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595 Septic System Installation Checklist 2015 Commonwealth of Massachusetts City/Town of Septic System Installation Checklist 744, 1464th% El B. Application Checklist (cont.) Construction Inspection at, &iv/ : Building Sewer(310 CMR 15222 PSS All waste pipes fled mto building sewer Schedule 40 PVC 4'or cast iron Minimum slope of 0 01-0 02 Pipe laid in Continuous straight ins Pipe lad on compact firm base Cleanouts precede all charges in alignment/grade Cleanest provided every 100 ft Bali material dean b) Septic Tank(310 CMR 15.223) Tank is set level with 6" stone under (15 228) Tank is required sizefloadirg per plan Inlet and outlet we at proper lOCalion (15227) Tank is water tight(15.226) Outlet lees extend 6'above now line Approved filter device pieced at outlet Gas baffle installed at outlet tee Inlet and outlet tees on Canter lilt Basement cflech// GY's /vy Verify oy reading pipe ran ��ded 4d1 P✓k/a4il , Approved 6y lNS4 Verify ply vlsual/tape E Verify Cy visual tape NIA Problem Li S Li u Approved /N/A Problem Check wile leve/l) / eXrs6 o' 4 Verify plan / �,v f,0❑ Verify with plgn�p� / '. Test rdm/ LE Verify by visual/tape DEP list Visual Visual S S u Tank is badMNed with acceptable material Visual S Notes U u S SooOc Broom IndiaMbn CM C M1 11-09 doo•dote Form Norio Pope 2 of e sine Commonwealth of Massachusetts City/Town of Septic System Installation Checklist 8. Application Checklist (cont.) ci Distnbuton Box (310 CMR 15232; All outlet pees at elevation Number of outlets es:pep( Inlet tee min. 1' over outlet D box set on level base eve/ Top of D box 36- max depth D box is water-tight aoAd/ D box has a minimum of 2' thirx wall and 12-inside dimension �,// Approved N;A Problem rte-aa+Le C eve or/ Cheri Dy aaamg water Number of laterals visual and witape 'tape d) Pump Chamber (310 CMR 15.231) Tank is set level Proper volume is provided Float elevations set per plan Min. 2'delivery lire to D box Number of pumps. Specified pump provided or designers aP Woval for equal pump Corset pump sequence Covers set to grade Electrical permit provided 6'of store beneath clamber Chamber to water-bght Min. 9' cover provided Correct loading provided per plan Notes %plc System inotoilgon Chocking tt- a deo•date /v/ Visual and w^level Cheri plan and tank Measure weepe Visual Visual Test Visual Visual on tank ❑ 1 Approved NA Problem Focm Nam Peg 3 ore Commonwealth of Massachusetts City/Town of Septic System Installation Checklist B. Application Checklist(cont) a) Leaching Factnty ,310 CMR 15 240. No frozen material used InCludmg back fi /No Gay, tailings or stones larger than 6' for .� V Cover material Soil at bottom/sides of excavation matches info on deep holes AN impervious Meyers removed No remaining A/B szons t— Groundwater conditions match pier and �. deep holes Visual16ck plan Vented if under impervious cover per plan (15 241) Vent is protected from precipitation and animal entry Q� Cover of a minamu er leach area Pipe slope equal to 0 005 rg , o9 `oft an5t Leach area per($9($999r ev (1524 ) ✓ Excavation is level and at required depth Removal of 5 ft material and replacement Of in fill) Back fill material Is acceptable Fowl contours correct per pen Surface/subsurface drainage any from teed,area Fine grade and side slopes we stable Distribution tines are capped, vented. or connected together Impermeable burner(15 255(2)) Retaining wall inspected by Approved N;A Problem L 0 7 is ❑ ❑ ❑ ❑ ❑ ❑ Retaining wall s water-proofed Retaining wall/banter is at correct depth/height sews swam 4WYbn Clwirp 11-09.eon•aw IJ Form Name•Pape 4 of 6 Commonwealth of Massachusetts City/Town of Septic System Installation Checklist B. Application Checklist (cant)- -- -- - _-- - --- -- -- Cendicats of Compliance 1310 OMR 15 02' As Built Plan Submitieo Signed by Installer — Date Signed by Designer Dace Certrfrcate of Compliance Issued Notes Jett t; of / _f sr14L slxs [. cti 4. -(70//s) y sew sperm bnW.6en cheats 11-0s.doe•de. Fonn N.m.•Page 6 or 6 Commonwealth of Massachusetts CftyfTown of Septic System Installation Checklist B. Application Checklist (cont) f) Leaching trenches (310 CMR 1525+.. Number of trenches. Depth of trenches Wdth of trenches Trench speong per p:aai Stone is double-washed 114'to 114'1:1524'; g) Leaching fields (310 CMR 15.242) Length of feltl hash# wI Width of field 7 es Lri. Mn i . of 2 distribution lines Separation distance conforms to plan Stone is dou h) Leaching Pits(310 CMR 15253) Number of pas Depth of pts. Store is double-wasted(3/41 to 11c)(15 247) Each pit has min. 1 201 access cover Piping network and configuration of PiWUwtlen par plan i) Ttght Tank(310 CMR 15.260) Tank is set level with 6"stone under Tank is proper size per plan Pumping contract has been provided Covers to grade Visual NV alarm set at 3/5 tank capacity . AN alarm test on separate orWit Sayan S1STh kesasen enemas 1 t da doc•die Approved NA Problem or i_ r7 ✓� 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Visual and with level r,• ❑ Visual with plan r! ❑ Check floats by raising Set off alarm L. 1 ❑ ❑ C■ ❑ Form Name•Faye 5 of 6