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324 Septic Check List 1 ommonL ' 3 ' , .i... , 47 1„// # te2/ C.--/6 %sLxcj .>� / City/Town of !, .-' 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 1 / _c_it,),Qe3r :___ ^ ter- O �� r � it ,I, p g Gce3. e . - rIL E-Cap y 7 I NS 1--e,Ile-C: Le, Pic,kvIC • COSI-roC-110 ' ' z " System lnstsllstlon Checklist i 1-09.doc•date CT-?7 tr���� ' 1 I Z %-orm Neme•Pepe 2 pf 6 0 . 3,4 " 1�/,l/1� ` ii eoli► oki was ON -5/ k c 5/7 Z 190If 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 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 ,/. w 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 o �� ma • Notes: /74 /1/ 6re ,vIet,t, -- il/ed4 v. ojwskge f/. - 'cies ft,_tv.e_c • home Septic System Installation Checklist 11-09.doc•date Form Name•Popo 6 of 8 i., • k ,r/ 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 -