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TOWN OF YARMOUTH ,
SEWAGE PLAN REVIEW CHECKLIST ���� ����
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, Location: A.M. '�J � Lot � Zone of Contribution: In Out Acreage � �-�v
Commercial: Residential: �
Street:
Village: Floor Plan: (� #Bedrooms: �
Owner: Insta.11er: /��ZJ > �
Address: Phone: -- O'
Phone:
Builder: Engineer:
Address: Phone: -- ' ���- :
Phone: .-�G .X i �_��?'� �
N/A YES NO
l.Re uired#of co ies received
2.Date of soils exam and ercolation test not older than 2 ears �----
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 septic components Var.:
6.Benchmark indicated and shown-NGVD if near wetlands
7. Se tic tank minimum 10 ft from foundarion, deck Var.:
8.Lea.chin minimum 20 ft fu11, 15 ft crawl, 10 ft slab Var.:
9.Leaching minimum 100 ft from wetlands Var.: -
10.Leaching minimum 150 ft from drinking welU25 ft irrigation well Var.: � �
11.Tank/leaching minimum 10 ft from ro erty line Var.: �-�
12. S stem meets all other setback r uirements Var.:
13.Uses ad'ustment for ma�mum high groundwater Var.:
14.Leaching set 4-5 ft above adj.water or bottom of test hole Var.: `.�r
15. System not in to or subsoil(A,B horizons)or 5'removal
16.Pro osed contours are suitable
17. S stem meets slo e re uirements-min. 1/8", '/4" referted
18. System meets breakout re uirements PVC liner: Wall: �-�
19. S ecified tee sizes are ro er, gas baffle on outlet tee
20. Sewa e is under 10,000 d for arcel '
21.No arbage disposal �/ '
- 22. S stem ade uatel sized for its intended use
23.Minimum 6"stone or com acted below tank and dbox
24.Manhole covers within 6"of grade, um cha.mber cover to grade
25.Ins ection ort on lastic chambers/leach field ��
26.Electrical ermit for um cha.mber/Se arate meter for du lexes ----
27.Pum system-2" line,wee hole,check valve,tee in dbo�pump size ,
28. S tic tank/ ump chamber to be factory waterproofed
29.Vent rovided if leaching below 3 feet,under driveway/ arking
30.Buoyancy calculations for tank/pum cha.mber '
31.En ' eer to ins ect and cert soils: wall: commercial: - ,�_-
32.Engineer/Registered Sanitarian and Land Surveyor sta.m s/signature ��
33.H-201oadin is subject to vehicular tr�c, groundwater `_� i
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: ma.x. flow: d '
37.Check area lots for groundwater/Label oundwater in Assessor's Map �- ;
Plan reviewed by: (,�,� �
6/03/03 E
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