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308 Septic System Checklist 2016 air gale ae5itel Commonwealth of Massachusetts //' / M :/ Cit !Town of t/3/7 C /Al/[�( J ' Septic System Installation hect / B. Application Checklist (cont) 111.-/0b - - i 2. Construction Inspection e inovei6ci N £ a) Building Sewer(310 CMR 15.222) /fZ 0'✓� 5Ape //Ne ApprovedroN/A Problem //' All waste pits- e• into building sew r Basement check • I' _ ❑ J lO� P Schedul. 40 PVC 4" • cast iron Ven by reading pipe E ❑ ❑ e 20/ i. .2 Minimum slope of 0.1 -0.02 Visual ❑ r Pipe laid in continuous straight line Visual(UrosJ rr ❑✓ S ❑ p telae {,o l Pipe laid on comped, firm base Visual ,-F 't,I>e \ ❑ ❑ 0 1 y/ Clearrouta precede all changes in Verify beep° / ❑ ❑ ❑ Pe i "P....-1- no v alignment/grade Cleanout provided every 100 ft Verify by isuaV pe V ❑ ❑ Ball material clean Visual L5f • ❑ ❑ b) Septic Tank(310 CMR 15.223) App_r�ovedd N/A Problem Tank Is set level with 6'stone under Check with level (,� ❑ ❑ // (15.228) / / Tank is required size/loading per plan Verify im plan EZ--------- �/ ❑ ❑ T • Inlet and outlet are at proper location 27) Verify vi plan L� ❑ ❑ Inlet an ' y�� Tank is water tight(15.226) Test 0 K ,❑ ❑ ❑ �j7 i ( Outlet tees extend 6"above flow kne Verify by visual/tape t ❑ ❑ /" r " • 6 C Approved filter device placed at outlet DEP list I ❑ CI QNv✓e 4 /0 Gas baffle installed at outlet tee is L-�'�/ ❑ ❑ f/� Inlet and outlet tees on center lire h u I LW'7 ❑ ❑ I1Wef5✓1vac9 / ,//' /� Tank is badcfllled with acceptable material Visual ---14X,1f 12?1 ❑ ❑ ❑ /�i2U / AkS Notes: d,/ 5(05593 c.. INS i-x. lie/(�jpn)/77,2/) --Z-ns. _ JleL_- 60r.)e-- ._ I ot-ca1 _ J IVCLT 77 1 oyN'S;4 'f/3//7 4r/el '13e6re goo/- i...,s/ cl /t-re;A; gap*System Installation Checklist f 1-0i.doc•date Form Name•Page 2 of 5 Commonwealth of Massachusetts t II - Cityrfown of ':-i ; Septic System Installation Checklist 1/4 -- ------ ----- B. Application Checklist front.) c) Distribution Box (310 CMR 15.232) Approved N/A Problem All outlet pipes at same eleva/tion Check by adding water [g�r ❑ r]• Number of outlets {p/ -"�— Number of laterals per plan Inlet tee min. 1•over outlet Visu and w/tape [P' C ❑ D box set on level base 14-.'" ❑ ❑ Top of D box 36"max depth isu d w/tape ❑ ❑ D box is water-tight Ado water g'7. ❑ ❑ D box has a minimum of 2" thick wall and L0�. / G, ❑ 12"inside dimension / d) Pump Chamber(310 CMR 15.231) Approved N/AProblem L� Tank is set level Visual and w/level C ` / ❑ Proper volume is provided Check plan and tank ❑ El ❑ Float elevations set per plan Measure w/taps ❑ ❑ ❑ , Min. T delivery line to D box Visual ❑ ❑ ❑ Number of pumps: .... _ __ _.._... ❑ ❑ ❑ Specified pump provided or designers approval for equal pump ❑ I: ID Correct pump sequence ❑ ❑ Covers set to grade ❑ ❑ ❑ Electrical permit provided ❑ ❑ ❑ 8'of stone beneath chamber Visual ❑ 0 5 Chamber is water-tight Test ❑ ❑ ❑ M . 