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779 Septic System Checklist 2018 hi 179 7hs t4vt77 4.Ai / Commonwealth of Massachusetts CityfTown of // / i iii.i Septic System Installation Chec1,1-/'751 li t 2...d 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 QN • • 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 y' � City/Town of `. 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 ❑ Sok Stn kinsmen Cheakgq t taa.d«•date Form Homo•Piga 5 ole Commonwealth of Massachusetts w' City(Town of ri . Septic System Installation Checklist .,.., 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__-__'--___—_.,—.. Dm Certificate of Compliance Issued - _._. .------- ___......_.___- dma Notes: Sapeo system Installation Cherkihn 11 AG.doc•dire Form Niue•Pape 6 of 0