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� TOWN OF YARMOUTH
i : SEWAGE PLAN REVIEW CHECKLIST
' Location: A.M.�� Lot� Zone of Contn`bution: In Out�" Acrea.ge
Commercial: Reside�ial: �
Street:
Village: Floor Plan: � #Bedrooms: �
o��: ,�'�� ��.n�: C s
Address: � �- Phone: - -l�' -
Phone:
Builder: Engineer: r ��
Address: Phone: S7� - � -d'
Phone:
`/��� �/� �'�;G�L� r �G�
N/A YES NO
1.R ired#of c ies received
2. Date of soils exam and ercolation test not older than 2 ears t�
3.4-5 ft of natura occurrin ervious ma.terial, above water table .
4.Foundation 2 ft above high ourt of road H.P.: Fnd: Vaz.:
5. Water line 10 ft from s tic com onents Var.:
6.Benchmark indicated and shown-NGVD if near wetlands
7. S tic tank minimum 10 ft from foundaxion, deck Var.:
8.Leachin minimum 20 ft full, 15 ft crawl, 10 ft sla.b Var.:
9.Leachin minimum 100 ft from wetlands Var.:
10.Lea.chin minimum 150 ft from drinkin welU25 ft urigation well Vaz.:
1 l.Tank/leaching mi.nimum 10 ft from roperty line Vaz.: '
12. S stem meets all other setback r uirements �T�,;
13.Uses ad' stment for maX�mum hi groundwater Var.: '
14.Leachin set 4-5 ft above ad'.water or bottom of test hole Vaz.:
15. System not in to or subsoil(A,B horizons)or 5'removal
16.Pro osed contours are suita.ble
17. S stem meets slo e r uirements-min. 1/8", '/4" eferred
18. System meets brea.kout r irements PVC liner: Wall:
19. S ecified tee sizes are ro er, gas ba.ffle on outlet tee f
20. Sewa e is under 10,000 d for arcel �- �
21.No ba.ge dis osal �
- 22. S stem ad ua.tel sized for its intended use �
23.Minimum 6"stone or com acted below tank and dbox
24.Manhole covers within 6"of ade, um chamber cover to grade
� 25.Ins ection ort on lastic chambers/leach field
26.Electrical ermit for um cha.mber/S arate meter for du lexes '
27•P system-2"line,w hole,check valve,tee in dbo� um size /
28. S tic tank/ um chaxnber to be facto waterproofed ;
29.Vent rovided if leachin below 3 feet,under driveway/ arkin �
30.Buoyancy calcula.tions for tank/ cha.mber �
31.En ' eer to ins ect and c ' soils: wall: commercia.l: �
32.En ' eer/Regis�ered Sauitaria.n and Land Surveyor stam s/si e �
33.H-20 loadin is sub'ect to vehicular traffc, oundwater . �_J
34.Title V A lica.tion and ermit fee, installer si ture �
35.Founda.tion footin min.2 feet above ad'usted ound-water for new house ��
36.Deed Restriction r uired max. #bedrooms: max. flow: d �
37.Check area lots for oundwater/Label oundwater in Assessor's Ma
Plan reviewed by: L� �
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