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32 Septic Checklists 2015 PROJECT NO.: 2 X1.5 - CITY/TOWN: ok= •aF.Prp,.i APPLICANT: c3g..&5 'c tcot ADDRESS: War Fa∎R, DESIGN FLOW: REVIEWED BY: 443 C�A4JNrJ gpd DATE: yL4/7O75! OK f t Legal boundaries denoted [310 CMR 15.220(4)(a)] Street, Lot,tax parcel number and lot number noted on plan [310 CMR I5.220(4)(u)] Locus Provided [310 CMR 15.2204(t)] / x Plan proper scale?(1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] /- -. 3a' Asav-tcA Easements shown [310 CMR 15.220(4)(b)] eve,->c.--- System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required [310 CMR 15.412(4)] Location of impervious surfaces (driveways,parking areas etc.) [310 CMR 15.220(4)(d)] ✓ Location all buildings existing and proposed 310 CMR 15.220(4)(c)] ✓ Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] 7" fAtiLg System Calculations [310 CMR 15.220(4)(f)] daily flow ✓ septic tank capacity(required and provided) ✓ soil absorption system(required and provided) ,C whether system designed for garbage grinder ✓ North arrow [310 CMR 15.220(4)(g)] Existing and proposed contours [310 CMR 15.220(4)(g)] ,' Location and log of deep observation holes (existing grade el. on each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h)and (i)] ✓ Location and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)0)] 7 Percolation test results match loading rate? [310 CMR 15.242] Certification statement by Soil Evaluator [310 CMR 15.220(4)(j)] erg-- Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3)and 310 CMR 15.220(4)(n)] 7, Address 5 q5 Aop ✓ ADD / tars,`fr.v ex tihcfO Ciwamrf��s? Sheet 1 of 13 Address WkTEC UNE, r.1ur 5Keu-tl Sheet 2 of 13 ovation of every water supply,public and private, [310 CMR 5.220(4)(k)] f surface water supplies and gravel packed public water supply ells within 250 feet of the proposed system location in the case f tubular public water supply wells ✓ / within 150 feet of the proposed system location in the case f private water supply wells ✓ ovation of all surface waters and wetlands located up to 100 ft. eyond setbacks listed in 310 CMR 15.211 and any catch basins >cated within 50 ft. [310 CMR 15.220(4)(1)] Vater lines and other subsurface utilities located [310 CMR 5.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[1]) ✓ Profile of system showing invert elevations of all system omponents and the bottom of the SAS [310 CMR15.220(4)(o)] ✓' !tamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2)] damp of Registered Land Surveyor(required if construction ctivities within 5 ft. of lot line) [310 CMR 15.220(3)] 'est Holes adequate (two in each of the primary and reserve finless trenches as permitted in 310 CMR 15.102(2)or as tpproved for an upgrade under LUA at 310 CMR I5.405(1)(k)] ✓ fest hole adequate to demonstrate four feet of suitable material? 310 CMR 15.103(4)] ✓ fest Holes adequate to confirm adequate groundwater separation? 310 CMR 15.103(3)] 7 3enchmark within 50-75'of system [310 CMR 15.220(4)(q)] Materials specifications noted? [various sections of 310 CMR 15.000] System components not>36" deep (unless Local Upgrade Approval or LUA requested) [310 CMR 15.405(1(b)] All system components marked with magnetic tape 15.221(12) Address WkTEC UNE, r.1ur 5Keu-tl Sheet 2 of 13 e OK? [310 CMR 15.2230)] et tee located ten inches below flow line [310 CMR 15.227(6)] diet tee 14" or 14" +5" per foot for increase ft depth [310 CMR .227(6)] ttlet tee with gas baffle or approve rte regarding installation on stable compacted base [310 CMR .228(1)] paration between inlet and outlet tees (no less than liquid pth) [310 CMR 15.227(2)] let/Outlet elevations at least 12" above high groundwater xcept as described 310 CMR 15.227(5))or permitted for grades under LUA [310 CMR I5.405(1)(k)] inimum cover 9" (Tanks buried more than 9" must have risers all openings and on the d-box) [310 CMR 15.22280) and 310 MR 15.232(3)(f)] -tree access covers (inlet and outlet must be 20" or greater)- iddle access at least 8" (by 7/07) [310 CMR 15.228(2)] ccess to within 6 " of grade - one port for systems<1000gpd, vo for