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288 Septic System Checklist 2012 8 10,P;i465 1206,A Commonwealth of Massachusetts City/Town of c�6C� ,q' Septic System Installation Checklist (Di k 8. Application Checklist (cont) 2 Construction Inspection a) Building Sewer(310 CMR 15 222) Ail waste pipes tied into building sewer Basement check Schedule 40 PVC 4' or cast iron rl ❑ Minimum slope of 0 01-0 02 Visual i� Pipe laid in continuous straight line Visual L/' Approved N/A Problem Verify by reading ppe fCi S C Pipe laid on compact, firm base Visual [j/ ❑ J Cleanouts Precede all changes in /� alignmenUgrade Verify by visualltape ❑ Cleanout provided every 100 ft Verify by visual/tape Er. ❑ ❑ Bail material dean Visual Li7 ❑ ❑ b) Septic Tank(310 CMR 15.223) Approved WA Problem Tank is set level with 6'stone under - ' (15228) Check with level LJ 0 U Tank is required size/loading per plan Verify with plan D . 0 0 Inlet and outlet we at proper location (15.22n Verify with plan i�/ I U Tank is water tight(15.226) Test Lyj/ ❑ n u Outlet tees extend 6'above flow line Verify by visual/tape ,} ❑ ❑ Approved filter device placed at outlet DEP list [j— U' ❑ Gas baffle installed at outlet tee Visual [r- ❑ Inlet and outlet tees on center line Visual ❑ ❑ Tank is baddiUed with acceptable material Visual 04-- ❑ ❑ Notes —Pit.pr_e,ueti S.sin Ine*Myon Checklist 11-0s.6x•date Fwm Pain. Ppr 2 of 6 Commonwealth of Massachusetts City/Town of Septic System Installation Checklist B. Application Checklist (cont.) c) Distnbution Box(310 GMR 15.232) Approved NIA Problem All outlet pipes at same elevation Check by adding water V ❑ Number cif outlets Leafarli Number of laterals F,-,plan 2 Inlet tee min. 1'over outlet Visual and w/tape - ❑ ❑ _40'..< D box set on level base Visual u Top of 0 box 36' max depth Visual and wltape L L ❑ D box is water-tight Add water g-'' ❑ ❑ D box has a minimum of 2'thick wall and ©- `1 17 inside dimension d) Pump Chamber(310 CMR 15.2231) Approved N/A Problem Tank is set level Visual and w/level U X ❑ Proper volume is provided Check plan and tank ❑ Float elevations set per plan Measure w/lape E❑ ❑ ❑ Min. T delivery ho.to D box Visual ❑ ❑ ❑ Number of pumps. _....._ ___ ❑ ❑' ❑ Specified pump provided or designers ❑ ❑ ❑ approve/for equal purr Correct pump sequence ❑ ❑ ❑ Covers set to grade Electrical permit provided 6' of stone beneath chamber Visual ❑ ❑ ❑ Chamber is water-tight Test ❑ ❑ ❑ Min. 9' cover provided Visual ❑ ❑' ❑ Correct loading provided per plan Visual on tank ❑ 'n ❑ Notes ❑ ❑ ❑ ❑ ❑ ❑ plc System nMM. on Check it-01i.Suc•Site Fonn Name•Page 3 of 8 Commonwealth of Massachusetts City/Town of Septic System Installation Checklist B. Application Checklist(cont) el Leaching Facility (310 CMR 15.240) No frozen material used including back fill Visua. No clay, tailings or stones larger than 6' for cover material Soil at bottorresides of excavation matches info on deep holes All impervious'eyers removed Visual No remaining A/B horizons Visual Groundwater conditions match plan and deep holes Vented d under impervious cover per plan (15.241) Vent is protected from prectptanon and animal entry Cover of a minimum of Sr over leacn area Pipe slope equal to 0 005 Leach area per design(15241) Excavation is level and at required depth Removal of 5 ft matenal and replacement Of in fill) Back fill material is acceptaole Final contours boned per plan Surface/kite(face drainage away from leach area Final grade and side slopes am stable Distribution lines are capped, vented,or connected together Impermeable banner(15.255(21) Retaining wall inspected by PE Retaining wall is water-proofed Retaining walVbamer is at correct depth/height lac Syatem klatsbbn Che d iat 1149 doc•data VisuaVCherk plan