107 Septic Checklist (2) PROJECT NO.:
CITY/TOWN: iP,SLI/i4W1.l� ,
APPLICANT: R/SA.✓5
ADDRESS:
DESIGN FLOW: gpd
REVIEWED BY: �/rsr. DATE: r% 1/
N/A OK NO
•
GENERAL
Legal boundaries denoted[310 CMR 15.220(4)(a)] r/
Street. I.ot, Fax parcel number and lot number noted on plan [310
CMR 15.220(4)(u)]
_ ✓
Locus Provided [310 CMR 15.2204(t)]
Plan proper scale?(I"=401 for plot plans, 1"=20'or fewer for
components)[310 CMR 15.220(4)]
Easements shown 1310 CMR 15.220(4)(b)]
System located totally on lot served [310 CMR 15.405(I)(a) for
upgrades]- if noi, a variance is required[310 CMR 15.412(4))
Location of impervious surfaces(driveways,parking areas etc.)
1310 CMR 15220(4)(d)]
Location all buildings existing and proposed 310 CMR
15.220(4)(c)1
Location and dimensions of system components and reserve areas.
[310 CMR 15.220(4)(c)1
System Calculations[310 CMR I5.220(4)(W1
daily flow
septic tank capacity(required and provided)
soil absorption system(required and provided)
whether system designed for garbage grinder
North arrow[310 CMR 15.220(4)(0
Existing and proposed contours [310 CMR 15.220(4)(g)]
Location and log of deep observation holes(existing grade el. on /
each test) [310 CMR 15.220(4)(h)] !/
Names of soil evaluator and RON representative [310 CMR
15.220(4)(h)and(i)]
Location and date of percolation tests(performed at proper
elevation?)[310 CMR 15220(4)(1)]
Percolation test results match loading rate? [310 CMR 15.242]
Certification statement by Soil Evaluator[310 CMR I5.220(4)(j)]
Observed and Adjusted groundwater(method for adjustment
given or indicated) [310 CMR 15.103(3) and 310 CMR
I5.220(4)(n)]
GENERAL cant. N/A OK NO
Location of every water supply,public and private, [310 CMR
15.220(4)(k)]
within 400 feet of the proposed system location in the case
of surface water supplies and gravel packed public water supply
within 250 feet of the proposed system location in the case
of tubular public water supply wells ✓
within 150 feet of the proposed system location in the case
of private water supply wells
Location of all surface waters and wetlands located up to 100 ft.
beyond Setbacks listed in 310 CMR 15.211 and any catch basins
located within 50 ft. [310 CMR 15.220(4)(1)]
Water lines and other subsurface utilities located [310 CMR
I5.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[1])
Profile of system showing invert elevations of all system
components and the bottom of SAS [310 CMRI 5.220(4)(o)]
Stamp of designer 1 310 CMR 15.220(1) and 310 CMR
Stamp of Registered Land Surveyor(required if construction
activities within 5 ft.of lot Tine)[310 CMR 15220(3)]
Test Holes adequate(two in each of the primary and reserve
unless trenches as permitted in 310 CMR 15.102(2)or as
approved for an upgrade under LUA at 310 CMR 15.405(1)(k)J
Test hole adequate to demonstrate four feet of suitable material?
[310 CMR 15.103(4)]
Test Holes adequate to confirn adequate groundwater separation?
