22 Septic Installation Checklist 2015 Commonwealth of Massachusetts a Oa (Ai, I5., c .
City/Town of
Septic System Installation Checklist 6145
15
tA.L4Nrit
B. Application Checklist (conL)
2. Construction Inspection
a) Building Sewer(310 CMR 15.222) Approved N/A Problem
All waste pipes tied into building sewer Basement check I,,Jt' ❑ ❑
Schedule 40 PVC 4'or cast iron Verify by reading pipe ,Lk� ❑ ❑
Minimum slope of 0.01-0.02 Visual �✓ ❑ ❑
Pipe laid in continuous straight line Visual ly ❑ ❑
Pipe laid on compact firm base Visual [2' ❑ ❑
Cleanouts precede all changes in Verify by visual/tape 1311- ❑ ❑
alignment/grade
Cleanout provided every 100 ft Verify by visuaVtape ❑ ❑
Ball material clean Visual ❑ ❑
b) Septic Tank(310 CMR 15 223) Approved N/A Problem
Tank is set level with 6'stone under Check with level I� ❑ ❑
(15 228)
Tank is required sizefloading per plan Verify with plan ❑ ❑
Inlet and outlet are at proper location veri/ with plan 7 ❑ ❑
(15227) Y
Tank Is water tight(15.226) Test [/Y ❑ ❑
Outlet tees extend r above flow line Verify by visual/tape [1W ❑ ❑
Approved filter device placed at outlet DEP list Lyy ❑ ❑
Gas baffle installed at outlet tee Visual [' ❑ ❑
Inlet and outlet tees on center line Visual ❑
,(_�,/ ❑
L'1 ❑ ❑
Tank is baGdNed with acceptable material Visual
c System Inatallabon Chatichai 11-09.doc•date
Form Name•Page 2 of 6
Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist front.)
c) Distribution Box(310 CMR 15.232)
An outlet pipes at same elevation
C17e--
per pion
Inlet tee min. 1'over outlet
D box set on level base
Number of outlets
Top of D box 36' max depth
D box s water-tight
D box has a minimum of 2'thick wall and
IT inside dimension
d) Pump Chamber(310 CMR 15.231)
Tank is set level
Proper volume is provided
Float elevations set per plan
Min. 7 delivery line to D box
Number of pumps.
Specified pump provided or designers
approval for equal pump
Correct pump sequence
Covers set to grade
Electrical permit provided
6'of stone beneath chamber
Chamber is water-tight
Min. 9' cover provided
Correct loading provided per plan
Notes:
Check by adding water
Number of laterals
Visual and w/tape
Visual
Visual and w/tape
Add water
Visual and w/level
Check plan and tank
Measure w/tape
Visual
Visual
Test
Visual
Visual on tank
c System Imitation Checklist 11-09.doc•date
Approved N/A Problem
r ❑
V ❑
Rt
V
27"
LA
Approved
n
❑ ❑
Li
N/A
Problem
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
Approved N/A Problem
❑ ❑
No clay, tailings or stones larger than 6°for ,,,/ ❑ ❑
cover material �7L
Soil at bottom/sides of excavation matches
info on deep holes !� ❑ ❑
All impervious layers removed Visual [/ ❑ ❑
No remaining NB horizons Visual L ❑
Groundwater conditions match plan and
Visual/check plan ❑ ❑
deep holes
Vented rf under impervious cover per plan .,/ ❑ ❑
(15.241) i�
Vent is protected from prat/Nation
and animal entry ❑ ❑
Cover of a minimum of 9' over leach area V ❑ ❑
Pipe slope equal to 0 005 Check w&Vansit ❑ ❑
Leach area per design(15241) R7 ❑ ❑
Excavation is level and at required depth Visual/check plan ❑ ❑
Removal of 5 ft material and replacement [• ❑
(if in fill) Visual/check plan u
Back fill material is acceptable Visual ay' ❑ ❑
Final contours correct per plan Check with plan [e.}^ ❑ ❑
Surface/subsurface drainage away from
loath loath area
Final grade and side slopes are stable ❑ ❑
Distribution lines are capped, vented, or ❑ ❑
connected together
Impermeable barrier(15.255[2)) [4--*— ❑ ❑
Retaining wall inspected by PE ❑ ❑ ❑
Retaining wall is water-proofed ❑ ❑ ❑
Retaining wall/banier is at correct
depth/height ❑ ❑ ❑
c System IMtellebon Cheated 11-09.doc•este
Fpm Name•Pepe 4 of
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
Notgs:
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Dale
(12_/5
Dale
Date
Date
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System Installation Checklist 11-09.doc•dote
Form Nam.•papa 6 of
A
Commonwealth of Massachusetts
City/Town of
Septic System Installation Checklist
B. Application Checklist(cont)
f) Leaching trenches (310 CMR 15.251) Approved N/A Problem
Number of trenches: . - -- - ❑ r ❑
Depth of trenches --.... - ❑ ❑ ❑
Width of trenches: ------ ❑ ❑ ❑
Trench spacing per plan J ❑ ❑
Stone is double-washed[3/4" to 1%1015247) ❑ ❑ ❑
g) Leaching fields(310 CMR 15242)
Length of field __ ❑ ❑ ❑
Width of field: ❑ ❑ ❑
Min. of 2 distribution lines ❑ ❑ ❑
Separation distance conforms to plan ❑ ❑ ❑
Stone is double-washed[3/4'to 1111)(151247) ❑ ❑ ❑
h) Leaching Pits(310 CMR 15.253)
Number of pits: -.-._._. ❑ ❑ ❑
Depth of pits ❑ ❑ ❑
Stone is double-washed[3/4'to 1W](15.247) ❑ . ❑ ❑
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 r stone under Visual and with level ❑ ❑ ❑
Tank is proper size per plan Visual with plan ❑ ❑ ❑
Pumping contact 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 ❑ ❑ ❑
Sydem Inebbon Cherklel 11-09.doc•dak
Form Name•Pape 5 of 6
45 -d /t
HILLTOWN‘ACPWIRONMENTAL
CONSULTING
P.O. BOX 314
CHESTERFIELD, MA 01012
(413) 296 -4499
JOB LEDECKl -22 oLb l4ILS0rJ_(Z.o4]1/
SHEET N0 OF
CALCULATED BY DATE
CHECKED9Y / '! DATE ` Z/ZO/5
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