IM Inspection Worksheet_18-01-2024_11-44-01INSPECTION WORKSHEET (SEP-000290-2024)
SEP-0030-2024Case Number:Case Module:Permit Management
01/18/2024 Partial PassInspection Status:Inspection Date:
SepticInspection Type:Inspector:Charles Dyer
Job Address:Parcel Number:3 Ames Pl
Queensbury, NY 12804
309.7-3-6
Company Name NameContact Type
Applicant Phil Tucker
Engineer Warren Longacker PE
Granted Permission DANIEL TUCKER
Primary Owner DANIEL TUCKER
Checklist Item CommentsPassed
Building Inspector Notes False
Soil Type: Sand True
ETU Maintenance Contract provided False
Size of Stone True #2
Final Electrical False
Waterline separation distance True
Building to Tank True 4" SCHD 40
[Provide extension collar if Yes]True
Tank to Distribution Box True 4" SCHD 40
Opening Sealed:True
Soil Type: Clay False
End Cap True
Absorbtion Fields: Total Length True 120 ft
Septic system field above flood plain False
Foundation to Tank True 10 ft
Engineer Report and As-Built False please provide engineer asbuilt
Sump pump not connected to septic system False
Water shut off activates at 90% full False
Location of system on property True right rear of home, looking at home from street
Inlet & Outlet manholes 12"+ below grade True
Septic tanks & pump station anchored in flood zone False
Water softener not connected to septic system False
Type of Water: Municipal / Well Water True munincipal
Locations / Separations True
Depth of Trenches True 2 ft
Length of Each Trench True 40 ft
System Use Status True
Conforms as per Plot Plan True
Size of tank True 1000 gallon
Distribution box to Field / Pit True 4" sewer and drain perforated
January 18, 2024 Page 1 of 2
INSPECTION WORKSHEET (SEP-000290-2024)
Checklist Item CommentsPassed
Foundation to Absorption True 20+ ft
InletOutlet Pipes & Baffles True
Soil Type: Loam False
January 18, 2024 Page 2 of 2