123 Septic System Checklist 2016 1...\.. , 00/6-a
,t
,� Commonwealth of Massachusetts ,t/ /7 C
UCity/Town of /,3 /7i!tic%.� X71`
Septic System Installation Checklist
./40 ')/‘
B. Application Checklist (cont)
(C2frT,fl05� /Oi e �•4)
2 Construction Inspection
a) Building Sewer(310 CMR 15.222) Approved N/A Proble
All waste pipes bed into building sewer Basement check %i L ❑
Schedule 40 PVC 4' or cast iron Verify by reading pipe E r; ❑
Minimum slope of 0 01-0.02 Visual ` ❑
Pipe laid in continuous straight line Visual V ❑
Pips laid on compact, firm base Visual ❑ u 0
Cleanouts precede all changes in Verify by visual/tape 0 . 0 0
alignment/grade
. Cleanout provided every 100 ft Verify by visuaUtape 0 0 0
Backfill material dean Visual 0 • 0 0
4
b) Septic Tank(310 CMR 15.223) Approved N/A Problem,--6
Tank is set level with 6'stone under
(15-228) Check with level 0 0 0
e
,per Agic . 1 Tank is required size/loading per plan Verify with plan ❑ ❑ ❑
U (15 227)Inlet and outlet are at proper location
5 verify with plan ❑ (] ❑
P
�+ Tank is water tight(15.226) Test 0 0 0
Outlet tees extend 6' above flow line Verify by visual/tape 0 0 0
Approved filter device placed at outlet DEP list 0 0 0
Gas baffle installed at outlet tee Visual 0 ❑ 0
Inlet and outlet teas on center line Visual 0 0 0
Tank is baddliled with acceptable material Visual 0 0 0
&/ 2sL
� [�r�5hcQQ;r..e..__Iv r�et
14 pi 0 st 1 le.7....‹,,_
----,7)-4_,;(.e I 4 4
e_ . ._ , 21. eP a.
.._ ______ _. a,y_ . . ,.. .___
..* • -i,-1/0. V /,6---• UG,I,� 4 rid
Syotom I CMckiyt 11-os.doc•data t,,,?
� o
Form Pismo•P 2 of 0
? 7
if4 //�/aJ 0A m.. /628g-
'� . I
x,
, ., .
___.40.40 a 4._ m a 5/7
A..,„.,i
Z
';, Commonwealth of Massachusetts
•
w City/Town of
i
Septic System Installation Checklist
B. Application Checklist (cont.)
c) Distribution Box(310 CMR 15 232) Approved NIA Probl
All outlet pipes at same elevation Check by adding water ❑ u
Number of outlets --Pir aan--- --- Number of laterals PerPlan ------
Inlet tee min. 1'over outlet Visual and w/tape 0 0 0
D box set on level base Visual J , u 0
Top of D box 36 max depth Visual and w/tape ❑ 0 0
D box is water-tight Add water 0 0 0
D box has a minimum of 2' thick wall and
0 0
12'inside dimension
• d) Pump Chamber(310 CMR 15.231) Approved NJA Proble+
Tank is set level Visual and w/level 0 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
Number of pumps. ❑ ❑ ❑
Specified pump provided or designers
0 ❑ ❑
approval for equal pump
Correct pump sequence 0 0 0
Covers set to grade 0 0 0
Electrical permit provided 0 0 ❑
6'of stone beneath chamber Visual 0 0 0
Chamber is water-tight Test 0 0 0
Min. 9' cover provided Visual 0 0 0
Correct loading provided per plan Visual on tank 0 0 0
Notes-
aspic System IntWsOion Checklist 11-00.doc•date Form Menti•Pip 3 all
•
ti
I
la
Commonwealth of Massachusetts
:+ - City/Town of
Septic System Installation Checklist
B. Application Checklist (cont.) __ ___ _+ �� _-
e) Leaching Facility (310 CMR 15 240) Approved 1 N/A Probi
No frozen material used including back fill Vrsua r 0
No clay, tailings or stones larger than 6' for
0 •
❑ ❑
cover material
Soil at bottom/sides of excavation matches o ❑ 0
info on deep holes
AlI Impervious layers removed Visual 0 0
No remaining NB horizons Visual 0 0 0
Groundwater conditions match plan and VrsuaUchecic plan ❑ [) ❑
deep holes
Vented if under impervious cover per plan
(15.241) ❑ ❑ ❑
Vent is protected from precipitation
and animal entry 0 ❑ ❑
Cover of a minimum of 9' over leach area 0 0 0
Pipe slope equal to 0.005 Check w/transit 0 . 0 0
Leach area per design(15241) 0 0 0
Excavation is level and at required depth Visual/check plan 0 '❑ 0
Removal of 5 ft matenal and replacement
(if in fill) Visual/check plan D 0 0
Back fill material is acceptable Visual 0 0 0
Final contours correct per plan Check with plan 0 0 0
Surface/subsurface drainage away from ❑ ❑ ❑
Final grade and side slopes are stable 0 0 0
Mtee cid, vented, or ❑ ❑ ❑eed tbubonogether
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
❑ ❑ ❑
depth/height
Sepik*Ow boEWssen Cheekiest 11-09 doc• Farm Wimp•Papp 4 of 6
Commonwealth of Massachusetts
..i .:060.)., City/Town of
Septic System Installation Checklist
B. Application Checklist (cont)
f) Leaching trenches(310 CMR 15 251) Approved NIA Problei
Number of trenches. ------------- 0 0
Depth of trenches: — ---- Q 0 • 0
Width of trenches -- --- (] 0 0
Trench spaang per pan ❑ 0 0
Stone is double-washed[3/4' to 1'1(15.247) 0 0
g) Leaching fields (310 CMR 15.242)
Length of field. — - -- 0 0 0
Width of field. C 0 ❑
Min. of 2 distribution lines 0 0 0
•
Separation distance conforms to plan 0 ❑ 0
Stone is double-washed 13/4'to 1',41(15.247) 0 0 0
h) Leaching Pits(310 CMR 15.253)
Number of pits -- --- — 0 0 0
Depth of pits: - --- - -- 0 0 0
Stone is double-washed[3/4'to 1 x'1(15.247) 0 0 0
Each pit has min. 1 20'access cover 0 0 0
Piping network and configuration of ❑ ❑ ❑
pita) tubers per plan
i) Tight 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
A/V alarm set at 3/5 tart capacity Check floats by raising 0 0 0
- AN alarm test on separate arcuit Set off alarm 0 0 0
Spfic ayolorn Motasoson Ctraidrt 1 I-09.doc•do* Form t •Pogo 5 or 0
I. • , Commonwealth of Massachusetts
UCity/Town of
Septic System Installation Checklist
a. Application Checklist(cont)
Certtc ate of Compliance(310 CMR 15.021)
As Buo Plan Submttec .
Dia
Signed by Instalier ---- __..____
Date
Signed by Designer Date --
Certrfioate of Compl+ance sued
tate
Notes
906 Brion,i nitMen Chsekl t 11-0e.doc•dMt Form kerne•Pape 5 of 6