systems>1000 gpd [310 CMR 15.228(2)] 11 at-grade covers secured to unauthorized access? [310 CMR 5.228(2)] 10 ft from building foundation [310 CMR 15.211(1)] uoyancy calculation Required/Done [310 CMR 15.221(8)] [-20 Where appropriate? [310 CMR 15.226(3)] etbacks from resources [310 CMR 15.211] t ter 310 CMR 15.227(4)] ✓ V V I required when other than single-family dwelling or flow>1000 pd [310 CMR 15.223(0(b)] irst compartment 200%daily flow; Second compartment 100% Laity flow [310 CMR 15.224(2)and(3)] U" pipe through or over baffle,outlet of each compartment with as baffle or approved filter[310 CMR 15.224(4)] t/ Address Sheet 3 of 13 table compacted base [310 CMR 15.221(2) and 310 CMR 5.232(2)(a)] plash plate or baffle tee required on inlet/provided? (when ressure sewer to d-box or steep pitch of gravity sewer) [310 :MR 15.323(3)(a)] riser if deeper than 9" [310 CMR 15.232(3)(f)] )side minimum dimension 12" [310 CMR 15.232(2)(6)] Minimum sump 6" [310 CMR15.232(3)(e)] Vatertight cover if<2000gpd); waterproof manhole if>2000gpd 310 CMR 15.232(3)(d)] Japacity(emergency storage above working design flow)? [310 :MR 231(2)] ?roper setbacks [310 CMR 15.211 (same as septic tanks)] Watertight 20-in minium access manhole at least 20" MUST BE ro GRADE [310 CMR 15.231(5)] Service components accessible(not too deep with piping, disconnects accessible) Alarm floats- alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6)and(8)] Address Sheet 4 of 13 rated at least ten feet from any water line? [310 CMR 222(2)] ,y,/\ sposal piping at least 18" below water line(when water and ver cross, see 310 CMR 15.211(1)[1]) required/provided? [310 CMR 15.222(8)] ✓ .tanouts rust blocks specified in force mains?310 CMR I5.221(6)(c)] vi Jpe of sewer line not less than 0.01 (1/8"/fr) 0.02 preferable 10 CMR 15.222(6)] oper pitch on all runs? (.005 within gravity-distributed trenches d beds) [310 CMR 15.251(9)and 310 CMR 15.252(2)(c)] ✓ phon problem/(leachfield below pump chamber) / idcaps or vent manifold specified? N/ ze and orientation of discharge holes specified? (not smaller an 3/8" not larger than 5/8") [310 CMR 15.251(8)and 310 MR 15.252(2)(h)] ✓ l [aterials specified (310 CMR 15.251(5) specifies various pipe nes allowed) �/ table compacted base [310 CMR 15.221(2) and 310 CMR 5.232(2)(a)] plash plate or baffle tee required on inlet/provided? (when ressure sewer to d-box or steep pitch of gravity sewer) [310 :MR 15.323(3)(a)] riser if deeper than 9" [310 CMR 15.232(3)(f)] )side minimum dimension 12" [310 CMR 15.232(2)(6)] Minimum sump 6" [310 CMR15.232(3)(e)] Vatertight cover if<2000gpd); waterproof manhole if>2000gpd 310 CMR 15.232(3)(d)] Japacity(emergency storage above working design flow)? [310 :MR 231(2)] ?roper setbacks [310 CMR 15.211 (same as septic tanks)] Watertight 20-in minium access manhole at least 20" MUST BE ro GRADE [310 CMR 15.231(5)] Service components accessible(not too deep with piping, disconnects accessible) Alarm floats- alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6)and(8)] Address Sheet 4 of 13 kddress Sheet 5 of 13 We Compacted Base[310 CMR 15.221(2)] oyancy calculations needed?Provided? [310 CMR 15.221(8)] sing chamber capacity(required and provided),pump curves 1 specifications,number of dosing cycles and depth per cycle? 0 CMR 15.220(4)(r)] I luent tee filter provided? [310 CMR 15.231(10)] kddress Sheet 5 of 13 lculations correct? eet of naturally occurring material demonstrated? [310 CMR .240(1)] quired separation to groundwater? [310 CMR 15.212)] ;gregate specified as double washed [310 CMR 15.247(2)] stem Venting required/provided? (system under driveway or 6" deep) [310 CMR 15.241] ;pection ports specified and within 3"final grade? [310 CMR .240(13)] eakout requirements met? (No violation of breakout elevation thin 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and ridance Document] iambers and Gal. in trench configuration supplied with inle try 20 ft. [310 CMR 15.253(6)] ich structure with one inspection manhole (if>2000 gpd must to grade) [310 CMR 15.253(2)] ggregate 1' minimum-4'maximum. [310 CMR 15.253(1)(b)] sidewall