HomeMy WebLinkAboutReview Checklist � � �� -�6
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� SEWAGE PLAN REVIEW CHECKLIST
Location: A.M. � Lot �j Zone of Contribution: In Out � Acreage��
' Commercial: Residential:
Sireet:
Village: Floor Plan: � #Bedrooms:�
Owner: Q �f�2.�G�-. Insta.11er: O�
Address: C '"/ � Phone: �' --
Phone: � ` `� , ,,�
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Builder: Engineer:
Address: Phone: �
Phone: . ��,- 4- .� ��
� S ,,�5'
N/A YES NO
l.Required#of copies received
2.Date of soils exam and ercolation test not older than 2 years
3.4-5 ft of natural occurrin ervious material,above water table -
4.Foundation 2 ft above hi oint of road H.P.: Fnd: Var.:
5.Water line 10 ft from s tic com onents Var.:
6.Benchmark indicaxed and shown-NGVD if near wetlands
7. Se tic tank minimum 10 ft from foundation, deck Var.:
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.:
9.Leaching minimum 100 ft from wetlands Var.: �
10.Lea.chin minimum 150 ft from drinking welU25 ft irriga.tion well Var.:
1 l.Tank/leachin minimum 10 ft from prop line Var.:
12. S stem meets all other setback r uirements Var.: t�.��
13.Uses adjustment for maximum hi groundwater Var.: �
14.Leaching set 4-5 ft above ad'.water or bottom o ar.:
15. System not in to or subsoil(A,B horizons)or 'removal
16.Pro sed contours are suitable ��
17. S stem meets slo e r uirements-min. 1/8", '/4" eferred
18. System meets breakout requirements PVC liner: Wall:
`19.S ec�ed tee sizes are proper, gas baffle on outlet tee
20.Sewa e is under 10,000 d for arcel
21.No garba 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 de, um chamber cover to grade
25.Ins ection ort on plastic chambers/leach field
26.Electrical ermit for um chamber/S arate meter for du lexes •
27.Pum system-2"line,w hole,check valve,tee in dbox, um size
28. Septic tank/ um chamber to be factory wa roofed �''
29.Vent rovided if leachin below 3 feet, under driveway/ arking
30.Buoyancy calculations for ta.nk/ ump cha.mber
31.En ' eer to ins ect and cert' soils: wall: commercial:
32.En ' eer/Re 'stered Sanitarian and Land Surve or stam s/signature
33.H-201oadin is sub'ect to vehicular traffic, groundwater
34.Title V A lication and ermit fee, insta.11er si ture .._�
35.Foundation footing min. 2 feet above ad'usted ground water for new house
36.Deed Restriction r uired max. #bedrooms: max. flow: d
37.Check area lots for oundwater/Label groundwater in Assessor's Ma
Plan reviewed by: �o3io3