779 Septic System Checklist 2018 hi
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Commonwealth of Massachusetts
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Septic System Installation Chec1,1-/'751
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B. Application Checklist(cont.) 20 I Q — L.
2. Construction Inspection O
a) Building Sewer(310 CMR 15.222) Approved N/A Problem
All waste pipes bed into building sewer Basement check ,❑9 ❑ ❑
Schedule 40 PVC 4' or cast iron Verifyby reading pipe IE}' C ❑
Minim um slope of 0.01-0,02 Visus ,,,1oda,, CI////''' ❑
Pipe laid in continuous straight line Visual ❑ ❑
Pipe laid on compact,firm base0. I� /f` ❑
. Cleanouts precede all changes in vent b uiauallla•: ❑ ❑� ❑
alignment/grade
Cleanout provided every 100 ft. Von' by vi uautaps C/[E---- --.
" El
Backfill material dean atsuai fE-- . 0 0
b) Septic Tank(310 CMR 15.223) Approved
N/A Problem
Tank is set level with 6"stone under check with level Ea/ ❑ ❑
(15.228)
Tank is required size/loading per plan Ven . ' 0 0
• Inlet and outlet are at proper location Verif with plan / 0 0
(15.227) i� ��///
Tank is water tight(15.226) ® ❑ ❑
Outlet tees extend 6"above flow line •��by visual/tape �/ ❑ ❑
Approved filter device placed at outlet DEP list —` ❑ ❑
Gas baffle installed at outlet tee vi 'I r❑f/ ❑ 0
inlet and outlet tees on center fire Visual i,,,l
C0
Tank is backfliled with acceptable material Visual ❑ ❑ 0
Notes:
Septi°System Installation Checklist 11-09,doo•date Form Marna•Page 2 of B
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• Commonwealth of Massachusetts
lit City/Town of
, tr Septic System Installation Checklist
1/41/4
B. Application Checklist (cont.) __----------._. ____
c) Distribution Box(310 CMR 15.232) Approved N/A Problem
All outlet pipes at same elevation Check by adding water a 0 ❑
' Number of outlets -11:1121.---I / Number of laterals `"`
Pm
Inlet tee min. 1"over outlet Visual and wttape T 0 0
D box set on level base Vis [ ❑ 0
Top of D box 36" max depth Visu and w/tape 0 0 0
,,_____--
D box is water-tight Add water 0 0
-- <___,
D box has a minimum of 2"thick well and ❑ fa12'Inside dimension
• d) Pump Chamber(310 CMR 15.231) Approved N/A Problem
Tank is set level Visual and w/level ❑ ❑ 0
Proper plume is provided Check plan and tank ❑ ❑ ❑
Float elevat• s set per plan j Measure wttape ❑ ❑j ❑
. Min. 2'delivery li . to D box Visual ❑ ❑ ❑
Number of pumps: _____.._.-.._.-___._- ❑ ❑ ❑
Specified pump provided • designers ❑ 0
❑
for equal pump
Correct pump sequence ❑ ❑ ❑
Covers set to grade 0 0 ❑
Electrical permit provided ❑ ❑ ❑
6'of stone beneath clamber Vi al ❑ ❑ ❑
Chamber Is water-tight Test 0 0 0
Min. 9"cover provided Visual ❑ ❑ 0
Correct loading provided per plan Visual on tank 0 El 0
Notes:
Septic System InstepuUon chaos*f f-pecao•date Farm Mime•Pepe 3 of 6
Commonwealth of Massachusetts
V ` City/Town of
= i Septic System Installation Checklist
B. Application Checklist(cont) _T_~ "'
e) leaching Facility (310 CMR 15,240) Approved N/A Problem
No frozen material used including back fill Visual {,e/ ❑ 0
No clay, tailings or stones larger than 6'for E ❑ ❑
Saver material
Soil at bottom/sides of excavation matches C,:d"/ ❑ El
info on deep holes
All impervious layers removed Visust< ❑ 0
No remaining NB horizons VI al ❑ El
Groundwater conditions match plan and 41
Isuallcheck plan ❑ ❑
deep holes
Vented if under impervious cover per plan -------- ❑ ❑
(15.241)
Vent is protected from precipitation tal7 ❑ 0
and animal entry
Cover of a minimum of 9"over leach area �/ ❑ ❑
Pipe slope equal to 0.005 Check w/tr sit 7 ❑ ❑
Leach area per design(15.241) ❑ ❑
Excavation is level and at required depth Visual/check plane 47. ) ❑ ❑
R in oval of 5 ft material and replacement VisuaEClleck plan C) .... ❑ El El
(ill)
. Back fill material is acceptable Visual ❑ ❑ ❑
Final contours correct per plan Check with plan �" ❑ El Surface/subsurface drainage away from - "moi/
leads area ,� /
Final grade and side slopes am stable V ❑ 0
Distribution lines are capped, vented, or ia. ❑ ❑
connected together
Impermeable banter(15.255[2]) ❑ 0 ❑
Retaining wall inspected by PE ❑ ❑ ❑
Retaining wall is water-proofed ❑ ❑ ❑
Retaining wall/barrier is at correct ❑ ❑ ❑
depth/height
gape°System Instillation Checklist 11-00.doc•dale Form Name•Page 4 of 6
' Commonwealth of Massachusetts
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`. h I Septic System Installation Checklist
B. Application Checklist (cont.)
f) Leaching trenches(310 CMR 15.251) Approved NIA Problem
Number of trenches: ---------------- ❑ 0 0
Depth of trenches ❑ 0 • 0
Width of trenches: ❑ ❑ 0
Trench spacing per pan ❑ ❑ ❑
•
Stone is double-washed[3/4"to 11/2"1(15.247) 0 0 0
g) Leaching fields(3W CMR 15.242)
Length of field: _.._.____.___,___ ❑ ❑ ❑
•
Width of field: --- ------- ❑ ❑ ❑
Min. of 2 distribution lines 0 0 0
Separation distance conforms to plan ❑ ❑ ❑
Stone is double-washed(314" to 1W](15,247) 0 0 0
h) Leaching Pits(310 CMR 15253)
Number of pits: .-.___..._._____, ❑ 0 0
Depth of pits: -________.__—__ ❑ 0 ❑
Stone Is double-washed(314"to 1x•1(15.247) 0 0 0
Each pit has min. 1 20'access cover ❑ C ❑
Pipping network and configuration of ❑ ❑ ❑
pits/chambers par 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 drcuit Set off alarm ❑ 0 ❑
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Commonwealth of Massachusetts
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ri . Septic System Installation Checklist
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B. Application Checklist(cont.)
j) Certificate of Compliance(310 CMR 15.021)
As Built Plan Submitted _-----_......__.___.__._- __.._..__...____.,_._.
Date
Signed by Installer ._._._____.__.-_--____._._._.,_.___—_______._...
Data
Signed by Designer --_"'__._,_.__._v_..v__-__'--___—_.,—..
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Certificate of Compliance Issued - _._. .------- ___......_.___-
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Notes:
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