502 Septic Checklist 2012 ,% h ter,, /le / / 03/0
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Commonwealth of lylass$chlisetts
CitylTown of
Septic System Installation Checklist
B. Application Checklist(cont.)
2. Construction Inspection
a) Building Sewer(310 CMR 15 222)
All waste pipes tied into building sewer
Schedule 40 PVC 4" or cast iron
Minimum slope of 0.01-0.02
Pipe laid in continuous straight line
Pipe laid on compact,firm base
Cleanouts precede all changes in
alignment/grade
Cleanout provided every 100 ft.
Backfill material clean
b) Septic Tank(310 CMR 15.223)
Tank is set level with 6° stone under
(15.228)
Tank is required size/loading per plan
Inlet and outlet are at proper location
(15.227)
Tank is water fight(15.226)
Outlet tees extend 6" above flow line
Approved filter device placed at outlet
Gas baffle installed at outlet tee
Inlet and outlet tees on center line
Basement check
Verify by reading pipe
Visual
Visual
Visual
Verify by visual/tape
Verify by visual/tape
Visual
Check with level
Verify with plan
Verify with plan
Test
Verify by visual/tape
DEP list
Visual
Visual
Tank is badcfilled with acceptable material Visual
Notes:
Approved N/A Problem
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Approved N/A Problem
3/j.
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Septic System Installation Checklist 11-09.doc•date
Form Name•Page 2 of 6
Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist (cont.)
c) Distribution Box(310 CMR 15.232)
All outlet pipes at same elevation Check by adding water
Number of outlets per plan Number of laterals per plan
Inlet tee min. 1"over outlet Visual and w/tape 51EV" El
D box set on level base Visual 3.7): ❑ ❑
Top of D box 36° max depth Visual and w/tape [ ❑ ❑
D box is water-tight Add water El'/ ❑ ❑
D box has a minimum of 2"thick wall and LB' ❑ ❑
12"inside dimension
d) Pump Chamber(310 CMR 16231) Approved NIA(/ Problem
Tank is set level Visual and w/level ❑ Cl ❑
Proper volume is provided Check plan and tank ❑ ❑ ❑
Float elevations set per plan Measure w/tape ❑ ❑ ❑
Min. 2°delivery line to D box Visual ❑ ❑ ❑
Number of pumps: El ❑ ❑
Specified pump provided or designers ❑ ❑ ❑
approval for equal pump
Correct pump sequence ❑ ❑ ❑
Covers set to grade ❑ ❑ ❑
Electrical permit provided ❑ ❑ ❑
6"of stone beneath chamber Visual ❑ ❑ ❑
Chamber is water-tight Test ❑ ❑ ❑
Min. 9" cover provided Visual ❑ ❑ ❑
Correct loading provided per plan Visual on tank ❑ ❑ ❑
Notes:
Approved
N/A
Problem
Septic System Installation Checklist 11-09.doc•data Form Name•Page 3 of 6
Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist(cont.)
e) Leaching Facility(310 CMR 15.240)
No frozen material used including back fill Visual
No clay,tailings or stones larger than 6° for
cover material
Soil at bottom/sides of excavation matches
info on ee holes
All impervious layers removed Visual
No remaining NB horizons Visual
Groundwater conditions match plan and
deep holes
Vented if under impervious cover per plan
(15.241)
Vent is protected from precipitation
and animal entry
Cover of a minimum of 9"over leach area
Pipe slope equal to 0.005.
Leach area per design(15.241)
Excavation is level and at required depth
Removal of 5 ft material and replacement
(if in fill)
Back fill material is acceptable
Final contours correct per plan
Surface/subsurface drainage away from
leach area
Final grade and side slopes are stable
Distribution lines are capped, vented, or
connected together
Impermeable barrier(15.255[2])
Retaining wall inspected by PE
Retaining wall is water-proofed
Retaining wall/barrier is at correct
depth/height
Septic System Installation Checklist 11-09.doc•date
Visual/check plan
Check w/transit
Visual/check plan
Visual/check plan
Visual
Check with plan
Approved N/A Problem
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Et // ❑ ❑
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107 ❑ ❑
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Form Name•Page 4 of 6
Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist (cont.)
