414 Septic Install Checklist 2017 A • is 7
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> ,, Septic System Installation Checklist El.
B. Application Checklist (cont) 9/9/7
2. Construction Inspection 2 aS,LK
a) Building Sewer(310 CMR 15.222) Approved
N/A Problem
•
All waste pipes tied into building sewer Basement check Lroys ❑
Schedule 40 PVC 4' or cast iron Verify by reading pipe ❑ ❑ ❑
Minimum slope of 0.01-0.02 Visual (2J---- ❑ ❑
Pipe laid in continuous straight line Visual ❑
Pipe laid on compact, firm base C. ❑ ❑.
Cleanoute precede all changes in Verif visual ❑ [Ti
alignment/grade
Cleanout provided-eveq-0(49-k-- Van eTpe ❑ ❑
Backfill material Olean Visual ❑ • ❑ ❑
b) Septic Tank(310 CMR 15.223) Approved N/A Problem
Tank is set level with 6' stone under (;heck with level ❑ ❑
(15.228)
Tank is required size/loading per plan Verify with plan P ' ❑ ❑
Inlet and outlet are at proper location VerifyVerify wi� 71i---- ❑ D
(15.227)
Tank is water tight(15.226) Test ---.
est ��11 IY ❑ ❑
Outlet tees extend 6' above flow line Verif pe [41"--- ❑ ❑
Approved filter device placed at outlet DEP list //]/ ❑ ❑
Gas baffle installed at outlet tee Visual(2/cl— 00'. ❑ ❑
Inlet and outlet tees on canter line Visual ❑ ❑
Tank is backfilled with acceptable material Visual V ❑ ❑
ANotes:
Sepgc System Inataltetton Checklist 11-09.doc•dote Form Name•Page 2 PIG
Commonwealth of Massachusetts
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Septic System Installation Checklist
B. Application Checklist (cont.)
c) Distribution Box (310 CMR 15232) /Approved N/A Problem
' All outlet pipes at same elevation Check by ante( drif/ (-1 ❑
' Number of outlets �� Number of laterals/
' a Plepis d_pla/n
Inlet tee min. 1"over outlet Visual and w/tape CX -] ❑
D box set on level baseS
V ,;..l . ❑, ❑
Top of D box 36" max depth al d w/tape 3"/ ❑ ❑
D box is water-tight Add water [T----1 ❑ ❑
D box has a minimum of 2" thick wall and rrt,/❑
12" inside dimension � ❑
d) Pump Chamber(310 CMR 15.231) Approved N/A Problem
Tank is set level Visual and w/I=vel ❑ K ❑
Proper volume is provided Check plan and t. k ❑ ❑ ❑
Float elevations set per plan Measure w/tape ❑ ❑ ❑
. Min. 2"delivery line to D box Visual 0 0 0
Number of pumps: _. - ❑ ❑ ❑
Specified pump provided or designers
approval for equal pump ❑ ❑
Correct pump sequence ❑ ❑ ❑
Covers set to grade
0 0 ❑
Electrical permit provided ❑ " ❑ ❑
6"of stone beneath chamber Visual [Ti N
Chamber is water-tight Test ❑ ❑ ❑
Min. r cover provided Visual ❑ Li
N.
❑
Correct loading provided per plan Visual on tank Li Li Cl
Notes:
eeptic system InalaMtlon Checklist I1-Oedoc•dale
Form Name.Pepe 3 of 8
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'- e Septic System Installation Checklist
B. Application Checklist(cont.) •
•
a) Leaching Facility (310 CMR 15.240) Approved N/A Problem
No frozen material used including back fill Visual C4✓ ❑ 0
Noetailings or stones larger than s" for / I L 0
cover
m matererial V ILS
' Soil at bottom/sides of excavation matches �� ❑ 0
info on deep holes
All impervious layers removed ❑ 0
No remaining NB horizons ❑ ❑
Groundwater conditions match plan and
deep holes Visual eck plan 1-1 . 5 ❑
Vented if under impervious cover per plan ,—,r . ❑ ❑
(15.241) l�
Vent is protected from precipitation
and animal entry / / ❑ ❑
Cover of a minimum of 9° over leach area — `4"'y(i' ❑ ❑
Pipe slope equal to 0.005 Check w/transit V3----... ❑ ❑
•
Leath area per design(15.241) lam' 0 0
Excavation is level and at required depth CP eck plan ❑ ❑
Removal of 5 ft material and replacemen
ortioninBack material is acceptable t�, / ❑ 0
Final contours Correct per plan Check with plan IV ❑ 0
Sunace/subsurfaos drainage away from O VI,/ ❑ ❑
leach area r� L�
Final grade and side slopes are stable V 0 0
Distribution lines are capped, vented, or ❑ 0
connected together
Impermeable barrier(15.255(2)) V 0 ❑
Retaining wall inspected by PE 7 ❑ ❑
Retaining wall is water-proofed ❑
Retaining walVberrier is at correct /I!d ❑ ❑
depthlheight '
Septic System Installation Chealdiet 11-09.doc•date
Form Name•Pape 4 o(8
,, Commonwealth of Massachusetts
1/441/4
r City/Town of
n " Septic System Installation Checklist
B. Application Checklist (cont.)
j) Certificate of Compliance(310 CMR 15.021)
As Built Plan Submitted
Dote
Signed by Installer
Dale
Signed by Designer
Data
Certificate of Compliance Issued - -. —-- —-- - - ------.-.__.
Date
• Notes: ` / / // 4
-- AL& We is5 ofu -5 Ile at/ r A/7
.. -.. ..._....... ...
Samtie System Installation Checklist 11-00 deo•date Form Name•Page 6 of 6
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Commonwealth of Massachusetts
1/41/4
w ,i City/Town of
h :" Septic System Installation Checklist
B. Application Checklist(cont.)
f) Leaching trenches (310 CMR 15 251) Approved N/A Problem
Number of trenches: - - -- - --- -- ❑ ❑ ❑
Depth of benches: --- -- __- - ---- L ❑ ❑
Wdth of trenches: _ -. _._._..._..__-. ❑ ❑ ❑
Trench spacing per plan ❑ ❑ ❑
Stone is double-washed[3(4"to 1%1(15.247) ❑ Li ❑
g) Leaching fields (310 CMR 15.242)
Length of field, _.. . .___-______.. ❑ ❑ ❑
Wdth of field: -___-._..-___ ❑ ❑ ❑
Min. of 2 distribution lines ❑ ❑ ❑
Separation distance conforms to plan ❑ ❑ ❑
Stone is double-washed pc to 1'%'7 (15.247) ❑ ❑ ❑
h) Leaching Pits(310 CMR 15.253)
Number of pits: - — -------- ❑ ❑ ❑
Depth of pits: - ❑ ❑ ❑
Stone is double-washed[314"to 1W] (15.247) ❑ • 0 0
Each pit has min. 1 20" access cover 0 0 0
Piping network and configuration of ❑ ❑ ❑
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 El ❑ I]
Pumping contract 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 ❑ L I ❑
Septa System IretaMson Chadds'1I-09.doc•date Form Name*Page 5 06