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` /� ���� TOWN OF YARMOUTH ��� � 1' �
- SEWAGE PLAN REVIEW CHECKLIST GS������
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Location: A.M.�� Lot� Zone of Contribution: In Out_ Acreage ��!'��'hC
• Commercial: Residential:_• ��
Street:
Village: Floor Plan: ✓ #Bedrooms:�_
Owner: �'�"����� Installer: �
Address: Phone:
Phone:
Builder: Engineer:
Address: Phone: -- �7 --t�
Phone: l��� * /,C�'�,���' _
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N/A YES NO
1.Required#of copies received
2.Date of soils e�m and percolation test not older than 2 years �...�'
3.4-5 ft of naturall occurrin ervious material,above water table L.../
4.Foundation 2 ft above high oint of road H.P.: Fnd: Var.:
5.Water line 10 ft from septic com onents Var.: i,_...�
6.Benchmark indicated and shown-NGVD if near wetlands
7. S tic tank minimum 10 ft from foundation, deck Var.:
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: �/
9.Leaching minimum 100 ft from wetlands Var.:
10.Leaching minimum 150 ft from drinkin welU25 ft irri ation well Var.:
11. Tank/leachin minunum 10 ft from pro line Var.: ✓
12. S stem meets all other setback r uirements Var.:
13.Uses adjustment for maximum high groundwater Var.:
', 14.Leaching set 4-5 ft above adj.water or bottom.�f test hole Var.: �--'
15. System not in to or subsoil(A,B horizons) r 5'removal '
16.Pro sed contours are suitable -� v� �„�
17. S stem meets slo e r uirements-min. 1/8", Y4" referred �' '
18. System meets breakout re uirements PVC liner: � all: •
19. S ecified tee sizes are roper, as baffle on outlet tee
20. Sewage is under 10,000 d for arcel
- 21.No arbage dis osal
22. S stem ad uatel sized for its intended use
23.Minimum 6"stone or compacted below tank and dbox .
` 24.Manhole covers within 6"of ade,pump chamber cover to ade
25.Ins ection port on plastic chambers/leach field
26.Electrical ermit for um chamber/S arate meter for du lexes
27.Pump system-2" line,wee hole,check valve,tee in dbox,pum size
28. S tic tank/ um chamber to be factory waterproofed � � ' "
29.Vent rovided if lea.ching below 3 feet,under driveway/ arking
30.Buoyancy calculations for tank/ ump chamber
31.En ' eer to ins ect and cert' soils: wall: commercial:
32.Engineer/Registered Sanitarian and Land Surveyor stam s/signature ,
33.H-201oading is sub'ect to vehicular trai-�ic, groundwater �- '
34.Title V A lication and permit fee, installer signature
35.Foundaxion footing min. 2 feet above adjusted ground 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 _
Plan reviewed by: � wo3�o3 �
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