f) Leaching trenches(310 CMR 15251) Approved N/A Problem
Number of trenches: ❑ ❑ ❑
Depth of trenches: ❑ ❑ ❑
Width of trenches: ❑ ❑ ❑
Trench spacing per plan ❑ ❑ ❑
Stone is double-washed[3/4"to 11/41(15.247) ❑ ❑ ❑
g) Leaching fields (310 CMR 15.242)
Length of field: ❑ ❑ ❑
Width of field: ❑ ❑ ❑
Min. of 2 distribution lines ❑ ❑ ❑
Separation distance conforms to plan ❑ ❑ ❑
Stone is double-washed[3/4"to 1W] (15247) ❑ ❑ ❑
h) Leaching Pits(310 CMR 15.253)
Number of pits: ❑ ❑ ❑
Depth of pits: ❑ ❑ ❑
Stone is double-washed[3/4"to 1%1 (15247) ❑ ❑ ❑
Each pit has min. 1 20" access cover ❑ ❑ ❑
Piping network and configuration of ❑ ❑ ❑
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 ❑ ❑ ❑
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 ❑ ❑ ❑
Septic System Installation Checklist 11-09.doc•date Form Name•Page 5 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
Signed by Installer
Signed by Designer
Certificate of Compliance Issued
Notes:
Date
Date
Data
Date
Septic System Installation Checklist 11-09.doc•date
Form Name•Page 6 of 6
A//
C CKLIST e
ST FOR REV IE t/'G P ANS FOR PROPO ED SEPTIC Y 'GEMS
�t,�✓,�N - • New Repair r//
Property Location ✓�
Owner Designer
Reviewer
e
Date R evNed «�Z 1/1 Revision Needed Satisfactory
Plot Plan Information; NS=No[Shown A'4) tAmite/
o
NA=No ADDIic ye
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1 ✓Size of lot to be served and location of all iron pins.
2 ✓ Show location of wate4r line(s)on the property.
3 ✓Show location of proposed well or water line to serve the lot on plan.
4 %Show known sources of surface water supplies i
4 '
of the sewage lisp disposal system and/or
show any tributaries to surface water supplies within
5 • Show location of all existing and proposed wells within 200'of leaching fields. If Town Water,
show waterline. I within l00'of the sewage disposal
6 'Show location of surface waters(other than water supply)
system.
7 ✓Show any wetlands within 100' of the sewage disposal system.
g v Show any subsurface or surface drains(excluding foundation drains)within 100' of the Sewage
Disposal System.
9 ✓ Show location of deep observation holes and pert/tests.
10JLExisting and proposed contours on plan. Designate with a legend.
11 1/ on and size of soil absorption system to be shown on plan.
12 •/S-how distances of wells to leaching field,septic tank to foundation,leaching field to foundation
and property lines.
13!-Show a benchmark with all elevations tied in.
14 ,, Show presence of undergr and tanks and utility lines.
15 r, Show location of known and presently existing fill on plan.
16_Show and identify existing structures,old foundations,swimming pools,stone walls,ledge
outcrop and any known solid waste disposal areas on the lot.
17 Construction if fill: Show 15'around leach field,with notation showing topsoil and subsoil layers
stripped. Is a retaining wall or barrier required?
18 r/Show north arrow,true or assumed north.
19 ✓Show location of septic tank,D-box and SAS.
20 resign calculations to be shown on plan(110 gal.per bdrm.). septic tank,disc Boxes,and
21—..Cross section showing invert and outlet elevations at foundation,
leaching field.
22 Description of soil logs,water table,and ledge.
23esults of soils suitability tests.
24 ✓Calculations of leaching field.
25 _ Profile of the system and leach field 5' above groundwater and 4' above ledge showing elevations.
26 ✓Number of bedrooms.
27 V garbage grinder calculated if to be used
28_Name of installer,if known.
29 ✓Gates of any plan revision and,if other than the original designer,the name,address,original
signature and stamp of designer of the revised plan.
30 If system is to constricted in fill,include fill specifications.
32If pump system,include pump specifications.
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32 Local upgrade approval request forms 9A and 9B.
33 Is the SAS located within Zone II?>
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