credit maximum [310 CMR 15.253(1)(a)] i bed configuration, inlet every 40 sq. ft. [310 CMR 15.253(6)] Tidth 2'minimum 3' maximum [310 CMR 15.251(1)(6)] DO feet-maximum length [310 CMR 15.251(1)(a)] linimum separation 2x effective depth or width whichever t mate• -serve between trenches) [310 CMR 251(1)(d)] 9 ituated a ong contours [310 CMR 15.251(2)] ireakout OK? [310 CMR 15.211(1)[4] and Guidance Document] Minimum 2 distribution lines [310 CMR 15.252(2)(a)] ilaximum separation between lines 6' [310 CM R15.252(2)(d)] ataximum separation between lines and outside of bed 4' [310 :MR 15.252(2)(e)] kggregate depth below discharge pipes 6" minimum, 12" naximum. [310 CMR 15.252(2)(g)] separation between beds 10'minimum. [310 CMR 15.252(2)(0] 3ottom area used in calculations only [310 CMR 15.252(2)0)] Sheet 6 of 13 Address assure Dosed System ? Provided pump and piping zulations as required [310 CMR 15.220(4)(r)] ,undwater Separation Per 310 CMR 15.240(12) does the undwater separation take into account mounding. ssure dosing required on all systems>2000gpd or alternative tems under remedial approval [310 CMR 15.254(2) and 1/A medial Use Approvals] rsed in gravelless system-make sure jet is directed as not to mr soil interface[Guidance Document] once per year(systems<2000 gpd)or quarterly ?000gpd)good to note on plan [310 CMR 15.254(2)(d)] ?nstruction in fill - Did the plan specify that the fill shall meet specification of 310 CMR 15255(3)? fl i.L FWLr15 ri 772— pervious barrier and/or retaining wall ? [Guidance Document] Impervious barrier installation must be supervised by signer [310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional igineer [310 CMR 15.255(2)(a)] Side slope not exceed 3:1 ? [310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2)and uidance Document] At least 5 ft. from impervious barrier to edge of SAS (10 ft. commended) [310 CMR 15.255 (2)(e)] Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge • scour soil interface Was DEP Approval Letter provided and/or have you ;viewed the letter for conditions? Is the technology being properly applied and does it meet all /EP Approval Conditions? Is there a note on the plan regarding the requirement for perpetual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? agreement? Are the variances listed on the plan? [310 CMR 15.220 4)(p)] kddress • Sheet 7 of 13 Wdress Sheet 8 of 13 RLS Stamp necessary on plan if a component is within five t of property line [310 CMR 15.412(4)] New construction or increased flow proposed- [Refer to 310 1R 15.4141 Wdress Sheet 8 of 13 he system in a Designated Nitrogen Sensitive Area(Zone II for ublic supply well)? [310 CMR 15.214, 310 CMR 15.215 and CMR 15.216 - also refer to Policy regarding upgrades of such sting systems] he system proposed on the same lot as served by private well ? 0 CMR 15.214(2)] the nitrogen loads proposed in compliance? [310 CMR 216(1)] mping to septic tank? [ 310 CMR 15.229] ared System [310 CMR 15.290] address Sheet 9 of 13 Commonwealth of Massachusetts City/Town of Septic System Installation Checklist B. Application Checklist(cont.) 2 Construction Inspection a) Building Sewer(310 CMR 15.222) All waste pipes bed into building sewer Schedule 40 PVC 4'cc cast iron Minimum slope of 0.01-0.02 Pipe laid in contiron"c straight Me Pipe ltd on compact, firm base Cleanouts precede all changes in alignment/grade Cleanout provided every 100 ft Baddill material dean b) Septic Tank (310 CMR 15223) Tank is set lval with 6'stone under (15 228) Tank is required size/loading per plan Inlet and outlet we at proper location (15.227) Tank is water tight(15.226) Outlet tees extend 6'above flow ire Approved filter device placed at outlet Gas bawl installed at outlet tea Inlet and outlet tees on wrier lira Approved Basement check Verify by reading pipe .l>d Visual L_i" Visual rL__N/// Visual L" Verify by visuavtape Verify by visual/tape Visual LS Check wth level Verify with plan Verify with plan Test Verify by DEP list Visual Visual Tank is badMNed with axeptab1e material Visuall 'emu g N/A U ❑ ❑ Problem ❑ ❑ ❑ Approved N/A Problem