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- TOWN OF YARMOUTH , �/ ---� '
SEWAGE PLAN REVIEW CHECKLIST �-,..d>'j���'��`�� �� �
' Location: A.M.�� Lot_'�� Zone of Contribution: In Out_ Acreage I����'-��.
� Commercial: Residential:
Street: '
Village: Floor Plan: �#Bedrooms: � �.�
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Owner: � Installer: �'
Address: Phone:
Phone:
Builder: Engineer: �i �����
Address: Phone: `�� 4 ^��
Phone: . ,� � �� �
N/A YES NO '
1.Re uired#of copies 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 ta.ble �----` ,
4.Foundation 2 ft above hi 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.: j
8.Leaching minimum 20 ft full, 15 ft erawl, 10 ft slab Var.: ;
9.Leaching minimum 100 ft from wetlands Var.: '
10.Lea.chin minunum 150 ft from drinkin welU25 ft irrigation well Var.:
11.Tank/leachin minimum 10 ft from ro erty line Var.: l._-� ';
12. S stem meets all other setback r uirements Var.: �.�-
13.Uses ad'ustment for maximum hi groundwater Var.: '
14.Leaching 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 osed contours are suitable �;.....� _
17. S stem meets slo e r uirements-min. 1/8", '/4" eferred �.�- '
18.S stem meets breakout r irements PVC liner: Wall: ��
19. S ecified tee sizes are pro er, as ba.ffle on outlet tee ;
20. Sewa e is under 10,000 for arcel '
2 L No garbage dis osal '
' 22. S stem ad uatel sized for its intended use �.-/ '
23.Minimum 6"stone or compacted below tank and dbox
, 24.Manhole covers within 6"of ade, ump cha.mber cover to ade
25.Ins ion 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, ump size ✓� '
28. S tic tank/ u cha.mber to be facto wat roofed L,�
29.Vent rovided if leachin below 3 feet,under drivewa / arkin
30.Buoyancy calculations for tank/ um cha.mber i.✓�
31.En ' eer to ins ect and c ' soils: wall: commercial: �/"
32.En ' eer/Re 'stered Sanita.rian and Land Surveyor stam s/si ture ��
33.H-20 loadin is sub'ect to vehicular tr�c, 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 ired m�. #bedrooms: max.flow: d
37.Check area lots for oundwater/Label oundwa.ter in Assessor's Ma
Plan reviewed by: �� �o3ro3