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TOWN OF YARMOUTH
� " SEWAGE PLAN REV�W CFIECKLIST
, Location: A.M. � Lot�3 Zone of Contribution: In Out ��.. Acreage �
��� Commercial: Residential:�
Street: 7%
Village: ,� Floor Plan: �/ #Bedrooms: �
Owner:� C�2 ����� Installer: �
Address: Phone:
Phone:
Builder: Engineer: C �
Address: Phone: � - - � �
Phone: '�/l/G��i l�l y��-� �
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N/A YES NO
1.Required#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 watex table
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.Benchmaxk indicated and shown-NGVD if near wetlands ,.�
7. Se tic tank minimum 10 ft from foundation, deck Var.: �
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: t.��
9.Leaching minimum 100 ft from wetlands Var.: �
10.Lea.ching minimum 150 ft from drinking welU25 ft irri ation well Var.: ��
1 l.Tank/lea.ching minimum 10 ft from rop line Var.: �i
12.S stem meets all other setback r uirements Var.:
13.Uses adjustment for maximum hi oundwater Var.: `�
14.Leachin 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 sed contours are suitable ��
17. S stem meets slo e r uirements-min. 1/8", '/4" referred �
18. System meets breakout requirements PVC liner: Wall:
19.S ecified tee sizes are roper, gas baffle on outlet tee ��
20. Sewage is under 10,000 d for parcel .
21.No arbage dis osal
22.S stem ade ua.tel sized for its intended use
� 23.Minimum 6"stone or com acted below tank and dbox �
24.Manhole covers within 6"of grade, um chamber cover to ade �-
� 25.Ins ection ort on lastic chambers/leach field
26.Electrical ermit for um chamber/S arate meter for du lexes
27.Pum system-2" line,weep hole,check valve,tee in dbo�pum size
28. S tic tank/ um chamber to be factory wat roofed -
29.Vent rovided if leachin below 3 feet,under driveway/ arking
30.Buoyancy calculations for tank/ um cha.mber ��
31.En ' eer to ins ect and c ' soils: wall: commercial:
32.En ' eer/Registered Sanitarian and Land Surveyor stam s/signature
33.H-201oading is subjeet to vehicular traffic, groundwater
34.Title V A plication and ermit fee, installer si ture
35.Foundation footing min. 2 feet above adjusted ound water for new house '
36.Deed Restxiction r uired max. #bedrooms: �ax. flow: d --�-�"�"
37.Check area lots for oundwater/Label oundwater in Assessor's Ma '
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Plan reviewed by: I
6/03/03 �
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