324 Septic Check List 1 ommonL ' 3 '
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!, .-' Septic System Installation Checklist 5/g/7
B. Application Checklist (cont) Gras ,,,
�/ 2. Construction Inspection
o a) Building Sewer(310 CMR 15.222) t''/Al 17•�J(e-s�✓ Approved N/A Problem
Aidk : All waste pipes tied into building sewer Basement check � ❑ ❑
f if/N
Schedule 40 PVC 4'or cast iron Verify by reading pipe ❑ ❑ 0
Minimum slope of 0.01-0.02 Visual ❑ ❑ ❑
j7VL. ql Pipe laid in continuous straight Lne Visual Xto ❑ ❑ 't❑_
lo bel Pipe laid on compact. firm base Visual v ❑ ❑ ❑
A)511Cleanouts precede all changes in Verify b ape El El
Z / e alignment/grade
Cleanout provided every 100 ft Verify by �s pe ❑ El ❑
F. C�1 C
- 1 ` 7. Backfill material clean Visual ❑ • ❑ ❑
gV
/ b) Septic Tank(310 CMR 15.223) Approved N/A Problem
111////1111
Tank is set level with 6 stone under Check with level (� ❑ ❑
(...e,Pitt n- k
(15.228)
Tank is required size/loading per plan Verify with plan L ❑ ❑
''CvJ1 Jlrf9 Inlet and outlet are at proper location !7 ❑ ❑
(15.22T) Verify with plan
ciw,,ey Tank is water tight(15.226) Test ❑ ❑
AA) Outlet tees extend 6' above flow line Verif .y visual/ .pe [V ❑ ❑
I., Approved filter device placed at outlet DEP list El ❑
0-VOX Gas baffle installed at outlet tee � Visu 0� 0 0
Inlet and outlet tees on center line 410 Q- ❑ 0
Tank is backfilled with acceptable material Visual ❑ ❑ ❑
Notes: 4 ( Ili 1
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= City/Town of
� Septic System Installation Checklist
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B. Application Checklist (cont.) -- ---_-----__�
c) Distribution Box(310 CMR 15.232) Approved N/A Problem
All outlet pipes at same ell7pti Check by adding water go'' ''. ❑ ❑
Number of outlets -- -----
per Number of laterals — _
Inlet tee min. 1"over outlet eilitgr - w/tape ® --- ❑ ❑
D box set on level base Cj [,fir ❑ El
Top of D box 36" max depth esu w/tape 1--------- [] ❑
D box is water-ti. v Ada water ❑ l-
J ❑
- ` := T=s a minimum of 2" thick wall and
12" inside dimension 5-V-4."..1,4 s� D-IO L ❑ •
d) Pump Chamber(310 CMR 15.231) x
Approved N/A Problem
Tank is set level Visual and w/level ❑ /-*A--- ❑
Proper volume is provided Check plan and tank 0 0 ❑
Float elevations set per plan Measure w/tape ❑ ❑ 0
, Min. 2"delivery line to D box Visual ❑ ❑ 0
Number of pumps: -_-.._. ❑ ❑ ❑
Specified pump provided or designers
approval for equal pump ❑ ❑ ❑
Correct pump sequence ❑ 0 0
Covers set to grade ❑ 0 ❑
Electrical permit provided ❑ ❑ 0
6"of stone beneath chamber Visual ❑ 0 0
Chamber is water-tight Test 0 0 0
Min. 9"cover provided Visual 0 ❑ 0
Correct loading provided per plan Visual on tank 0 ❑
Notes:
&Vic System lnstaltation Checldist I 1-09.doc•date Form Name•Page 3 of 6
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Commonwealth of Massachusetts
:0City/Town of
Septic System Installation Checklist
B. Application Checklist (cont.) ___.._.--------------
a) Leaching Facility (310 CMR 15.240) Approved N/A Problem
No frozen material used including back fill Visual ❑ 0
No clay, tailings or stones larger than 6'for L, s Q a
cover material �
Soil at bottom/sides of excavation matches /
EJ---
EJ--- ❑ ❑
info on deep holes
All impervious layers removed 411P C-e—. ❑
• No remaining NB horizons Visua ❑ 0
Groundwater conditions match plan and Visual/check plan 12._-- 0 0
deep holes
Vented if under impervious cover per plan El 0
(15.241)
Vent is protected from precipitation
and animal entry ❑ o
Cover of a minimum of 9" over leach area --��� 6� I [� D ❑
UCItit�
Pipe slope equal to 0.005 Check w/trans g --.. . 0 0
Leach area per design(15241) 07,E /0/4-, ,1 0 ❑
Excavation is level and at requirep Vis (!check plan 0 0
Removal of 5 ft material and repiacemen eck plan [?--- ❑
(if in fill) ❑
Back fill material is acceptableVisu "
al Cg-- [] ❑
Final contours correct per plan Check with plan [],� 0 0
Surface/subsurface drainage away from D,/' ❑ ❑
• leach area LT
Final grade and side slopes are stable 0 ❑
Distribution tines are capped, vented, or ma ❑
connected together
Impermeable barrier(15.255(2)) / ❑ ❑
Retaining wall inspected by PE El ❑ ❑
Retaining wall is water-proofed 0 ❑ 0
Retaining waltbarrier is at correct a •
0 0
• depth/height
Septic System installation Checklist 11-09.doc•date Form Name•Page 4 of 8
Commonwealth of Massachusetts
M` = City/Town of
• Septic System Installation Checklist
B. Application Checklist (cont.)
j) Certificate of Compliance(310 CMR 15.021)
As Built Plan Submitted
Data
Signed by Installer
Dote -- --
Signed by Designer _____
Date
‘0,40/6- Issued
ertificate of Compliance
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•
Notes:
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Septic System Installation Checklist 11-09.doc•date
Form Name•Popo 6 of 8
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Commonwealth of Massachusetts
City/Town of
- : H' 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: _ _.__....._ _.._. ❑ ❑ 0
Trench spacing per pian ❑ 0 0
Stone is double-washed[3/4" to 1'/'J (15.247) 0
g) Leaching fields (310 CMR 15.242)
Length of field: __..____ _ _ ❑ ❑ 0
Width of field: ----------- ❑ ❑ 0
Min. of 2 distribution lines 0 0 0
Separation distance conforms to p:an 0 0 0
Stone is double-washed[3/4" to 1W] (15.247) 0 0 0
h) Leaching Pits(310 CMR 15.253)
Number of pits: __—_ ❑ 0 0
Depth of pits: __._.____ _ ❑ 0 0
Stone is double-washed[3/4`to 1W](15.247) ❑ ❑ ❑
Each pit has min. 1 20"access cover 0 0 0
Piping network and configuration of
pits/chambers per plan 0 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 ❑ ❑ 0
• Pumping contract has been provided ❑ ❑ ❑
Covers to grade Visual ❑ 0 ❑
AN alarm set at 3/5 tank capacity Check floats by raising ❑ 0 ❑
. NV alarm test on separate circuit Set off alarm 0 ❑ 0
Septic System Inatawdion ct>aoidist 11-09.doc•date Form Name•Page 5 of 6
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