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Review Checklist
I �. . ; .- _ . TOWN OF YARMOUTH SEWAGE PLAN REVIEW CHECKLIST � Location: A.M.� Lot /.�-� Zone of Contribution: In Out� Acreage. Commercial: Residerttial:� Street: � /� Village: G- Floor Plan: � #Bedrooms:_� Owner: �/��.l.1 -' Installer: /�%sy'�'' Address: Phone: Phone: Builder: „ Engineer: Z � Address: Phone: �-1 — Phone: __ _ , .. N/A YES NO 1.R ired#af ies received ; _ 2. Date of soils exarn and catation test not older than 2 ears � ; - , 3:4-5 ft of na.tural occurrin e�vious material,above water table ;. . 4.Founda.tion 2:ft above lri 'ir�t of road _ H.P.: Fnd: t Var.. �; � _ . _. . , :..; 5. Water line l 0 ft fr�t s tic corn onents Var.: - : ,,� � . :< 6.Benchmark indi�at�i arad sho�vu�a-NGVD.i€near wexlands � °� . ' � 7. S �tic tank minimum�10 ft finm foundation,�deck � Var.. � � �. �.�� , �< � : ��� � � �� �� 8. Leaching minimum 20#�full,:i5 ft crawl,:10 ft slab Var.: � � , _ . 9.Leaching minimum I.OQ.ft from wetlands Var.: , . ' °, 10. Leachin mini�nt� 1�4�ft fram�drinicin� welU25�ft�irri tion well :.��..Var,:�� 1 � - , � � ; 11.Tank/leachin mintmu� 10 ftfrom` r fine Var.: .;_� . _ ., , _ . � 12.S� stem�meets��all oiher:setba c�g ' emen'ts Var.: -.aS: _ _ _ _ ^ _.: 13. tlses ad' stment forma7cimum.l�i ,. oumdwater Var.: -- .�:.�; : , � : 14.Leachin set 4-5 ft above ad':.w�atec 4r bottom of:test hole, .�Tar::. , - � �: 15. System not in to or subsoil(A,B horizons)"or 5'removal lb.Pr osed contours are suitable , � , . _ . � : 17.� stem me�ts sl e r. , uirements-tnin. 11$'; '/4", fer�ed , . ' . _ �_ . � � �� ; t 8. S stem meets bre,akout r u' �.._.:` �V� liuet: .Wall: 19. S ifxed tee sizes a�e ro ; s baffle on ou tee . . : _. :. , .. . . ,;�. .- - . �. , } 20. Sewa e is under 10,000 for • �,:.:. . ; , . : >, 23.Na ba e dis osal ; . :; ;:•.�K. -. . _ . . .: .. � , . ..: , . _. �. � �� ,F,.��'� •,�. �� ���2�..���s�Em ad te� si��d�€or i�s��ni�ded us,� -�� � ��- � - � � � : � _. _ ,._,._ �. _ ... , . _. . , �. 2�.11�in�nu�n b'��stone or com et�b�l�w tank and=d.ba� .3 ��F, y � � 24.1�anh+�le covers�vit�in 6"of_ d�,: �;ch�u�er,cc����.ta: � d� ; , . , . .: �, r ,:: . , .. , 25:.In ion ort oit lastic chambers/leach.field ; - � , -. � . , ., _ . _ . .. 26:Electrical ermit for u� chamber/ ate m�ter�or du l�xes ,__, , ., ;.. _ , , � 2'7:Pum system-2" line,w hole,che�#valve,tee i.�dlac�ar� um size ... . , . 28. Septic tank/ u chamber to be facto wax r�f� ; . ,. _ . 29.. Vent rovided if leaching below 3 feet,u�der dti�ayl arking - 3�. Buo ancy calculations for tank/ um chambex . . 31.En � eer to ins ect and c ' sir�ils: alL• commerciaL• � 32.En 'neer/Re 'stered Sanirtarian and Surv,� s/s gnature 33:H-20 loadin is subject to vehicnlar traffic, 34.Title V A lication and ermit fee, installer si ture ✓/ � 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 azea lots for oundwater/Label oundwater in Assessor's Map Plan reviewed by: wo3im