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-�- 7 /`7 ��-��`
- TOWN OF Y`ARMOUTH �>Z' /�
SEWAGE PLAN REVIER'CHECKLTST ����. � �-��`�'�l�
� Location: A.M.� Lot�_ Zone of Contribution: ut_ Acreage�J � r�'f�� C���
Commercial: ResidentiaL• `-.�� �
Street: �
Village: Floor Plan: � #Bedrooms: �
Owner: ' (l Installer: �!�" ' S" `
Address: -�{j Phone: Z �
Phone: '�9�.--� �i 7� �` �` ��j
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Builder: Engineer: �
Address: Phone: � --' �
Phone: d t� ��'��`� j'�L��' C�'`a �l
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N/A S NO
1.Required#of co ies 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 table
4.Founda.tion 2 ft above high oint of road H.P.: Fnd: Var.:
5.Water line 10 ft from s tic com onents Var.:
6.Benchmark indicated and shown-NGVD if near wetlands ;_,./'
7. Se tic tank minimum 10 ft from foundarion, deck Var.: �----�
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.:
9.Leaching minimum 100 ft from wetlands Var.: c.�i'
10.Leaching minimum 150 ft from drinking welU25 ft irrigation well Var.:
11.Tankllea.ching minimum 10 ft from ro erty line Var.: �
12. S stem meets all other setback r uirements Var.: �/''
13.Uses ad'ustment 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 borizons)or 5' removal ��
16.Pro osed contours are suita.ble
17. S stem meets slo e r uirements-min. 1/8", '/4" referred �-�"
18. System meets breakout r uirements PVC liner: Wall: `�
19. Specified tee sizes are pro er, gas baffle on outlet tee �..-�--�"
20. Sewa e is under 10,000 d for arcel v�'
21.No garba e 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 grade, um chamber cover to ade �f
25.Inspection ort on plastic chambers/leach field ✓�'
26.Electrical ermit for um chamber/S arate meter for du lexes ��� -
27.Pum system-2" line,wee hole,check valve,tee in dbo� ump size
28. Septic tank/ um chamber to be factory wat roofed
29.Vent rovided if leaching below 3 feet,under driveway/parking
30.Buoyancy calcula.tions for tank/pum chamber ��-
31.En ' eer to ins ect and cert' soils: wall: commercial: ,,,i'"
32.Engineer/Registered Sarutarian and Land Surve or stam s/si ature
33.H-201oadin is subject to vehicular traffic, groundwater
34.Title V A lication and permit fee, installer signature
35.Foundation footing min. 2 feet above adjusted 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
Plan reviewed by: 7 �o3io3