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:.s> _ TOWN OF YARMOUTH �
�} „ ��. SEi�VAGE PLAN REVIEW CHECKLIST " '
: ; Location: f£ y A.M.� Lot �7 Zone of Contribution: In Out� Acreage
Commercial: R�sidential: i + I�
Street: � � � ' I
Village: Floor Plan: #Bedrooms: �
Owner: Installer: � �
Address: Phone:
Phone:
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Builder: (�/L� Enginee�-:
Address-� Phone: - ,�-r�'2-Z_
Phone:
N/A YES NO
l.R uired#of co ies received
2.Date of soils exarn and colation test not older than 2 ears
3.4-5 ft of natural occwrin ervious material,above wat�table
4.Foundation 2 ft above h� 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 foundation,deck Var.:
8.Leachin minimum 2Q ft full, 15 ft crawl, 10 ft slab Var.:
9.Leachin minimum 100 ft from wetlands Var.:
10.Leachin minimum 150 ft from drinkin welU25 ft irri tion well Vaz.:
1 l.Tank/leachin minimum 10 ft from r line Var.:
12.S stem meets all other setba.ck irements Var.: .�./
13.Uses ad'ustment for maximum hi oundwater Var.:
14.Leachin set 4-5 ft above ad'.water or botto test ho e Var.:
15. S stem not in to or subsoil A,B horizons) 5'remo
16.Pro sed contours are suitable
17.S stem meets slo e r irements-min. I/8", '/4" erred
18. S stem meets breakout irements PVC liner: Wa1L•
19. S ified tee sizes aze ro , baffle on outlet tee � i
20. Sew e is under 10,000 for arcel
21.No 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 de, um chamber cover to ade
25. Ins tion rt on lastic chamberslleach field
26. Electrical ermit for um chamber/3 te meter for du lexes
27. s stem-2" line,w hole,check valve�,tee in d6o� um size
28. S tic tank/ um chamber to be fac wa roofed
29. Vent rovided if leachin below 3 fe,et,under drivewa / arkin
30. Buo anc calculations for tank/ um chamber • ✓
31. En ' eer to ins ect and c ' soils: wall: commercial:
32.En ' eer/Re 'stered Sanitarian and Land Surve �stam s/si ture I
j 33.H-20 loadin is sub'ect to vehicular tr�c, oundwater
34. Title V A lication and it fee,installer si ture
35.Foundation footin min.2 feet above ad'usted ound water for new house i
36.Deed Restriction r uired max. #bedrooms: max. flow: '
37.Check area lots for oundwater/Label oundwater in Assessor's `
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Plan reviewed b : �'03�03 �
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