Check wNansit Visual/check plan VisuaYcheck plan Visual Check with plan Approved N!A Problem Eirt L/ ❑ ❑ ry J ❑ ❑ T ❑ D LY ❑ L.11 JX ❑ ❑ QV GY ❑ ❑ • ❑ ❑ yY ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Fan,Name•Page 4 of 6 Commonwealth of Massachusetts City/Town of Septic System Installation Checklist B. Application Checklist(cant) f) Leaching trenches(31 C CMR 15251 Approved NIA Problem Number of trenches. -- - -- _-- ❑ Depth of trenches. - __ _ - _. . . L ❑ Width of trenches Trench spaang per plan Stone is double-washed[3/4'to lX'] I15.247j C u u g) Leaching fields (310 CMR 15.242) Length of field: - - _... _._.__ ❑ f',, ❑ Width of field. ___ .._—._.__. C C ❑ Min. of 2 distribution lines ❑ ❑ ❑ Separation distance conforms to plan u ❑ LL Stone is double-washed p14•to 11411 (15.247) C ❑ C h) Leaching Pits(310 CMR 16253) Number of pits. / U ❑ Depth of pits. ----- ---- r / ❑ ❑ Stone is double-washed[3/4'to 1:S1(15 247) ❑ ❑ Each pit has min. 1 20' access cover 1?,,,/ ❑ ❑ Piping network and configuration of [1 ❑ ❑ pitsldtetnbers per Wan i) Tight Tank(310 CMR 15.260) Tank is set level with 6' stone under Visual and worth level ❑ ❑ ❑ Tank ie proper size per Wan Visual with plan LI ❑ ❑ • Pumping contract has been provided ❑ ❑ ❑ U ❑ r Covers to grade visual ❑ ❑ ❑ AN alarm set at 315 tank capacity Check floats by raising ❑ ❑ . M/alarm test on separate arcuit Set off alarm ❑ 5 ❑ to Sprs Installation Checklist 11-09.doc•dab Form Mane•Psgs 5 of 6 Commonwealth of Massachusetts City/Town of Septic System Installation Checklist B. Application Checklist(cont) 11 Certificate of Compliance(310 CMR 15.0211 As Built Plan Submitted Signed by Installer Signed by Designer Cedtficate of Compliant Issued Notes: Date Date Date c System Inbtaan Checklist II-00 doc•date Form Name•Page 6 of 6 gAo/i PAS, ,o/V /2 Checklist for Septic System Plan Review o`er 4)5 74. /C,//A S /Application page attached to plan OE or RS stamp,date,signature te Variances to property line setback distances must have Surveyor stamp V� �Legal boundaries noted fr�, E��ssements noted V u ings and buildings existing or proposed noted • Location of driveway or parking areas,other impervious areas (a/ cation and dimensions of reserve area (new construction only) design calculations �rbage grinder,yes B chmark not disturbed during construction within 75ft of facility /�yerth arrow // E" Contours d'S �peep hole location(s)and data ,J,J Perc hole location(s)and data / 4 t 72/,/SO.✓ Elevations O! / mes of approving authority and soil evaluator 1y Location of water supplies, public and private o Within 400ft of system in case of surface water and gravel-packed public water supply o Within 250k of system in case of tubular public water supply o Within SOOft of system in case of private wells(50ft from tank) j',/Gtell statement, if applicable- :e —Location of any surface waters, rivers,vegetated wetlands ation of water fines and other subsurface utilities 0/0bserrved and adjusted groundwater elevations in vicinity of system • rofile of system • Locus plan to show location of facility, including nearest street W Materials of construction and specs for system e Gas baffle 661 iPipe in center line of tank c2/15-o-uble-washed stone Schedule 40 PVC for trafficked areas, house to tank Distances noted from house to tank, etc. ` `D sing is proposed, design and specs of dosing system When n alternative technology is required,complete plan and spe/,c including hydraulic profile 5 tratC/( tee 4,...,4 ❑ Buoyancy calculations for tanks or components partly below gro ndwater level ❑ 3:1 slope outside of mound, toe ending 5ft from property line ❑ Local upgrade requests on the plan, all variances ❑ Local upgrade forms attached to the application Jenlu 1_ c