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- ' • � TOWN`OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
Location: AM !/.� LOT�x/ Date of Subdivisio p rov 1
Street s E Zone of Contributi . ut
Village Commercial Residential
Owner:��ce�f .�D �,Ss�zA7i'9 C`s9�Plfbt/ Installer /!�/D � � �
7� - i2 �
BuIIder: En�ineer �� �� ��—
�77 — �16
N/A YES NO
1. R uired num er f co ' s ive
2. Date of ' exam an ercol tion test not older than 2 ars.
4 feet of naturall u ' rvi �al abov t e w c stru '
4. F ndatio 2 feet ov hi in f d r ew con cti .
. Wa v il bilit lett fr at r e r n ctio
6 Benc mark 'ndicated and shown-N D if neaz wetlands �
7 Buildin,,n, sewer does not e�t center of house �
$, S_entic tank a c�n;,,�um of 10 feet from house and deck. X
9. Leac i � a min�num of 20 feet from house and 10 feet from deck. `f'.�l�vvca�l! x_
10 Leachine a�nim�m of 100 feet from wetlands X--
1. Le ' f 0 fr d ' ' we f et from irri tion
�' 12 Svstem meets il other setback reauuements �.?��
I, 1 . U s ad'ust ent for ' um hi ro dw t r.
� 14. eachin 4 -5 feet ve d'usted water or tt f test it.
15 Sy�tem not in to or subsoil or 5 foot removal
16 Proposed contours are suitable. __
l�vstem meetc slo�e requirements - r2n 1/8" 1/4" pteferred h
18 S�stem meets bre�kout rgquirements- �rastone elevat►on carried out 15 feet muumum. x
19 9y�ecified tee sLPs are proner gas baffle on outlet tee X
w w der �— f r 1
21. o I.
22. vt d i ' due
23. ;vl' ' um 6" t or me �ca c m t w the tank d d-bo
�4. ?vlanho cove s wi ' " f rad - tic tank an um chambe
25. Ele ric 1 rmi f r um '
'i � . Pum s stem - 2" 1' w hole ch v Iv i in - al n circui
I 27. Se Facto wate d.
' � . V t rovided i le low f r un 'vewa in
29. Engineer to inspect and certifv : r v
wa l co stru i n h l
: c mmerci stem
0. En ineer and d urve o a d si nature
31 H20 loadine when sy.�em subject to vehicular traffic X —
32 Title V aQplication and fee signed by a licensed installer x
33 Foundation footing 2 feet above adjusted water table. k
34 Lot subdivided prior to Julv 31 1986 - Nitrate Loading �
5. Subdivided rior co A i17 19R - Phos horu Zone 00'.
Plan reviewed b��: