Signed Inspection Worksheet (03-07-2018) (2) IIII IIIIIIIIIIIIIIIIII IIII IIII IIIIIIIIII III IIII III I IIII IIIIIIIIIIIII IIIIIIIIII IIIIII IIIIII III IIII III III IIIIIII IIII II III�I
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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
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
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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 Use Status NO
O'Brien,John(Inspector)
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