Review Checklist . �„ z� '�� ��-�
TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST ���, --� -�
� Location: A.M.� Lot ` � Zone af Contribution: ut_ Acreage�i���""l
! Commercial: Residential.�-
Street: 7G
Village: r • Floor Plan: � #Bedrooms:�_
Owner: ���i' Installer:
Address: Phone: z ' � � "
�� �
Phone: ,� � G,�, �,��:f� ��,: G<'
Builder: Engineer:
Address: Phone: �d � -
Phone: � - ''`�-
N/A YES NO
1.Re uired#of copies received
2. Date of soils e�m and ercolation test not older than 2 years ✓
3.4-5 ft of naturall occurrin ervious material, above water ta.ble �-----
4.Foundation 2 ft above hi point of road H.P.: Fnd: Var.: �____.---
5.Water line 10 ft from septic com onents Var.: `�
6.Benchmark indica.ted and shown-NGVD if near wetlands �.----
7. Se tic tank minimum 10 ft from foundation,deck Var.: =--+'
8.Leachin minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: ti---�"
9.Leaching minimum 100 ft from wetlands Var.: �
10.Leachin minimum 150 ft from drinkin welU25 ft irri tion well Var.: �
11.Tank/leaching minixnum 10 ft from ro line Var.: �-'
12. S stem meets all other setback r uirements Var.: �_.---�
13.Uses adjustment for maximum high oundwater Var.:
14.Leaching set 4-5 ft above ad'.water or bottom of test hole Var.:
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 r uirements-min. 1/8", 1/a" referred
18. S stem meets breakout r uirements PVC liner: Wall:
19. S ecified tee sizes are roper, as baffle on outlet tee
20. Sewage is under 10,000 gpd for arcel
21.No arbage 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 ade, um cha.mber cover to grade
� 25.Ins ection ort on lastic chambers/leach field
26.Electrica.l ermit for um cha.mber/S arate meter for du lexes 4-----
27.Pump stem-2" line,wee hole,check valve,tee in dbox, um size
28.S tic tank/ um chamber to be factory waterproofed /-
29.Vent rovided if leaching below 3 feet,under drivewa / arking ,✓'-
30.Buo ancy calculations for tank/ ump cha.mber �r'
31.E ' eer to ins ect and cert' soils: wall: commerciaL•
32.Engineer/Re ' tered Sanitarian and Land Surveyor sta.m s/si ature
33.H-201oadin is sub'ect to vehicular tr�c, oundwater �
34.Title V A lication and ermit fee, insta.11er si ture
35.Foundation 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 groundwater in Assessor's Ma
C.e�-v'
Plan reviewed by: �o3�os