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TOWN OF YARMOUTH �/ ��� ���
SEWAGE PLAN REVIEW CHECKLIST d a
Location: A.M.�_ Lot � � �b Zone of Contribution: In Out �1 Acreage _
" CommerciaL• Residential:� '
StCeet: 3 ,
Village: litf Floor Plan: � #Bedrooms:�_
Owner: _ /Y���%�� Insta.11er: �
Address: Phone: '
Phone:
Builder: � Engineer: �
Address: Phone:
Phone: `� � /GZ`�.�-e-C��i �`��Z���
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N/A NO
1.R uired#of co ies received
2. Date of soils exam and colation test not older than 2 years �/
3.4-5 ft of naturall 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 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.Leachin minimum 150 ft from drinkin welU25 ft irri tion well Var.:
11.Tank/leachin minimum 10 ft from ro erty line Var.: ✓
12. S stem meets all other setback r irements Var.:
13.Uses adjustment for maximum hi oundwater Var.:
14.L,eachin set 4-5 ft above ad'.water or bottom test ho Var.:
15.System not in to or subsoil(A,B horizons)0 5'remov
16.Pro sed contours are suita.ble
17. S stem meets slo e r uirements-min. 1/8", '/4" eferred
18. S stem meets brealcout re uirements PVC liner: Wall:
19. S ecified tee sizes are ro er, as ba.ffle on outlet tee
20. Sewa e is under 10,000 for arcel
21.No arba e dis osal
22. S stem ade uatel sized for its intended use t�
23.Minimum 6"stone or com acted below tank and dbox
24.Manhole covers within 6"of ade, um chamber cover to ade �/ , '
25.Ins tion rt on la.stic chambers/leach field
26.Electrica.l ermit for um cha.mber/S arate meter for du lexes •--�
27.Pum stem-2" line,wee hole,check valve,tee in dbox, um size
28.S tic tank/ um chamber to be factory wat roofed /
29.Vent rovided if leachin below 3 feet,under drivewa / arkin -
30.Buoyanc calcula.tions for ta.nk/ u chamber
31. En ' eer to ins ect and cert' soils: wall: commercial: '
32.En ' eer/Re ' tered Sanitarian and Land Surve or stam s/si ture
33.H-201oadin is sub'ect to vehicular traffic, oundwater .
34. Title V A lica.tion and ermit fee, installer si ture
35.Foundation footing min.2 feet above ad'usted ound water for new house
36.Deed Restriction r uired max. #bedrooms: max. flow: d V. '
37.Check area lots for oundwater/Label oundwater in Assessor's Ma '
Plan reviewed by: �r�v
NO3/03