249 Lot 5 Septic System Checklist 2016 /veeCommonwealth of Massachusetts di6 (�y 4.44
goM City/Town of"� Septic System Installation Checklist
B. Application Checklist (cont.) //--- / / v:4.1 •
4,..4,,,,,A
2 Construction Inspection
a) Budding Sewer(310 CMR 15.222) Approved N/A Probler
Ail waste pipes teed into building sewer Basement check L: ❑ 0
V'
Schedule 40 PVC 4' or cast iron Verify by reading pipe 0 0
Minimum slope of 0 01-0.02 u 0
Pipe laid in continuous straight linede" ;al ❑ ❑
Pipe laid on compact, firm base Visual Eir---------n 0
. Cleanouts precede all changes in Verify b Ark: 0 0 0
alignment/grade r• ,_ /
Cleanout provided every 100 ft A/4 Verify •,lf . :pe LL' 0 0
Backfill material dean (vis ❑ 0
1 b) Septic Tank(310 CMR 15.223) Approved N/A Problem
Tank is set level with 6' stone under Check withlevel [ 0 0
1 (15.228)
Tank is required size loading per plan Verify with plan0
Inlet and outlet we at proper location verify with plan [❑ ❑
l (15227)
Tank is water tight(15.226) Test 4/< 0 0 0
Outlet tees extend 6'above flow line Verify by visual/tape [ 0
Approved filter device placed at outlet DEP listIE 0 0
Gas baffle installed at outlet tee Visual r - i 0
Inlet and outlet tees on canter line Visual l] 0
Tank is backfilled with acceptable material Visual 0 j] 0
Notes
—AfrOVell .
Sw/sa sywm Inewaslloo Chboidhe 11-oe.doc•date Form Nie•Pip 2 0 II
Ort Commonwealth of Massachusetts
I.!. ..:1.)... City1Town of
Septic System Installation Checklist
B. Application Checklist (cont.)
ci Distribution Box(310 CMR 15 232) Approved N/A Probler
Ali outlet pipes at same eleva on Check by adding water _, 0
- 671SNum
Number of outlets pan Number of lateraIs --
Da Pin
Inlet tee min. 1'over outlet atr• wttape [1.--- . 0 0
D box set on level base dr V ❑ 0
Top of D box 36'max depth A-nd w/tape 0 0
D box is water-tight Add water 0
0
box has a minimum of 2'thick wall and C ❑
12'inside dimension
d) Pump Chamber(310 CMR 15.231) Approved NIA Problem
Tank is set level Visual and wllevel 0 0
Proper volume is provided Check plan and tank 0 0 0
Float elevations set per plan ' Measure w/tape 0 0 0
Min. 2'delivery line to D box Visual 0 0 0
Number of pumps. ❑ 0 0
Specified pump provided or designers ❑ ❑ ❑
approval for equal pump
Cared pump sequence 0 0 0
Covers set to grade 0 0 0
Electrical permit provided 0 0 0
6'of stone beneath chamber Visual 0 0 0
Chamber is water-bght Test 0 0 0
Min. 9' cover provided Visual 0 0 0
Correct loading provided per plan Visual on tank 0 0 0
Notes:
81*System pabl6lioo Chsci is 1 I-09.doc•dote Fon Name•Pops 3 ore
S\
49Commonwealth of Massachusetts
• ‘,..:1"): City/Town of
Septic System Installation Checklist
B. Application Checklist(cont) _____�__�
a) Leaching Facility (310 CMR 15 240) Approved NA Proble
No frozen material used including back fill isu Vr ❑
No clay, tailings or stones larger than 6"for o ❑
cover material
Soil at bottom/sides of excavation matches 121 ❑ Q
info on deep holes
All impervious layers removed411° ;✓ E. 0
No remaining A/B horizons 40 r U 0
Groundwater conditions match plan and _.; pian 0 0 0
deep holes
Vented if under impervious cover per plan
(15.241) J ❑
Vent is protected from precipitation [11 )...
11f 0 0
and animal entry
Cover of a minimum of 9'over leach area e 0 0
Pipe slope equal to 0.005 4, Check w/traisit 0 • 0 0
Leach area per design(15241) Q, r/C/5
Eciti 0 ❑
Excavation is level and at required depth VisuaUcheck plan
0
Removal of 5 ft matenat and replacement
Visual/check plan [] ❑
(if in fill)
Back fill material is acceptable Visual d.g 0 0
Final contours correct per plan Check with plan
Surfaas/subsurface drainage away from ❑ 0
• leach area
Final grade and side slopes are stablerM 0 0
Distribution lines are capped. vented, or
0
❑ ❑
connected together
Impermeable barrier(15.255{2j) 0 0 0
•
Retaining wall inspected by PE 0 0 0
Retaining wall is water-proofed 0 0 0
Retaining walVbarrier is at correct
0 •
❑ Q
depthTheight
Slplic S'yrsrn Mwfaasson CMckkst 11-09 doe•dab Form Mame•Pew 4 of 1
Commonwealth of Massachusetts
. /• • •/
ViCity/Town of
Septic System Installation Checklist
B. Application Checklist(cont.)
f) Leaching trenches(310 CMR 15 251) Approved NIA Problerr
Number of trenches 0 tJ 0
Depth of trenches: _. G 0 0
width of trenches -_.-.___._ ___. ❑ ❑ 0
Trench spaang per plan C 0
Stone is double-washed[3/4'to 1W1(15.247) 0 i—• 0
g) Leaching fields (310 CMR 15.242)
Length of field - - 0 0 0
Width of field. —. ------ — 0 0 0
Min. of 2 distribution lines 0 0 0
Separation distance conforms to pian _0 / 0 0
Stone is double-washed(3/4' to 1W] (15.247) l4Y 0 0
h) Leaching Pits(310 CMR 15.253)
.
Number of pits: .. - --------- 0 0 0
Depth of pits: -- — 0 0 0
i Stone is double-washed[314'to 1WJ(15.247) ❑ 0 0
Each pit has min. 1 20'access cover 0 0 0
Piping network and configuration of 0 ❑ ❑
pits/chambers per pian
i) TO!Tank(310 CMR 15.260)
Tank is set level with 6'stone under Visual and with level 0 0 0
Tank is proper size per plan Visual with plan 0 0 0
• Pumping contract has been provided 0 0 0
Covers to grade Visual 0 0 0
NV alarm set at 3/5 tank capacity Check floats by raising 0 0 0
AN alarm test on separate arcuit Set off alarm 0 0 0
avec Showy'ineaboason Checklist 11-0a.doc•dors Form Wows•Pep 5ot 5
Commonwealth of Massachusetts
•
City/Town o`
Septic System Installation Checklist
B. Application Checklist(cont)
Certificate of Compliance(310 CMR 15 0211 �
/
As Built Plan Submitted
D/O �e 5e!_sJ - — i
.te
Signed by installer _
-- _
Signed by Designer ped._
Certificate of Compliance Issued Date
• Notes:
jjeel/(5 ---414, < 414._.)/r- 75
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