Review Checklist� �-�s�-�� ��� -�
TOWN OF YARMOUTH � ���������
� SEWAGE PLAN REVIEW CHECKLIST /,�-"l`-
/ r�- �
� � Location: A.M. `� 7 Lot � Zone of Contribution: In r/Out_ Acreage ���
CommerciaL• Residential: z/
Street: � �
Village: �li, Floor Pl • #Bedrooms: �
Owner: � � ��r�-.,�Z Insta ller: �/
Address: Phone: -�s --
Phone:
Builder: Engineer: GGG�
Address: Phone: - -
Phone:
N/A YES NO
1.Required#of c ies 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 Vaz.: �:�
6.Benchmark indicated and shown-NGVD if near wetlands
7. S tic 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 Var.: .
10.Lea.chin minimum 150 ft from drinking welU25 ft irri tion well Var.:
11.Tank/leachin minimum 10 ft from ro line Var.: `---�'
12. S stem meets all other setback r uirements Var.:
13.Uses ad'ustment for maximum hi oundwater Var.:
14.Leaching set 4-5 ft above adj.water or bottom of test hole Var.: ��f '
15. S stem not in to or subsoil(A,B horizons)or 5'removal L� ',
16.Pro sed contours are suita.ble
17. S stem meets slo e r irements-min. 1/8", '/4" eferred
18. System meets breakout r uirements PVC liner: Wall: ��
19. S ified tee sizes are ro er, as baffle on outlet tee
20. Sewa e is under 10,000 d for arcel �/
21.No ba e dis osa.l �..�---
- 22. S stem ade ua.tel sized for its intended use �`�
23.Minimum 6"stone or com acted below tank and dbox
p.. 24.Manhole covers within 6"of ade, um cha.mber cover to ade
25.Ins ion ort on la.stic chambers/leach field ��
26.Electrica.l ermit for um chamber/S arate meter for du lexes
27.Pum s stem-2"line,wee hole,check valve,tee in dbox, um size
28. S tic ta.nk/ um chamber to be factory wat roofed �-
29.Vent rovided if leachin below 3 feet,under drivewa / arkin -�
30.Buo ancy calcula.tions for tank/pum chamber
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-201oa.din is subject to vehiculax traffic, oundwater
34.Title V A lication and ermit fee,installer si ture
35.Foundation footin min. 2 feet above ad'usted ound water for new house
36.Deed Restriction r uired max. #bedrooms: Z--max.flow: ��'D
37.Check area lots for groundwater/Label groundwater in Assessor's Ma v�
Plan reviewed by: `' �03�03