ChecklistReport002-20-24 124336
INSPECTION WORKSHEET
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number: SEP-0857-2021 Case Module: Permit
Inspection Date: February 01, 2024 Inspection Status: Passed
Inspector: John O'Brien Inspection Type: Septic
Job Address: 15 PARK AVE
, Parcel Number:
Contact Type Company Name Name
Granted Permission N/A
Primary Owner N/A
Engineer Wales Engineering
IBS Septic null null
Contractor IBS Septic null null
Checklist Item
Status
Building Inspector notes
PASS
Public sewer sign off
PASS
Roof gutters don't discharge over leach
field
PASS
Soil type: sand
PASS
Soil type: loam
PASS
Soil type: clay
PASS
Type of water: municipal or well water
PASS
Waterline separation distance
PASS
Well casing length 50 ft. more or less
PASS
Total length of absorption fields
PASS
Septic system field above field plain
PASS
Sump pump not connected to septic
system
PASS
Septic tanks and pump station anchored
in flood zone
PASS
Water softener not hooked to septic
system
PASS
Length of each trench
PASS
Depth of trenches
PASS
System use status
PASS
Number of seepage pits
PASS
Size
PASS
Size of stones
PASS
Distance from building to tank
PASS
Distance from tank to d-box
PASS
Distance from d-box to field or pit
PASS
Opening sealed
PASS
End cap
PASS
Inlet outlet pipes and baffles, provide
extension collar if yes
PASS
Locations and separations
PASS
Distance from foundation to tank
PASS
Distance from foundation to absorption
field
PASS
Separation of seepage pits
PASS
Stone size
PASS
Size of tank
PASS
50 percent alarm level activates
PASS
90 percent alarm level activates
PASS
Water shut off activates at 90 percent full
PASS
Final electrical
PASS
Conforms as per plot plan
PASS
Engineer report and as -built
PASS
ETU Maintenance Contract provided
PASS
Location of system on property
PASS
Well separation distance
PASS
John O'Brien
Director of Building & Codes