LLJ,"/ ❑ ❑ L� ❑ ❑ Cr ❑ ❑ ❑ ❑ suautape CY ❑ ❑ Er ❑ ❑ Ritt L✓ ❑ ❑ ❑ ❑ d ❑ ❑ e System InbMeon Cheops't t.oe.aec•St. Form Norm•Per 2 of 6 Commonwealth of Massachusetts City/Town of Septic System Installation Checklist B.Application Checklist(cont) c) Distribution Box(310 CMR 15.232) Approved N/A Problem AP outlet pipes at same elevation Check by adding water E9 ['. ❑ Number of outlets Pwn Number of laterals Inlet tee ma r over outlet Visual and whape D box set on level base Visual Top of D box 37 max depth Visual and w/tape D box is water-tight Add water D box has a minimum of Y thick wall and tY inside dimension d) Pump Chamber(310 CMR 15.231) Approved _N/AA Problem Tank is set level \C and w/level 17� ❑ Proper volume is provided Check plan and tank //❑" ❑ Per Pia C� ❑ ❑ L�l ❑ ❑ 31/ ❑ ❑ Cif ❑ ❑ C� C ❑ Float elevations sat per plan Measure whop, jj) ❑ ❑ t Mm. 2•delivery line to D box Visual El ❑ Number of pumps. .__ __ ❑ El Specified pump provided or designers ❑ ❑ approval to equal pump 44 Correct pump sequence 4 fj9 ❑ ❑ Covers set to grade U ❑ ❑ Electrical Pamir provided `❑ ❑ ❑ G of stone beneath chamber Visual ❑ p Chamber is water-fight Test I❑ ❑ ❑ i Min. 9'cover provided Visual I, ❑ ❑ � Correct loading provided per plan Visual on tank "L JO ❑ ❑ Notes: lc Symbol CheceYN 11-0 .*.c•dot Farm Nana•Poe 3 of A Commonwealth of Massachusetts City/Town of Septic System Installation Checklist B. Application Checklist(cont.) e) Leaching Facility(310 CMR 15.240) 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'lisp holes All impervious payers removed Visual , / ❑ ❑ No remaining NB horizons Visual L�' ❑ Groundwater conditions match plan and Visual!•''= plan ❑ ❑ deep holes Vented if under impervious cover per plan ❑ ❑ (15241) Vent Vera is protected from preupnatan ❑ ❑ and animal entry N/A Problem ❑ ❑ 1G/ ❑ ❑ L ❑ ❑ Cover of a minimum of 9•over leach area Pipe slope equal to 0.005 Check w/Vansit (��.,//' ❑ ❑ Leach area per design(15241) L�1// ❑ ❑ Excavation is level and at required dap' !=' - plan L1 ❑ ❑ Removal of 5 ft material and replacement,1r plan (J ❑ ❑ (a in fill) Back fill material is acceptable Visual ❑ ❑ ^ry❑" V/ ❑ ❑ y0 0 ❑ l /❑ ❑ ❑ ❑ ❑ Retaining wall inspected by PE ❑ ❑ ❑ Final contours correct per Man Surfacrsubsuface drainage away from leach area Fined grade and side stapes are stable Distribution fines we upped, vented, or connected together Ihpem»able barrier(15.255[2)) Check with plan Retaining wall is water-proofed Retaining walUbarrier is at correct dot b System kNYlsfen Choldie 11-09.doc•dog Form Name•peps 4 of s Commonwealth of Massachusetts City/Town of / "4, 3a G: foci Pr, Lfc Septic System Installation Checklist B. Application Checklist(cons) f) Leaching benches(310 CMR 15251) Approv NIA Problem Number of trenches: — ❑ ❑ Depth of trendies: k`3 NFdth of trenches: r'-. ❑ ❑ Trench spaang par plan [k" ❑ Stone is double-trashed[3/4'to 1W1(15.247) l' U g) Leaching fields(310 CMR 15.242) nay (a.r) ❑ ❑ Length of field: r Width of field. 53' u ❑ Min. of 2 distribution lines ❑ ❑ Separation distance conforms to plan [F ❑ ❑ Stone is double-washed(314'to 1%1(15.247) ❑ ❑ h) Leaching Pits(310 CMR 15.253) Number of pits. _.- . ______ ❑ Depth of pits: ❑ Stone is doublrwaahW(314'to 1W (15.247) ❑ Each pit has min 1 20'access cover le ❑ Piping network and configuration of ❑ prhltlwrtten per plan 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 contact has been provided ❑ Covers to grade Visual ❑ AN alarm set at 315 tat capacity Check floats by raising ❑ . AN alarm test on separate emit Set off alarm ❑ Form rww•v.r s as System tmeHaaw•pedal I late•dy• Commonwealth of Massachusetts City/Town of Septic System Installation Checklist B.Application Checklist(cont) j) Certificate of Compliance(310 CMR 15.021) As Built Plan Submitted Signed by Installer Signed by Designer Certdicate of Compliance Issued Notes Dse Dee; Date — /'h i rv:17sew el Dy r�y�J� Env - psi. 7 fin__ P 5, I k System hmlablee CMSfs 1 1-0t doe•rime Form M mrm•pogo 6 of 6 O (0 y ark HO° SITE avwa` Dr a c y o N 4m utun Dr ° A j Autumn. Dc al PROJECT LOCUS FOR 32 FAIRWAY DRIVE FLORENCE, MA