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244 Septic System Instal Checklist 2017 . ;,.il. • Mil' ,.4. cLi 1. Commonwealth of Massachusetts Pe.." ,•(..) B -k' " 1 City/Town of Septic System Installation Che kli t B. Application Checklist (cont.) _- 2. Construction Inspection a) Building Sewer(310 CMR 15.222) Approved N/A Proble All waste pipes tied into building sewer Basement check 374 ❑ ❑ Schedule 40 PVC 4" or cast iron Verify by reading pipe R . C C❑ Minimum slope of 0.01-0.02 Visual Li ❑ Q Pipe laid in continuous straight line Visual ❑ ❑ ❑ Pipe laid on compact, firm base Visual 0 0 0 Cleanouts precede all changes in alignment/grade Verify by visual/tape [J ❑ Cleanout provided every 100 ft. Verify by visual/tape 0 0 ❑ Backfill material clean Visual ❑ ❑ ❑ b) Septic Tank(310 CMR 15.223) Approved N/A Problem Tank is set level with 6"stone under [ (15.228} Check with level ❑ 0 Tank is required size/loading per plan Verify with plan [iL 0 0 Inlet and outlet are at proper location (15.227) Verify with plan Ee( ❑ 0 Tank is water tight(15.226) Test 4iJ' ❑ ❑ Outlet tees extend 6" above flow line Verify by visual/tape V Q 0 Approved filter device plated at outlet DEP list ❑ 0 0 Gas baffle installed at outlet tee Visual frr ❑ 0 Inlet and outlet tees on center line Visual El ❑ 0 Tank is backfilled with acceptable material Visual L 0 0 Not s: fiepOpej • Septic System lnatallation Checklist 11-09.doc•date Form Name•Papa 2 of 8 ,, 1Commonwealth of Massachusetts =k' = Cityrfown of '''i' ' I; , Septic System Installation Checklist , ii0 B. Application Checklist (cont.) C) Distribution Box (310 CMR 15.232) Approved N/A Prabl All outlet pipes at same elevation Check by adding water ❑ i_ Number of outlets Number of laterals — _-_...__�-._ __._ per p:n Inlet tee min. 1"over outlet , • w/tape n D box set on level base L V. u ❑ Top of D box 36"max depth ' :nd w/tape p 0 ❑ 0 box is water-tight Add water Eid2 0 0 0 box has a minimum of 2"thick wall and 12"inside dimension C ❑ • d) Pump Chamber(310 CMR 15.231) Approved N/A Probler Tank is set level Visual and w/level ❑ ❑ Proper volume is provided Check plan and tank Float elevations set per plan Measure w/tape 0 0 Cl Min. 2" delivery line to D box Visual 0 0 0 Number of pumps: 0 0 0 Specified pump provided or designers approval for equal pump 0 0 0 Correct pump sequence 0 0 0 Covers set to grade ❑ ❑ Q Electrical permit provided 0 0 0 6"of stone beneath chamber Visual 0 0 0 Chamber is water-tight Test 0 Min. y"cover provided Visual t❑ Correct loading provided per plan Visual on tank 0 0 0 • Notes: Sept System Installation Checklist t t-08.doc•date ` Form Name•Page 3 of 6 ,� Commonwealth of Massachusetts u' City/Town of W B. Application Checklist(cont.) .____...____ • e) Leaching Facility (310 CMR 15 240) Approved N/A Proble No frozen material used including back fill Visual V ❑ ❑ No clay, tailings or stones larger than 6'for / ❑ cover material J" ❑ Soil at bottom/sides of excavation matches L_,r . info on deep holes t..t El ❑ All impervious layers removed Visual C ❑ ❑ No remaining AIB horizons Visual 0 0 Groundwater conditions match plan andr ❑ deep holes 41010P hack plan 0 Vented if under impervious cover per plan (15.241) ❑ ❑ ❑ Vent is protected from precipitation and animal entry 0 0 ❑ Cover of a minimum of 9"over leach area 0 0 Pipe slope equal to 0.005 Check w/transit Imo' . 0 ❑ Leach area per design(15.241) 0 0 Excavation is level and at required depth drO •. eck plan [<- ❑ ❑ Removal of 5 ft material and replacement (if in fill) Visu- check plan 0 0 • Back fill material is acceptable 411111101Th DV 0 0 Final contours correct per plan Che with plan ❑ ❑ Surface/subsurface drainage away from • leach area ( ❑ ❑ Final grade and side slopes are stable Ti 0 0 Distribution lines are capped, vented, or connected together ❑ ❑ Impermeable barrier(15.255(2)) ❑ 0 ❑ Retaining wall inspected by PE 0 0 ❑ Retaining wall is water-proofed 0 0 • Retaining wall/barrier is at correct 0 depth/height El ❑ E3 Septic System Installation Checklist 11-09.doc•date Form Name•Page 4 of 6 ,. ,2 Commonwealth of Massachusetts k` City/Town 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 pate • Notes: septic System Instegetion Checklist 11-09.doc•date Form Name•Page 6 of 6 ,� Commonwealth of Massachusetts ►' = City/Town of - '- M' Septic System Installation Checklist B. Application Checklist (cont.) __----___ ._.�._ --___ ._--___ f) Leaching trenches(310 CMR 15 251) Approved N/A Problem Number of trenches: ❑ 0 0 Depth of trenches: 0 0 0 Width of trenches: ,._..__...._. n_. ❑ ❑ ❑ Trench spacing per plan C ❑ Er Stone is double-washed [3/4"to 1Y°)(15.247) [J ❑ ❑ 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 Stone is double-washed[314" to VW] (15.247) C) 0 ❑ h) Leaching Pits(310 CMR 15.253) Number of pits: _.___ __._ ❑ 0 0 Depth of pits: _-_-..-_ ❑ 0 0 Stone is double-washed[314'to 1W)(15.247) 0 0 0 Each pit has min. 1 20" access cover 0 0 0 Piping network and configuration of pits/chambers 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 0 ❑ • Pumping contract has been provided 0 ❑ Covers to grade Visual ❑ 0 ❑ AN alarm set at 3/5 tank capacity Check floats by raising 0 0 ❑ - NV alarm test on separate circuit Set off alarm ❑ C) ❑ Septic System Installation CIS 11-O9.doc•dale Form Elam©•Page 5 of 6