HomeMy WebLinkAboutReview Checklist TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
, Location: A.M.�� Lot� Zone of Contribution: In Out �Acreage
� . Commercial: Residential: �
\' Street: ,
Village: y Floor Plan: ✓ #Bedrooms: �
Owner: ��l�l �/v�i��l���l Insta.11er:
Address: Phone: S`7�� G�
Phone:
Builder: Engineer:
Address: Phone: �7J � L - Z �
Phone: . '
N/A YES NO
1.R uired#of co ies received �,��
2. Date of soils exam and colation test not older than 2 years �.�-
3. 4-5 ft of naturall occurrin ervious material,above water table '
4.Foundation 2 ft above hx int 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. S tic tank minimum 10 ft from founda.tion, deck Var.: �/
_ _ 8.Leachin minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: �,,/
9. Leachin minimum 100 ft from wetlands Var.: :_--
10. Leachin minimum 150 ft from drinkin we1U25 ft irri tion wetl Var.: �
11.Tank/leachin minimum 10 ft from ro line Var.: �...-�
12. S stem meets all other setback r uirements Var.: ✓
13.Uses ad'ustment for maximum hi oundwater Var.: �--
14. L,eachin set 4-5 ft above ad'.water or bottom of test hole Var.: i/
15. S stem 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" eferred
18. S stem meets breakout r uirements PVC liner: Wall: �,./
19. S ified tee sizes a.re ro ,gas baffle on outlet tee �./
20. Sewa e is under 10,000 for arcel
2�.No ba 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 e, um chamber cover to de L�
25. Ins ion ort on lastic chambers/leach field L/
26. Electrical ermit for um chamb�er/S arate meter for du lexes
27.P s stem-2"line,wee hole,che�k valve,tee in dbo� um size ��
28. S tic tank/ um chamber to be factory wa roofed ;
29.Vent rovided if leachin below 3 feet,under drivewa / arkin �./
30. Buo ancy calculations for tank/pum chamber /
31. En ' eer to ins ect and cert' soils: wall: commercial: /
32.En 'neer/Re ' tered Sanitarian and Land Surv ar stam s/si ture
33. H-201oadin is sub'ect to vehieular traffic,groundwater �,
34. Title V A lication and ermit fee,installer 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:
37. Check area lots for oundwater/Label groundwater in Assessor's Ma
Plan reviewed by: ( �`' � c�o3ios