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TOWN OF YARMOUTH
, SEWAGE PLAN REVI�W CHECKLIST
Location: A.M.�_ Lot -.�5� Zone of Co�tribution: In Out� Acreage
ti Comme�ci,al: Residential:�_
Street: .,--..�`" . ,
Village: Floor lan: #Bedrooms:
� �
Owner: Installer:
Address: �'i! , Phone: 7 7�-- /�lo
Phone:
r
Builder: . Engineer:
Address: _ Phone; -
Phone:
N/A YES ,. O i
1.I�e uired#of.copies received '
2.Date of soils exam and reolation test not older thaut 2 years.._ � . .-
3. 4=5 ft of nat�irall occurrin ervious material, above vvater table � °
4. Foundation:2 ft above hi oint of road : H�P,: � . �nd: ;^. Vat.: , ^
_. _ . _ _ � ,
5.Water line 10 ft from s tic com onents Var.: �
6:Benchmark indica.ted and shown-NGVD if�zear w�tlands . . ,,..
7. S ' tic tank minimum 10 ft from foundation, deck= _ : : � : _ �
_ :-
8. Leachin minurium 20�t fa11, 15 ft crawl, 10 ft slab._
9. L,e�,c • �►inimum 100 ft from wettands . .. ° � . ; E .. �./'
10. Lea.chin minimum 150 ft from drinkin welU25 ft' ' ation well >}
_ _. .. . _
11.Tar�k/�eachin minimi�m�10 ft from r line; Var.: -: , '
_ _ � _ _ - _ _: . , _ .� ;
12: S stem meets all other setback re uirements Var.: � ° J
13. Uses ad'ustment for maximum hi roundwater: 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 suita.ble . : ._:
17. S stem meets slo e r ' ments.-min. 1/8", %a" ef�rred . � _ ,
18.S stem meets breakout re uirements ' PVC liner: . V�a.11: : . .
19.S ecified tee sizes are,}�ro �, baffle on outiet tee ; .. , ; , ; ..
20.Sewa e is under 10,000 for arcel :, ; , '
^ 21.No arb dis osal '
22. S stem ade uatel sized for its intended use . ; . _ r
_ _
i 23:Minimum 6"stone or com acted below tank and dbo� . . :. .; . :.: . , .
24.Manhole covers within 6"of grade. um ;chamber cover to e � ` : a:;s�
25. Ins ection ort on lastic chambers/leach field � -
26. Electrical ermit for 'um chamber/S arate meter for du lexes
27. Pum stem-2"line,wee hole check valve,tee in dbox, size :
28. S tic tank/ um chamber to be facto wate roofed ..
29.Vent rovided if leac ' below 3 feet,under drivewa. / arkin � '-. . , -
30. Buo ancy calculations fortank/ um chamber '
31. E � eer to ins ect and ce � soils: wall: commercial: '
32. E ' eer/Registered Sanitarian and Land Surve or stam s/si ture _
33.H-2010 ' is sub'ect to vehicular traffic, undwater
34.Title V A lication and ermit fee,installer si ture c�
35.Founda.tion footin min. 2 feet above ad'usted ound water for new house '
36. Deed Restriction r uired m�. #bedrooms: max. flow: d
37. Check area lots for groundwater/Label oundwater in Assessor's M
Plan reviewed by: �( J�-�► �vo3
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