1253 Septic Checklists 2013 /;55 1 kso49/6ti.:PJ 2 k/us wi 747/3
Checklist for Septic System Plan Review
Application page attached to plan
PE or RS stamp, date,signature
❑ Variances to property line setback distances must have Surveyor stamp
❑ Legal boundaries noted
O Easements noted -
0 Dwellings and buildings existing or proposed noted
O Location of driveway or parking areas,other impervious areas
O Location and dimensions of reserve area(new construction only)
O System design calculations
❑ Garbage grinder,yes or no
❑ Benchmark not disturbed during construction within 75ft of facility
❑ North arrow
❑ Contours
O Deep hole location(s)and data
❑ Perc hole location(s)and data
O Elevations
❑ Names of approving authority and soil evaluator
o 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 weak(50ft from tank)
C Well statement, if applicable-
O Location of any surface waters,rivers,vegetated wetlands
❑ Location of water lines and other subsurface utilities
O Obserrved and adjusted groundwater elevations in vicinity of system
❑ Profile of system
O Locus plan to show location of facility, including nearest street
O Materials of construction and specs for system
❑ Gas baffle
O Pipe in center line of tank
❑ Double-washed stone
❑ Schedule 40 PVC for trafficked areas, house to tank
O Distances noted from house to tank, etc.
O If dosing is proposed, design and specs of dosing system
❑ When alternative technology is required,complete plan and specs including hydraulic profile
O Trenches preferred over beds
❑ Buoyancy calculations for tanks or components partly below groundwater level
❑ 3:1 slope outside of mound,toe ending 5ft from property line
O Local upgrade requests on the plan, all variances
C Local upgrade forms attached to the application
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Septic System Installation Checklist
B. Application Checklist (cont.)
c) Distribution Box(310 CMR 15.232)
All outlet pipes at same elevation
Number of outlets
Per plan
Inlet tee min. r over outlet
D box set on level base
Top of 0 box 36°max depth
D box is water-tight
D box has a minimum of 2'thick wall and
12' inside dimension
d) Pump Chamber(310 CMR 15.231)
Tank is set level
Proper volume is provided
Float elevations set per plan
Min. 2'delivery line to D box
Number of pumps:
Specified pump provided or designers
approval for equal pump
Correct pump sequence
Covers set to grade
Electrical permit provided
6'of stone beneath chamber
Chamber is water-tight
Min. 9'cover provided
Correct loading provided per plan Visual on tank
Notes:
Check by adding water
Number of laterals
Visual and w/tape
Visual
Visual and w/tape
Add water
Visual and w/level
Check plan and tank
Measure w/tape
Visual
Visual
Test
Visual
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Approved N/A Problem
per plan
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Approved N/A Problem
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System Irstallaaan Checklist 11-09.dac•data
Form Name•Pepe 3 of IS
Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist(cont)
e) Leaching Facility(310 CMR 15240)
No frozen material used including back fill Visual
No clay, tailings or stones larger than 6'for
cover material
Soil at bottom/sides of excavation matches
info on deep holes
An impervious layers removed Visual
No remaining A/B horizons Visual
Groundwater conditions match plan and
deep holes
Vented if under impervious cover per plan
(15.241)
Vent is protected from precipitation
and animal entry
Cover of a minimum of 9'over leach area
Visual/check plan
Pipe slope equal to 0.005 Check w/transit
Leach area per design(15241)
Excavation is level and at required depth Visual/check plan
Removal of 5 ft material and replacement Visual/check plan
(if in fill)
Back fill material is acceptable
Final contours correct per plan Check h plan t/"....
Surface/subsurface drainage away from
leach area
Final grade and side slopes are stable
Distribution lines are capped, vented, or
connected together
Impermeable barrier(15.255[2])
Retaining wall inspected by PE
Retaining wall is water-proofed
Retaining wall/barrier is at correct
depth/height
Approved N/A Problem
d
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System Installation Checklist 11-0s,doc•date Form Name•Pepe 4 of 8
Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist(cons)
2. Construction Inspection
a) Building Sewer(310 CMR 15222) Approved N/A Problem
All waste pipes tied into building sewer Basement check ❑ ❑ ❑
Schedule 40 PVC 4'or cast iron Verify by reading pipe ❑ ❑ ❑
Minimum slope of 0.01-0.02 Visual ❑ ❑ ❑
Pipe laid in continuous straight line Visual ❑ ❑ ❑
Pipe laid on compact, firm base Visual ❑ ❑ ❑.
Cleanouts precede all changes in Verify by visual/tape ❑ ❑ ❑
alignment/grade
Cleanout provided every 100 ft. Verify by visual/tape ❑ ❑ ❑
Bacldill material clean Visual ❑ ❑ ❑
b) Septic Tank(310 CMR 15223) Approved WA Problem
Tank is set level with 6"stone under Check with level ($, ❑ ❑
(15228)
Tank is required sizefoading per plan Verify with plan Ti ❑ ❑
Inlet and outlet are at proper location Verify with plan 'A ❑ ❑
(15 227)
Tank is water tight(15226) Test '• ❑ ❑
Outlet tees extend 6'above flow line Verify by visuaVtape M ❑ ❑
Approved filter device placed at outlet DEP list G ❑ ❑
Gas baffle installed at outlet tee Visual /I ❑ ❑
Inlet and outlet tees on center line Visual I ❑ ❑
Tank is baddilled with acceptable material Visual 'A ❑ ❑
Notes:
System installaton Checklist 11-09.doc•0ete Form Name•Page 2 of 6
•
LiCommonwealth of Massachusetts
rCity/Town of
Septic System Installation Checklist
B. Application Checklist (cont.)
f) Leaching trenches(310 CMR 15.251) Approved N/A Problem
Number of trenches: ❑ ❑ ❑
Depth of trenches: ❑ ❑ ❑
Width of trenches: ❑ ❑ ❑
Trench spacing per plan ❑ ❑ ❑
Stone is double-washed[3/4"to 114'1(15.247) ❑ ❑ ❑
g) Leaching fields (310 CMR 15.242)
Length of field:
Width afield:
Min. of 2 distribution lines
Separation distance conforms to plan
Stone is double-washed[3/4'to 11WJ(15.247)
h) Leaching Pits(310 CMR 15.253)
Number of pits:
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Depth of pits: ❑ ❑ ❑
Stone is double-washed[3/4'to 1W](15247) ❑ ❑ ❑
Each pit has min. 1 20'access cover ❑ ❑ ❑
Piping network and configuration of ❑ ❑
pits/chambers per plan El
i) Tight Tank(310 CMR 15.260)
Tank is set level with 6'stone under Visual and with level ❑ ❑ ❑
Tank is proper size per plan Visual with plan ❑ ❑ ❑
Pumping contract has been provided ❑ ❑ ❑
Covers to grade Visual ❑ ❑ ❑
A/V alarm set at 3/5 tank capacity Check floats by raising ❑ ❑ ❑
AN alarm test on separate drwit Set off alarm ❑ ❑ ❑
ayalem IrubMtion Gladdest 11de.doc•dale
Form Name•Page 5 of 6
Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist front.)
Certificate of Compliance(310 CMR 15.021)
As Built Plan Submitted
Signed by Installer
Signed by Designer
Certificate of Compliance Issued
Notes:
Date
Date
Date
Date
System Installation Checklist 1 f-09.doc•date
Form Name•Page 6 of 6