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Address ileL2 Se QC'g s_ )—ff Title of File Page of
Date File Open: Date fie closed:
Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes
action Document/ document/
Num. Action Department
Board of Appeals — Board of Health — Planning Board — Conservation Commission — Bonding Department
G
Board of Health SEPTIC SISTEM �
/
North An ver Haan.
1
INSTALLATICK CHECK LIST LOTlC�r�
APPRUVO— DATE BISAPPROM EXAVATION OK FAIL
1 f
+ s
/� BaBDnst •
1. Distance Tot
a. Wetlands
b. 'Drains 1 j
c.. Well
' 2. Water Line Location
3. No PVC Pipe
}�. Septic Tank -
a. _Tees -_Length & To Clean Out Covers.
b. Cement Pipe .to Tank On Both Sides of Tank
5. Distribution Box
a. Covers & Box - No Cracks
b. All Lines Flowing Equal- Amounts
C. No Back Flow
6. - Leach Field or Trench
a. Dimensions
b. Stone Depth
c: Capped Finds
d. Clem Double'-Washed-Stone
7. Leach Pits
'
no Dimensions
r b. Stone Depth
i c. Splash Pads
d. Tees
e. Cm Mt Pipe to Pit - Both Sides
f. Clean Double Washed Stone
8. No Garbage Disposal
G/ 9. Final Grading Inspection
10. Barricading Covered System
11. As Built Submitted
a. Lot Location
b. Dimensions of System
c. Location with Regard-to Perc Test
' d. Elevations
F
e: Water Table
1
LaaT�^dof Health .
Nartt: :,ncbcer,2Sasa . -
SUBSURFACE DISPOSAL DESIGN CHECK LIST
t -LOT
APPROVED DATE DISAPPROM DAA --
Reasons:
(DY,�4
Title V FAIL CK :.
Reg 2.5 a submitted plan Faust show as a v�ni amm=
the lot to be served-area,dimensions lot #,abutters
' location and log deep observation holes-distance to ties
- location and results percolation tests-distance to ties
d o'design calculations k calculations showing required leaching Area
ocation and dimensions of system-including reserve area
xisting and proposed contours
location any vet areas vithin 1001 of sewage disposal system or
disclaimer-check wetlands mapping
-Vh) surface and subsurface dr-ins within 1001 of sewage disposal
system or disclaimer
(i) location any drainage easements i4thin 1001 of Bev-age disposal
r
system or disclair-er-Pl.annIng Board files
(3) know sources of meter surply witbin 2001 of serge disposal a _
system or disclaimer
— ofied �, lto serve lot-100!from leaching fact
( ) 3ocation ofkF P
cation of mater lines on property-10' from leaching fa.ci ty
m) location of benchmark
(n). drive-Says
(o)..,garbage disposals
(p nb PVC to be used in construction
prof le_of_:s stem-elevations of basement, plumb, pipe, septic tank,
distribution box inlets and outlets, distribution field piping and
Other elevations
r ,.ma)d=am, grovnd -ester elevation in area se�age disposal system
eer or otheir
s) plan must be prepared by a Professional
to prepare such plans
professional authorized by
Reg 6 Septic Tanks
a) capacities-150%_ of flog, meter table, tees, depth: of tee ,
,.-- access, pti'-?ing j
(.b) cleanout !
A(c)'10' from cellar tall or in round s4=ing pool
,,J(d) 251 from subsurface drains
Reg 10.2 s'' Distribution Foxes
(a)
slope greater than 0.08
Reg 10.4 I b) sum -.
z