933 Septic Checklist 2013 733 Xigs " e, h„/ ,P • S/6%3 40proa'i
Checklist for Septic System Plan Review
g. Application page attached to plan
PE or RS stamp,date, signature
Variances to property line setback distances must have Surveyor stamp
Legal boundaries noted
Easements noted
j} Dwellings and buildings existing or proposed noted
Location of driveway or parking areas, other impervious areas
;4` Location and dimensions of reserve area(new construction only)
(s System design calculations
?— Garbage grinder,yes or no
/, Benchmark not disturbed during construction within 75ft of facility
North arrow
Contours
7t- Deep hole location(s)and data
Perc hole location(s)and data
Elevations
Names 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 100ft of system in case of private wells(50ft from tank)
Well statement, if applicable'
Location of any surface waters, rivers,vegetated wetlands
/4X, Location of water lines and other subsurface utilities
Aci Obserrved and adjusted groundwater elevations in vicinity of system
Profile of system
Locus plan to show location of facility, including nearest street
X of construction and specs for system
Gas baffle
g Pipe in center line of tank
4 Double-washed stone
X Schedule 40 PVC for trafficked areas,house to tank
ff Distances noted from house to tank, etc.
❑ If dosing is proposed, design and specs of dosing system phq
❑ When alternative technology is required,complete plan and specs including hydraulic profile
RTrenches preferred over beds
X Buoyancy calculations for tanks or components partly below groundwater level --tta0.9
3:1 slope outside of mound,toe ending 5ft from property line U
Local upgrade requests on the plan,all variances ` n -P roJ�
XLocal upgrade forms attached to the application j /Yf
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