[3I0 CMR 15.103(3)J
Benchmark within 50-75' of system [310 CMR 15.220(4)(q)1
Materials specifications noted? [various sections of 310 CMR
15.000
System components not> 36"deep (unless Local Upgrade
Approval or I.UA requested) 1310 CMR 15.405(1(b)]
All system components marked with magnetic tape 15.221(12) J
SEPTIC TANK N/A OK 7 No
Size OK? [310 CMR 1523(1)] v
Inlet tee located ten inches below flow line[310 CMR 15.227(6)]
Outlet tee 14"or 14" 4 5"per foot for increase ft depth [310 b
CMR tee with(6)]
tee
Outlet wth gas baffle or approved filter X310 CMR 15.227(4)]
Note regarding installation on stable compacted base 1310 CMR
15.228(1)]
Separation between inlet and outlet tees (no less than liquid depth)
[310 CMR 15.227(2)1
InledOullet elevations at least 12" above high groundwater(except
as described 310 CMR 15.227(5))or permitted for upgrades
under LUA 1310 CMR 15.405(1)(k)]
Minimum cover 9"(Tanks buried more than 9"must have risers on
all openings and on the d-box) [310 CMR 15.2228(1)and 310
CMR 15.232(3)(01
'Three access covers (inlet and outlet must be 20"or greater)-
middle access at least 8"(by 7/07) 1310 CMR 15228(2)1
Access to within 6 "of grade - one port for systems<I 000gpd,
two for systems>I 000 gpd]310 CM R 15.228(2)1
All at-grade covers secured to unauthorized access? [310 CMR
15.228(2)1
> 10 1t from building foundation[310 CMR 15.21 1(1)]
Buoyancy calculation Requi Donis[310 CMR 15.221(8)]
11-20 Where appropriate?[310 R 15.226(3)]
Setbacks from resources[310 CM .21 1]
MuId-Compare meat Milts
Required when other than single-family dwelling or flow>1000 gpd
[310 CMR 15223(1)(6)]
First compartment 200%daily flow;Second compartment 100%
daily flow 1310 CMR 15.224(2)and(3)1
"U"pipe through or over baffle,outlet of each compartment with
gas baffle or approved filter[310 CMR 15.224(4)1
BUILDING.SEWER ANDOTHERPIPING - -N/A .'OK No '.
Located at least ten feet from any water line?[310 CMR
15.222(2)1
Disposal piping at least 18" below water line(when water and
sewer cross, sec 310 CMR 15.21 1(1)111)
Cleanouts required/provided '? [310 CMR 15.222(8)1
Thrust blocks specified in force mains?310 CMR 15.221(6)(c)1
Slope olsewer line not less than 0.01 (1/8"/f1) 0.02 preferable
1310 CMR 15122(6)]
Proper pitch on all runs?(.005 within gravity-distributed trenches t/
and beds) [310 CMR 15.251(9)and 310 CMR I5252(2)(c)]
Siphon problem/(Ieachfield below pump chamber)
Endcaps or vent manifold specified?
Size and orientation of discharge holes specified?(not smaller than
3/8" not larger than 5/8") 1310 CMR 15.251(8)and 310 CMR
15.252(2)(h)]
Materials specified (310 CMR 15.251(5) specifies various pipe
types allowed)
DISTRIBUTION BOX .
Stable compacted base [310 CMR 15.221(2) and 310 CMR
I5.232(2)(a)I
Splash plate or baffle tee required on inlet/provided?(when
pressure sewer to d-box or steep pitch of gravity sewer) X310
CMR 15.323(3)(a)I
Riser if deeper than 9" [310 CMR I5.232(3)(I)I
Inside minimum dimension 12" [310 CMR 15.232(2)(6)1
Minimum sump 6" [310 CMR I5.232(3)(e)]
Watertight cover if<2000gpd): waterproof manhole if>2000gpd
X310 CMR I5.232(3)(d)]
PUMP CHAMBERS
Ptifilig
Capacity(emergency storage above working-design flow)?[310
CMR 2
se
Proper setbacks [310 CMR 15.211 (same as septic tanks)]
Watertight 20-in minium access manhole at least 20"MUST BE
TO GRADE1310 CMR 15.231(5)1
Service components accessible(not too deep with piping,
disconnects accessible)
Alarm floats- alarm on circuit separate from pumps specified?
Exceeds two units must have two pumps operating in lead-lag
mode. f 310 CM R 15.231(6) and (8)f
Stable Compacted Base 1310 CMR 15.221(2)1
Buoyancy calculations needed ? Provided? [310 CMR 15.221(8)1
Dosing chamber capacity(required and provided), pump curves
and specifications,number of dosing cycles and depth per cycle?
[310 CMR I5.220(4)(r)1
Effluent tee filter provided? [310 CMR 15.231(10)1
SOIL.ABSORPTION SYStEMS(NAN)GENERAL TRA OK No
Calculations correct?
