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I
TOWN OF YARMOUTH
'i SEWAGE PLAN REVIEW CFIECKL.IST �
Location: A.M.� I,ot�Zone of Contribution: In_ Out � Acreage ,
Comm . Residential:�
�: Street: S
Village: - ti Floor Plan: � �� �Bedrooms:
�
� Owner: � Installer:
Address: Phone:
Phone:
i Builder: � Engincer: �
Address: � Phone: fof 7 � �/ 2 �
Phone: �
i N/A NO
1.R uired# of ies received
� 2.Date of soils exam and �colation test not older than 2 ears
3.4-5 ft of natural occurrin ervious material, above water table
4.Foundation 2 ft above hi im of road H.P.: Fnd: Vaz.:
5. Wat�line 10 ft from s tic com onerns Vaz.:
6. Benchmark indicated and shown-NGVD if near w�lands
7. S 'c tank minimum 10 ft from foundation, deck Var.:
8.Leachin minimum 20 ft full, 15 ft crawl, 10 ft slab Var.:
9.Leachin minimum 100 ft from wetlands Vaz.:
10.Leachin minimum 150 ft from drinkin welU25 ft irri rion well Var.:
11.Tank/leachin minimum 10 ft from r line Vaz.: ✓
12. S stem meets all other setback uirements Vaz.:
13. Uses ad' stment for maximum hi oundwater Vaz.:
14. Leachin set 45 ft above ad'.water or bottom of test hole Vaz.:
i15. S stem not in to or subsoil(A,B horizons)or 5'removal
16.Pr ed contours aze suitable
17. S stem meets slo e r irements-min. 1/8", '/d' erred
18. S stem meets breakout r ' ements PVC liner: Wall:
19. S ified tee sizes aze r er, baffie on outl�tee
20. Sewa e is under 10,000 for arcel
21.No ba e dis osal
22. S stem ad uatel sized for its intended use
23.Minimum 6"stone or com acted below tank and dbox .
24.Manhole covers within 6"of , chamber cover to e
25.Ins ection ort on lastic chambers/leach field
26. Elec;trical �nit for chamba/S ate m�er for du lexes
27• em-2" line,w hole,check vatve,t�in dboac, um size
28. S ic tank/ um chamber to be factory wa roofed
29.Vent rovided if leachin below 3 feet,mmder driveway/ azkin
30.Bu cy calculations for tank/ chamber
31.En ' eer to ' ect and soils: wall: commercial:
32.En ' eer/Re ' tered Sanitarian and Land Surv or stam s/si t�ue
33.H-201oadin is sub'ect to velucular traffc, oundwat�
34.Title V A lication and ermit fee,installer s' twe
35.Foundation footm min. 2 feet above ad'usted ound water for new house
36.Deed Restricrion ired ma�c, #bedrooms: max. flow:
37.Che�k area lots for oundwat�/Label oundwater in Assessor's Ma
Plan reviewed by: ��