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1 Septic System Installation 2017 ,/ Commonwealth of Massachusetts r. uN E y. City/Town of < " Septic System Installation Checklist /0/.20/7 is Application da Checklist (cont) P I5'i L,, 2. Construction Inspection ita) Building Sewer(310 CMR 15.222) Approved N/A Problem x1-4. All waste pipes tied into building sewer Basement check ❑ U • Schedule 40 PVC 4' or cast irun Verify by reading pipe ❑ C Minimum slope of 0.01,0,02 'V ❑ ❑ Pipe laid in continuous straight line a L1, - ❑ ❑ Pipe laid on compact, firm base I ,11�,//7 ❑ 0 Gleenouts precede all changes in Verify by visual/tape Et ❑ ❑ alignment/grade ,_,. /' Cleanout provided every 100 ft Verify by visual/tape l_Y ❑ ❑ Backfill material clean L Visual VI. ❑ ❑ b) Septic Tank(310 CMR 15.223) Approved N/A Problem Tank is set level with 6'stone under Check with level �N' ❑ (15.228) ,,, Tank is required size/loading per plan Verify ith plan IVY ❑ ❑ Inlet and outlet are at proper location e ❑ ❑ (15.227) Tank is water tight(15.226) Test ❑ ❑ ❑ Outlet tees extend 6'above flow line Verify by visual tape ❑ ❑ 0 Approved filter device placed at outlet DEP list gY ❑ ❑ Gas baffle installed at outlet tee LY ❑ ❑ Inlet and outlet tees on center line eglir ❑ ❑ Tank is backfilled with acceptable material Visual ❑ ❑ ❑ Notes: Septic System Inatasation Checklist 11-09.doc•date Form Name•Page 2 ale • „ • Commonwealth of Massachusetts 4 City/Town of it Septic System Installation Checklist L B. Application Checklist (cont.) c) Distribution Box(310 CMR 15232) Approved N/A Problem • All outlet pipes at same elevation/j/ Check by adding water V 0 ❑ Number of outlets ------- `- - Number of laterals nor plan Inlet tee min. 1"over outlet visual and w/tape EV' _ El11 box set on level base/ If "� vs��.... n (0 Tap of 0 box 36" max depth d w/tape V U ❑ D box is water-tight Add water Vk ❑i ❑ D box hese minimum of? thick well and ❑ ❑ 12'inside dimension • d) Pump Chamber(310 CMR 15.231) Approved N/A Problem Tank is set level Visual and w/level ❑ Ly... ❑ Proper volume is provided Check plan and tank ❑ ❑ ❑ Float elevat.•s set per plan ' Measure vi/tape ❑ ❑ ❑ Min. T delivery li i to D box Visual ❑ ❑ ❑ Number of pumps: _.._..____.___.. 0 ❑ ❑ Specified pump provi.=. .r designers approval for equal pump ❑ ❑ ❑ Correct pump sequence ❑ ❑ ❑ Covers set to grade LJ ❑ ❑ Electrical permit provided ❑ ❑ ❑ 6'of stone beneath chamber 'sual ❑ [] 0 Chamber is water-tight Test ❑ ❑ ❑ Min. r cover provided Visual ❑ ❑ .0 Correct loading provided per plan Visual on tank ❑ ❑ ❑ Notes: Septic System Insmllatlon Checklist 11-09.doc•dale Form Nome•Papa 3 of 6 Commonwealth of Massachusetts v City/Town of t 51 Septic System Installation Checklist B. Application Checklist(cont.) • e) Leaching Facility (310 CMR 15240) Approved N/A Problem No frozen material used including back fill Visual / ❑ C No clay, tailings or stones larger than 6" for � 9 ❑ ❑ cover material Soil at bottonVsides of excavation matches 2V. ❑ a info on deep holes All impervious layers removed411, ❑ 0 ' No remaining NB horizonsdo ❑ ❑ Groundwater conditions match plan and aver i;V. ❑ ❑ deep holes Vented if under impervious cover per plan ©K (15.241) K+' ❑ ❑ Vent is protected from precipitation and animal entry p ❑ ❑ ❑ Cover of a minimum of 9" over leach area f o0{^ ' / �/• ❑ Pipe slope equal to 0.005 Check wwltraansit ✓ [t3 ❑ ❑ Leach area per design(15.241) l_ - 0 Cl Excavation is level and at required depth eck plan ❑ Cl Removal of 5 ft material and replacementeeels pla�r} ¢•=r"r ❑ ❑ (Bain l) Back fill material is acceptable t") .[��, / LI ❑ Final contours correct per plan (// /Check with plan 7 0 ❑ Surface/subsurface drainage away from • leach area ❑ ❑ Final grade and side slopes are stable (ll------- 0 0 Distribution lines are capped, vented, or , / ❑ ❑ connected together rrrJIIrrr I J ICY impermeable barrier(15.255[21) U/eVl�'/�\ //I: ❑ Cl Retaining wall inspected by PE ❑ ❑ ❑ Retaining wall is water-proofed ❑ ❑ 0 Retaining wall/barrier is at correct ❑ ❑ depth/height Septic SyMem Inh1Nlation Cheoldiat 11-09Acc•date Farm Name•Pepe 4 of 6 • 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 Dale Signed by Installer Dale Signed by Designer Date Certificate of Compliance Issued - - — ---- -- -------- Date • Notes: Sepik System InWtlapon Checklist 1 f-eeaoc•date Form Name•page 6 of 6 A „ Commonwealth of Massachusetts City/Town of - `- h ' Septic System Installation Checklist Ji B. Application Checklist(cont.) 0 Leaching trenches(310 CMR 15 251) Approved N/A Problem Number of trenches: ----- ------- 0 0 0 Depth of trenches: - - - -- -- - --- ❑ ❑ ❑ Width of trenches: __.. -__._. _..- __. 13 0 0 Trench spacing per plan E 0 0 Stone is double-washed(3/4" to 1%1(15.247) ❑ ❑ 0 g) Leaching fields (310 CMR 15.242) Length of field: _. . ._-_.. _-...__.. ❑ ❑ Width of field: - - ----------. ❑ 0 0 Min. of 2 distribution lines ❑ ❑ ❑ Separation distance conforms to plan ❑ ❑ ❑ Stone is double-washed(3/4" to 1%0(15.247) 5 0 ❑ h) Leaching Pits(310 CMR 15.253) Number of pits: --- - ---------- ❑ ❑ 0 Depth of pits. - ❑ ❑ ❑ Stone is double-washed(3!4"to 1W1(15.247) ❑ ❑ ❑ Each pit has min. 1 20' access cover ❑ ❑ ❑ Piping network and configuration of LI ❑ 0 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 ❑ ❑ ❑ Covers to grade Visual ❑ ❑ ❑ AN alarm set at 3/5 tank capacity Check Floats by raising ❑ ❑ ❑ . AN alarm test on separate circuit Set off alarm [ LI ❑ aaptc swim^Installation Checklist 1 tde.0oc•here Form Homo•Pogo 5 of 5