HomeMy WebLinkAbout319 Griffin Road (3) I+7NAL INSPECTION ELEVATIONS
PROPERTY LOCATION: S/�? /9:P TOWN: S!iJ
i _-.) H'T.LE#
SANITARIAN: :]2 /thvL L� DATE: 3 3
LEVEL TO BENCHMARK _
BENCHMARK HLEVATION
HEIGHT OF LEVEL
ROD READINGS TOP OF PIPE DISTANCE TO INVERT INVERT ELEVATION
(Top of pipe&diameter of i e
SEWER LINE AT FOUNDATION
SEPTIC TANK INLET
SEPTIC TANK OUTLET
PUMFIQ TRAP INLET
I JWIGRWM TRAP OU MUT
D-BOX#1 INLET
FLOWLINE RIGHT
FLOWLINE LEFT '
OUTLET
D-BOX#2 INLET
FLOWLINE RIGHT
FLOWLINE LEFT
OUTLET
WBOX#3 INLET
FLOWLINE RIGHT z _
FLOWLINE LEFT
OUTLET
TRENCH#I
RIGHT
LEFT 3 , o�
TRENCH#Z i
RIGHT
LEFT
TRENCH#3
RIGHT
LEFT
INVERT ELEVATION=Top of Pipe+Diameter of Pape—Height of Level
HEIGHT OF LEVEL=Benchmark+Rod Reading
Reference:
PROPERTV LOCATION:. 31 f loR-r Ah TOWN: � L�
BOTTOM OIL EXCAVATION: ST,q r DATE: 3 3 I%TlAL
FERCULATION TEST "FILL C1IEC 0: DATE: IldI'1"IAL
DEPTH HOLE# DEPTH HOLE#
READING TIME READING
PBRC PERC
FWAL INSPECTION:SANITARIAN //Z, DATE:
1. SEWER LINE:
A. SBWER LINE CEMENTED AT k OUNDATIOIJ#�N) ................PIPE LENUI H /y
B. PITCH(.25 inches per foot min)REQUBED_- FT................PROVIDED _-- FT
D. PIPE TYPE&ASTM SPEC.—-
.................................PIPE SIZE(INCHES)
2. SEPTIC TANK:
A. MANUFACTURER. /Z(C- dam_. DATE WD / 5- / ' SIZE. 10410 GALLONS
B. TANK COMPARTMENTS PLACED PROPERLY(YIN).... .....................................
C. INLET BAFFLE(not in middle of opening)...........019SERVATION OPENING(s removal)
D. OUTLET BAFFLE FILTER TYPBO� /��� cli c,�.E S��RISERS NEEDED(Y/1�OPENING
E. TYPE OF PIPE�27 �� (approved by code)
3 puATP CIAMB GREAS`P:TRAP:
A. PUMP CHPABER MAI WACT[7RER ...SIZE GALLONS
...........P ALARM Cg KEID
C. k T CONTROL ELEVATION VERIFIED(Y/M .....TYPE OF PIPE _
D. GRI?ASE INTERCEPTOR TANK SIZE -_- GA NS........MANUFAC ^
4. D BOXES:
A. LEVEL(YM)_ SERIAL DISTRIBUTION(High loyal overflow within top 3")..... .
C. LEVEL SYSTEM(Ends tied together)(M iV
A. LENGTH OF TRENCH..........
B. GALLERIES(stona around all units).1. 2. 3. 4. 5. 6.
C. CENTER-TO-CENTER SPACING lu FILTER FABRIC PRESENT(YIN) TYPE
D. APPROVED AGGREGATE FREE U SILT DIRT&DEBRIS(YIN),
F. AGGREGATE MEETS PHC SPECIFICATIONS(YIN) 0_ F PIPE
G. LFjACHING SYSTEM DESCRIP'CION:
6. SEPARATION DISTANCES CONFORM WITH APPROVED PLAN(Y/N)
SEPARATION DISTANCES FIELD VERIFIED(Y/N) .�
PASS FAIL COMAONTS: •✓i io�t �/1 �'c o�+ �e
WELL INSPECTION: SANIT DA
WE ,LOCATION S Well Cap
REV 08/03/11 LS SEE REVERSE