35 Septic System Checklist 2014 WiCiamJ. Sieruta, P.E.
18(Depot Weal
Geverett, WA. 01054
413-627-7244
413-549-1817
City Hall Annex
Board of Health
Main Street
Northampton,MA.01060
August 19,2014
Subject: As built inspection
Ron Birrell
35 West Farms Road
Northampton,MA.
An as built inspection was completed for the subject septic system. This system is in compliance with
310 CMR 15.0 and local board of health regulations.
If you have any questions or need any additional information,please do not hesitate to contact me.
illiam J.Sieruta, P
2cc Ron Birrell
Skim k
Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist (cont)
2 Construction Inspection
a) Budding Sewer(310 CMR 15.222)
35 412es-E FwMS �i
Approved N/A Problem
All waste pipes tied Into building sewer Basement cnecx G L; 5
Schedule 40 PVC 4' or cast iron Verify by reading ppe ; U
Minimum slope of 001-0.02 Visual / I U
Pipe laid in continuous straight line Visual ;/% a
Pipe laid on compact. firm base Visual 6+' U
Cleanouts precede all changes in Vent by visual/tape ;�.
alignment/grade Y Y ps :J
Cleanout provided every 100 ft Verify by■rsual/tape :i/ U ❑
Backfdi material clean Visual l� - ' ' U
b) Septic Tank(310 CMR 15.2231 Approved N/A Problem
Tank is set level with 6'stone under Check with level _r:
U
(15.228) V Tank is required size/loading per plan Verify with plan L✓J "
Inlet and outlet are at proper location
Verify with plan (—� C
(15 227) ,.'/
Tank rs water tight(15 226) Test �y' ❑ U!
Outlet tees extend 6' above flow Me Verify by vrsual/tape V S U
Approved filter device placed at outlet DEP list [ U LI
Gas baffle installed at outlet tee Visual [r. U U
Inlet and outlet tees on center lire Visual Lar u U
U Er
Tank is baciSed with acceptable material Visual
Notes
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Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist (cont.)
Ci Distribution Box (310 CMR 15 232, Approved NIA Problem
AD outlet pipes at same elevation 1 Check by adding water _ ❑
Number of outlets ®w ` (2`/ Number of laterals o? - ---------- __..____
Per plan
Inlet tee min. 1'over outlet Visual and w/tape ❑
D box sat on level base V-sual '�-
Top of 0 box 36• max depth Visual and w/tape .�� i U
D box is water-tight Adtl water ._ ❑
D box has ammimum of 2'tnick wall and ❑ • ❑
12'inside dimension
d) Pump Chamber(310 CMR 15 231) Approved N/A Problem
Tank is sat level Visual and w/level L
Proper volume is provided Check plan and tank ._.
Float eievatwns set per plan Measure w/tape 'u ❑
Min. 2'delivery line to D box Visual ❑ ❑ ❑'
Number of pumps. _ ._--.. . _. ❑ ❑ ❑
Specified pump provided or designers r; ❑ `j
approval for squat pump
Correa pump sequence ❑ ❑ ❑
Covers set to grade ❑ ❑ ❑
Electrical permit provided ❑ ❑ ❑
6' of stone beneath chamber Visual ❑ ❑ ❑
Chamber is water-tight Test El ❑ ❑
Min. 9' cover provided Visual ❑ ❑ ❑
Correct loading provided per plan Visual on tank _J LI 0
Notes
Apse spram trwbYtlen Chet i 11-09 doc•dare
Form Name•Page 3 or 6
Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist (coot)
e) Leaching Facility (310 CMR 15 240; Approved NSA Problem
No frozen material used including back hli Visua IIG — ❑
No clay, tailings or stones larger than 6' for t< ,, ,❑
cover material
Soil at bottomisides of excavation matches fT/' 'E E info on deep holes Y�F�
Al] Impervious sayers removed Visual
No remaining A/B horizons Visl.al (G ❑
Groundwater conditions match plan and Visual/check plan 'i i ❑
deep holes
Vented if under impervious cover per Plan r ❑
(15241)
Vent is protected from preciptation J
and animal entry /
Cover of a minimum of r over leach area Y,,� ❑ ❑
Pipe slope equal to 0 005 Cheri:w/transit
Li rn
Leach area per design(15241) try ❑ ❑
Excavation is level and at required depth Visual/check plan iR J
E
Removal of 5 ft matenal and replacement Visual/check plan J E
(din fill) -�
Bade fill material is acceptable Visual ❑ :J
Final contours correct per plan Chem with plan � / M
Surface/subsurface drainage away from J ❑ r-I
leads area ,-J./' LJ
Final grade and side slopes are stable re ."' ❑ ❑
Distribution lines are capped, vented, or ❑
connected together
Impermeable barer(15 255[2]) 0 ❑
Retaining wall inspected by PE ❑ ❑ ❑
Retaining wall is water-proofed ❑ ❑ ❑
Retaining wall/barrier Is at correct (J C{ ❑
depttllheight
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Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist(cont)
f) Leaching trenches (310 CMR 15 251'.