4 feet of naturally occurring material demonstrated? [310 CMR
15.240(1)]
Required separation to groundwater?[310 CMR 15.212)]
Aggregate specified as double washed [310 CMR 15.247(2)]
System Venting required/provided?(system under driveway or
>36" deep)[310 CMR 15.241 1
Inspection ports specified and within 3"final grade?[310 CMR
15.240(13)]
Breakout requirements met?(No violation of breakout elevation
within 15 ft of SAS unless harrier) [310 CMR 15.21 I(1)[4] and
Guidance Document]
GAI LERIES.PITS,CHAMBERS.310 CMR 154253
Chambers and Gal. in trench configuration supplied with inlet every
2011. [310 CMR 15.253(6)]
Each structure with one inspection manhole(if>2000 gpd must be
to grade) [310 CMR 15.253(2)]
Aggregate I' minimum-4' maximum.[310 CMR 15.253(1)(6)]
2' sidewall credit maximum[310 CMR 15.253(I)(a)1
In bed configuration,inlet every 40 sq. R. 1310 CMR 15.253(6)1
TRENCHES 110 CMR t5;251
Width 2' minimum 3' maximum[310 CMR 15.251(1)(6)1 L
100 feet- maximum length[310 CMR 15.251(1)(a)]
Minimum separation 2x effective depth or width whichever greater
3x if reserve between trenches) X310 CMR 251(1)(d)]
Situated along contours 1310 CMR 15.251(2)]
Breakout OK? 1310 CMR I 5.211(1)[4.1 and Guidance t
BEDSASIMawf�ntmdheaE,-Ledal', $5 's :
minimum 2 distribution lines[310 CMR 15.252(2)(0]
Maximum separation between lines 6' [310 CM R I 5.252(2)(d)1
Maximum separation between lines and outside of bed 4' [310
CMR 15.252(2)(e)I
•
Aggregate depth below discharge pipes 6" minimum, 12"
maximum.[310 CAR 15.252(2)(g)]
Separation between beds 10' minimum.[310 CMR 15.252(2)0]
Bottom area used in calculations only[310 CMR I5.252(2)(i)]
DID THE PLAN INVOLVE WA : OK No
Pressure Dosed System ? Provided pump and piping
calculations as required 1310 CMR 15 220(4)(01
Groundwater Separation Per 310 CMR 15.240(12)does the
groundwater separation take into account mounding.
Pressure dosing required on all systems>2000gpd or alternative
systems under remedial approval [310 CMR 15254(2) and I/A
Remedial Use Approvals)
If used in gravelless system- make sure jet is directed as not to
scour soil interface[Guidance Document]
Inspections once per year(systems<2000 gpd)or quarterly
(>2000gpd) good to note on plan J310 CMR 15 254(2)(d)]
Construction in fill- Did the plan specify that the fill shall meet
the specification of310 CMR 15 255(3)?
Impervious barrier and/or retaining wall? [Guidance Document]
Impervious barrier installation must be supery ised by designer
1310 CMR 15.255(2)(b)]
Retaining wall must be designed by Registered Professional
Engineer X310 CMR I5.255(2)(a)]
Side slope not exceed 3:1 ? [310 CMR 15.255(2)]
Breakout requirements met?[310 CMR 15.252(2)and
Guidance Document]
At least 5 ft. from impervious barrier to edge of SAS (10 II.
recommended) [310 CMR 15.255 (2)(e)]
Gravelless System/VA Approval Le/hral
Check DEP Approval letters for credits and design conditions
If used with pressure dosing do not allow pressure discharge
to scour soil interface
Anemalive Sepik System fW/AApp+apat.X,eltertzt
Was DEP Approval Letter provided and/or have you
reviewed the letter for conditions?
Is the technology being properly applied and does it meet all
DEP Approval Conditions?
•
Is there a note on the plan regarding the requirement for
perpetual maintenance agreement?
Any alarms involved on separate circuits
Did the applicant submit an operation and maintenance
manual?
Has applicant submitted a copy of a maintenance agreement?
Are the variances listed on the plan? [310 CMR 15.230 � �
(OM
RLS Stamp necessary on plan if a component is within five
feet of property line]310 CMR 15.412(4)1
New construction or increased flow proposed- [Refer to
310 CMR 15.414]
Niir•ge Sensitive Areas :N/A `OK No::..
Is the system in a Designated Nitrogen Sensitive Area(Zone]] for
a public supply well)?[310 CMR 15.214, 310 CMR 15.215 and
310 CMR 15.216- also refer to Policy regarding upgrades of
such existing systems]
Is the system proposed on the same lot as served by private well?
1310 CMR 15.214(2)1
Are the nitrogen loads proposed in compliance?[310 CMR
15.216(1)1
Misceliaineaas
Pumping to septic tank ? [ 310 CMR 15.229]
Shared System [310 CMR 15.290]