay Road-(518)761-8256 Building(518)761-8206 Fire Marshal
Case Number: RC-000718-2017 Case Module: Permit
Inspection Date: 03/07/2018 Inspection Status: Failed
Inspector: John O'Brien Inspection Type: Septic
Job Address: 74 JOHN CLENDON RD Parcel Number: 295.15-2-7
Queensbury, NY 12804
Contact Type Company Name Name
Granted Permission [FOOTHILLS BUILDERS, LLC]
Primary Owner [FOOTHILLS BUILDERS, LLC]
Applicant [FOOTHILLS BUILDERS, LLC]
Contractor [FOOTHILLS BUILDERS, LLC]
Checklist Item Passed Comments
Building Inspector Notes NO 3/7/18 Septic System Not Approved-Not completed. Received call
from engineer Tom Center to reinspect tomorrow morning. Scheduled
for 9:00-11:00 am.
Public Sewer Sign-Off NO
Soil Type: Sand NO
Soil Type: Loam NO
Soil Type: Clay NO
Type of Water: Municipal/Well Water NO
Waterline separation distance NO
Well separation distance NO
Well Casing Lengt:50ft+/- NO
Absorbtion Fields:Total Length NO
Septic system field above flood plain NO
Septic tanks&p u m p station anchored in flood zone NO
Length of Each Trench NO
Depth of Trenches NO
Size of Stone NO
Seepage Pits: Number NO
Size: NO
Stone Size: NO
Building to Tank NO
Tank to Distribution Box NO
Distribution box to Field/Pit NO
Opening Sealed: NO
End Cap NO
Inil etOutlet Pipes&Baffles NO
Manholes 12 or less below grade NO
[Provide extension collar if Yes] NO
Locations/Separations NO
Foundation to Tank NO
Mar 07,2018 Page(13)
Checklist Item Passed Comments
Foundation to Absorption NO
Separation of Pits NO
Conforms as per Plot Plan NO
Engineer Report and As-Built NO
ETU Maintenance Contract provided NO
Location of system on property NO
System 0s6 Status NO
O'Brien,John(Inspector)
Mar 07,2018 Page(14)