9"cover provided Visual ❑ .1 ❑ Correct loading provided per plan Visual on tank ❑ 0 0 Notes: eept System Iris/agape Checklist t 1-O9.doc•date Form Name•Pepe 3 ole i\ Commonwealth of Massachusetts w r City/Town of u: tl ..J Septic System Installation Checklist -- - — B. Application Checklist(cont) #-070� e0053 (_y) leaching Facility (310 CMR 15 290)��j,� �� Approvetl N/A Problem (/ No frozen material used including back fill Visual Q ElS/re No clay, tailings or stones larger than 6" for cover material _ Q Soil at bottom/sides of excavation matches F.� Q ❑ info on deep holes �9 All impervious layers removed CZ? 7/ ❑ ❑ ' No remaining NB horizons Cal ❑ ❑ Groundwater conditions match plan and 64i/check plan ❑ ❑ deep holes Vented if under impervious cover per plan ❑ r ❑ (15.241) - Vent is protected from precigtehon ❑ ❑ ❑ and animal entry Cover of a minimum of 9°over Ioao,a area [� ❑ ❑ Pipe slope equal to 0 005 iaLand�/ A. ck w(transit ❑ ❑ Leach area design(15241)/ ,,(„„// ❑ O • Excavation is level and at required depth _check plan/ ,tJ ❑ ❑ Removal of 5 ft material and replacemene . eck pla t! ri El ❑ (If in fill) ^ 7�A �/ Back fill material is acceptable Vis /✓/ [El ❑ ❑ Final contours correct per plan Check with plan ❑ ❑ Surface/subsurface drainage away from / Al Q ❑ ❑ Final grade and side slopes are stable © ...--- ❑ ❑ Distribution lines ate capped, vented, or a/ ❑ ❑ connected together Impermeable barrier(15.255(2]) ❑ ❑ Retaining wall inspected by PE ❑ ❑ Retaining wall is water-proofed ❑ ❑ 0 Retaining wall/barrier is at correct Q ❑ ❑ depth/height Septic System Infitbon Checklist 11-09.doc•date Form Name•Page 4 of 6 1. 49Commonwealth of Massachusetts I CityiTown of r T. Septic System Installation Checklist B. Application Checklist (cont) jJ Certificate of Compliance(310 CMR 15.021) // le ,aeold As Built Plan Submitted Dots I Signed by Installer Data Signed by Designer ..e----- t f Data Certificate of Compliance Issued Delo • Notes: /fije ^a4/e 1 ///7 /yam /{ -ems sg,,,ci CCC / 4. _ive iceerlP _' 2 .vrd6(-",ve Sapko System Inols/ion GMcId st 11-09.doc•dale Form Name•Pepe 6 of 6 Commonwealth of Massachusetts -/ k City/Town of n Septic System Installation Checklist B. Application Checklist (cont.) f) Leaching trenches (310 CMR 15251) Approved N/A Problem Number of trenches, - ----- --- - ❑ ❑ ❑ Depth of trenches: - -- -- -- - -- ❑ 0 ❑ Width of trenches: ... - _. -. _... ❑ 0 ❑ Trench sparing per plan 5 ❑ 0 Stone is double-washed 1314"to 1;4"J (15.247) ❑ ❑ ❑ g) Leaching fields (310 CMR 15.242) Length of field: - - -- ------ ❑ ❑ ❑ • Width of field: - _---__ _._-._- ❑ 0 0 Min. of 2 distribution lines ❑ ❑ ❑ Separation distance conforms to plan ❑ ❑ ❑ Stone is double-washed(3/4" to 11/41 (15.247) ❑ ❑ 0 h) Leaching Pits(310 CMR 15.253) Number of pits: -- - ------ ❑ ❑ ❑ Depth of pits. ❑ ❑ ❑ Stone is double-washed(314'to 1W1(15.247) ❑ ❑ 5 Each pit has min. 1 20' access cover ❑ ❑ ❑ Piping network and oonfpuratiol of ❑ ❑ 0 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 ❑ ❑ El AN alarm set at 3/5 tank capacity Check floats by raising ❑ ❑ ❑ . AN alarm test on separate circuit Set off alarm ❑ ❑ ❑ upon Salem Inststylon Checklist I1-0s.doc•date Form Nome•Page 5 o/6