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TOWN OF YARMOUTH �
SEWAGE PLAN REVIEW CHECKLIST
Location: A.M.� Lot �3 Zone of Contribution: In Out �Acreage �
Commercial: Residential: Y--""`
Street: �'1 �
Village: ' Floor Plan: #Bedrooms: �
Owner: Installer: �
Address: Phone:
Phone:
Builder: Engineer: �
Address: Phone: ' `7
Phone: �!,t- a� �' ��� r<,'' ���i�:���^
%r� � 1�-
N/A YES NO '
1.Re uired#of copies received �_...-/
2.Date of soils exam and ercolation test not older than 2 years `.�--
3.4-5 ft of naturall occurrin ervious material,above water ta.ble
4.Founda.tion 2 ft above high oint of road H.P.: Fnd: Var.:
5. Water line 10 ft from septic 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.Leaching minimum 100 ft from wetlands Vaz.: _�- �
10.Leachin minimum 154 ft from drinking we1U25 ft irri tion well Var.:
11.Tank/leachin minimum 10 ft from ro line Var.: L----
12. S stem meets all other setback r uirements Var.: -
13.Uses adjustment for maacimum high groundwater Var.: Lf
14.Leaching set 4-5 ft above adj.water or bottom of test hole Var.: ��
15. S stem not in to or subsoil(A,B horizons)or 5'removal
16.Pro osed contours are suitable L�'
17. S stem meets slo e r uirements-min. 1/8", '/4" eferred �..-�
18. System meets breakout 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 d far arcel
21.No ba e dis osal `
22.S stem ad uatel sized for its intended use `�
23.Minimum 6"stone or compacted below tanlc and dbox `� .
24.Manhole covers within 6"of grade, um cha.mber cover to grade �i
25.Ius ection ort on plastic 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, ump size
28. S tic tank/ um chamber to be factory wat roofed --�^
29.Vent rovided if leachin below 3 feet,under drivewa / arkin _��'
30.Buoyancy calculations for tank/ um chamber �
3 l.E ' eer to ins ect and cert' soils: wall: commercial: /
32.Engineer/Re 'stered Sanitarian a.nd Land Surve or stasn s/si ture �
33.H-201oading is subject to vehicular traffic, oundwater
34.Title V A lication and ermit fee, insta.11er si ture '
35.Foundation footing min. 2 feet above ad'usted ground water for new house -�
36.Deed Restriction r uired max. #bedrooms: m�. flow: d ./-�
37.Check area lots for oundwater/Label oundwater in Assessor's Ma
Plan reviewed by: � �' wo3io3