Number of trenches.
Depth of trenches
Wdth of trenches
Trench spacng per pan
Stone Is double-washed(314' to 1151 5247)
g) Leaching fields (310 CMR 15 242) /
Length M field: fe(_.PL __
Wdth of field. -. ..._.
Min. of 2 distribution lines 2 /rNr 5
Separation distance conforms to pan
Stone is clouds-washed(3/4' to 1%1 (15.247)
h) Leaching Pits(310 CMR 15.253)
Number of pits. _ -.. -_-.. u' ❑
Depth of pits: C ❑ ❑
Approved N/A Problem
Stone is double-washed[3/4'to 1)51](15.247) ❑ ❑ ❑
Each pit has min. 1 20' access cover ❑ ❑ ❑
Piping network and configuration of `! ❑
pits/chambers per plan
i) Tight Tank(310 CMR 15.260)
Tank Is set level with 6' stone unoer Visual and with level ❑ i--)❑
Tank is proper size per plan Visual with plan `i ❑
pr
Pumping contract has been provided ❑ L1 0
Covers to grade Visual r-• r' ❑
AN alarm set at 3/5 tank capaoty Check!bats by raising ❑ ❑ ❑
AN alarm test on separate arcupt Set off alarm ❑ L 1 ❑
'no Spero InblYaen Quote!11 DBdoc•date Form Nome•Page 5 or 6
•
Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist (cant)
j; Certificate of Compliance (310 CMR IS C21
As Built Plan Submitted
Signed by Installer
Signed by Designer
Cart thcate of Compliance Issued
Notes
Dale�ab�i_ M II; LI_S
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Date
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Checklist for Septic System Plan Review
placation page attached to plan
7 for RS stamp, pete, signature � A ,/ �
,/ riances to property line setback distances must have Surveyor stamp �5 �,S / �r/f �
,regal boundaries noted
Easements noted p//�,p�� ,J/
wellings and buildings existing or proposed noted '/�/4✓�u
!t oration of driveway or parking areas,other impervious areas
Trpry,cation and dimensions of reserve area(new construction only)
ustem design calculations
ge grinder, yeses
chmark not disturbed during construction within 75ft of facility
North arrow ®�/
1'--fontours 'S
re Deep hole location(s) and data
;Ape hole location(s) and data
Y/Elevations
fV Na es of approving authority and soil evaluator
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 250ft of system in case of tubular public water supply
o Within IOOft of system in case of private wells(50ft from tank)
Well statement, if applicable
/ Location of any surface waters, rivers,vegetated wetlands
T.//Location of water lines and other subsurface utilities
7/ QSserrved and adjusted groundwater elevations in vicinity of system
He of system
✓ Locus plan to show location of facility, including nearest street
/T.� Materials of co,n/struction and specs for system
a//Gds ba uric,.
- ips.in center line of tank
t---Double-washed stone
i?,fst chile 40 PVC for trafficked areas, house to tank
histances noted from house to tank, etc.
4sing is proposed,design and specs of dosing systemfrAL
e1iW alternative technology is required, complete plan and specs including hydraulic profile
- Trenches preferred over beds A"//42/ R ncy calculations for tanks or components partly below groundwater level
:i slope outside of mound,toe ending 5ft from property line
/1 Local upgrade requests on the plan, all variances
L. Loyd upgrade forms attached to the application