HomeMy WebLinkAboutReview Checklist t
� ; �7-��- �- v� /�,��`�''�`� �� �' '
,�. ��_� OVVN OF Yi�RM8t1TH _ � �j�
. ����
SEWAGE PLAN REVIEW CHECK�.IST �``�' �"/
� / �� � �
Location: A.M. 7 7 Lot �_ Zone of Contributi¢n: In� Out_ Acreage < \ ,
; Commercial� Residential:�_
Street: 6t' '
Village: Floor Plan: t� #Bedrooms:�_ '
Owner:��-r!� /��_�i���'�f Installer: �/T ;;
Address: � Phone:
Phone: `-�P l/��L'`e, �`C.. �i��S °� ��`'��-
Builder: Engineer: �
Address: Phone: - � - Z_
Phone: �/ � � c� /�� ���,� �
� �`G��1� f /��`�� 6`�.`.�,"� l�JL
N/A YES NO
1.R uired#of co ies received
2. Date of soils elcam and colation test not older than 2 ears
3. 4-5 ft of natural occurrin ervious material, above wate,r table t�'
4.Foundation 2 ft above hi int of road H.P.: Fnd: Var.:
5. Water line 10 ft from s tic com onents Var.: cv
6. Benchmark indicated and shown-NGVD if near we�lands
7. S tic tank minimum 10 ft from foundation, deck Var.:
8. Leachin minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: (,.� S ' �--�
9. Leachin minimum 100 ft from wetlands Var.:
10. Leachin minimum ISQ R from drinkin welU25 ft irri tion well Var.: ` '
11. Tank/leachin minimum 10 ft from r line Var.: ��
12. S stem meets all other setback r uirements Var.: -
13. Uses ad'ustment for mauimum hi oundwater Var.: �' '
14. Leachin set 4-5 R above ad'. water or bottom e Var.: ---� '
15. S stem not in to or subsoil A,B horizons) 5'remov�
16.Pro contours are suitable `
17. S stem meets slo e r irements-min. 1/8", '/4" eferred l_/ ,
18. S stem meets breakout r irements PVC liner: � all: '
19. S �ed tee sizes are ro , bai�le on outlet tee �/
• 20. Sewa e is under 10,000 for arcel . '
21.No ba 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 e, um chambe�cover to de -•;,l
25. Ins tion rt on lastic chambers/leach field
26. Etectrical errnit far um chamb�/S arate me,te�r for du lexes
27.Pu stem-2"line„w hole,check valve,tee in dbolc, u size
28. S tic tank/ um chamber to be w roofed Li
29. Vent rovided if leaehin below 3 feet,under drivewa / kin
30. Buo anc calculations for tank/ u chamber �
3I. En ' eer to ins ect and certi soils: wall: commercial:
32. En 'neer/Re 'stered Sanitarian and Land Surv or stam s/si twe
33. H-201oadin is sub'ect to vehicular traffic, oundwater
34.Title V A lication and it fee, installer si
35.Foundation fo�in min.2 feet above ad'usted ound water for new house
36. Deed Restricrion r ired max. #bedrooms: ma�c. flow:
37. Check area lots for oundwaterlLabel oundwater in Assessor's Ma
Plan reviewed by: �o3roa