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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