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245 Septic System Checklist 2017 ;,.1\ • 0///5. 4)6i-- FZ74/5 Ee.e4 Commonwealth of Massachusetts i. -k' � ' City/Town of //7 //7 N Septic System Installation Che klist B. application Checklist (cont.) 2. Construction Inspection a) Building Sewer(310 CMR 15.222) Approved N/A Problem Ali waste pipes tied into building sewer Basement check V/ ❑ ❑ • 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 i❑_ ❑ ❑ Cleanouts precede all changes in Verify by visual/tape ❑ ❑ ❑ alignment/grade Cleanout provided every 100 ft Verify by visual/tape ❑ ❑ ❑ Backfill material clean Visual ❑ • 0 ❑ b) Septic Tank(310 CMR 15.223) Approved N/A Problem Tank is set level with 6"stone under E] ED(15.228} Check with level a/Tank is required size/loading per plan Verify with plan [V' 0 C • Inlet and outlet are at proper location �, /7 ❑ ❑ (15.227) Verify with plan �Y Tank is water tight(15.226) Test ❑ ❑ Outlet tees extend 6"above flow line Verify by visual/tape g/ El ❑ Approved filter device placed at outlet DEP list jD/ ❑ ❑ Gas baffle installed at outlet tee Visual Q/ 0 ❑ Inlet and outlet tees on center line Visual L41 0 ❑ Tank is backfilled with acceptable material Visual I ❑ ❑ Notes: ______. .p.".0._d_ ___________ _ __ ________ .__ . _________________________.____ _ _ _ _ _ . _ ......__________.. .... ... .. ....._____ _ __ __________ . _______ Septic System Installation Checklist 11-09.doc•date Form Nemo Pepe 2 of 6 ,, ,� Commonwealth of Massachusetts 01fk - City/Town of Septic System Installation Checklist B. Application Checklist (cont.) c) Distribution Box(310 CMR 15.232) Approved N/A Prcble All outlet pipes at same elevation Check by adding water 1V7r-1. ❑ Number of outlets -- --- --- ---- N per plan por pieumber of lateralsn__� ___ ._ _ Inlet tee min. 1"over outlet Visual and w/tape i ❑ ❑ 0 box set on level base Visual [ ❑ ❑ Top of D box 36" max depth Visual and w/tape E7 0 0 0 box is water-tight Add water [ r i D box has a minimum of 2" thick wall and 12"inside dimension ❑ ❑ ❑ • d) Pump Chamber(310 CMR 15.231) Approved N/A Problem Tank is set level Visual and w/level ❑ ❑ Proper volume is provided Check plan and tank 0 Float elevations set per plan Measure w/tape ❑ ❑ ❑ Min. 2" delivery line to D box Visual El 0 Number of pumps: ❑ ❑ f.J Specified pump provided or designers approval for equal pump ❑ j] ❑ Correct pump sequence 0 0 Cl Covers set to grade ❑ ❑ 0 Electrical permit provided 0 f❑ 6"of stone beneath chamber Visual 0 0 0 Chamber is water-tight Test 0 ❑ 0 Min. 9"cover provided Visual 0 ❑ ❑ Correct loading provided per plan Visual on tank 0 ❑ 0 Notes: --- Septic System Installation Checklist t 1-09.doo•date Form Name•Page 3 of 6 ,y ,� Commonwealth of Massachusetts 0 k, CityfTown of ,'y Septic System Installation Checklist B. Application Checklist (cont.) _ -- - -__ e) Leaching Facility (310 CMR 15.240) Approved N/A Proble No frozen material used including back fill Visual EZ ❑ ❑ No clay, tailings or stones larger than 6" for1S2//, ❑ ❑ cover material • Soil at bottom/sides of excavation matchesYr ❑ info on deep holes All impervious layers removed Visual LJ ❑ ❑ No remaining A/B horizons Visual Lid' ❑ 0 Groundwater conditions match plan and ,�,/ 0 0 deep holes Visual/check plan fes' Vented if under impervious cover per plan 0 0 ❑ (15.241) Vent is protected from precipitation ❑ 0 ❑ and animal entry Cover of a minimum of 9"over leach area ❑ ❑ • Pipe slope equal to 0.005 Check wltransit [] ❑ Leach area per design(15.241) 0 0 0 Excavation is level and at required depth Visual/check plan ER7[R7 0 0 Removal of 5 ft material and replacement (if in fill) Visual/check plan ❑ 0 Back fill material is acceptable Visual 0 El ❑ Final contours correct per plan -- Check with plan [Y 0 0 Su ce//ssubsurface drainage away 6.m0 [} ❑ Final grade and side slopes are stable t� 0 0 Distribution lines are capped, vented, or connected together ❑ ❑ ❑ Impermeable barrier(15.255(2)) ❑ 0 El • Retaining wall inspected by PE 0 0 0 Retaining wall is water-proofed ❑ ❑ 0 Retaining waltlbarrier is at correct depth/height ❑ ❑ ❑ Septic System Ineteastion Checklist 11-09.doc•date Form Name•Page 4 of 6 Commonwealth of Massachusetts Cityfrown of Septic System Installation Checklist B. Application Checklist (cont) j) Certificate of Compliance(310 CMR 15.021) • As Built Plan Submitted _.-__-- Date _ Signed by Installer date -- ---.- -.---_ _ __�� ___�..� _.___�_. Signed by Designer Date Certificate of Compliance Issued Date Notes: • _ 105 c I 444_ _ _______ Septic System Instatiation Checklist 11-09.doc•date Form Name•Pane 6 of 6 Commonwealth of Massachusetts ILi )11! .� City/Town of (: Septic System Installation Checklist B. Application Checklist (cont.) f) Leaching trenches(310 CMR 15.251) Approved N/A Problem Number of trenches: ❑ ❑ . u Depth of trenches: __ ._______. _ _..__ . ❑ ❑ • El Width of trenches: -- - --._...--- ❑ ❑ Trench spacing per plan 0 ❑ 0 Stone is double-washed [3/4"to 1'/")(15.247) El 0 0 g) Leaching fields (310 CMR 15.242) Length of field: ___.. ❑ ❑ ❑ Width of field: __________..... ❑ 0 0 Min. of 2 distribution lines ❑ 0 0 Separation distance conforms to plan 0 0 0 Stone is double-washed[3/4" to 1W](15.247) ❑ ❑ ❑ h) Leaching Pits(310 CMR 15.253) Number of pits: ❑ ❑ ❑ Depth of pits: ❑ ❑ Stone is double-washed[3/4`to 1W)(15.247) ❑ 0 0 Each pit has min. 1 20" access cover 0 ❑ ❑ Piping network and configuration of pits/chambers per plan ❑ 0 0 i) Tight Tank(310 CMR 15.260) Tank is set level with 6"stone under Visual and with level 0 0 0 Tank is proper size per plan Visual with plan ❑ ❑ ❑ • Pumping contract has been provided ❑ 0 ❑ Covers to grade Visual ❑ ❑ E AN alarm set at 3/5 tank capacity Check floats by raising ❑ 0 ❑ . AN alarm test on separate circuit Set off alarm ❑ Q ❑ Septic System InataYation Chectidiat 11-09.doc•date Forth Name•Page 5 of 8