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_ TOWN OF YARMOUTH � ��,,��
SEWAGE PLAN REV�W CHECKLIST ���"� �
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• Location: A.M.� Lot�_ Zone of Contribution: Itr� Out Acrea e� ��'���
�j��/l' Commercial: Residential: ✓ �
Street:
Village: Floor Plan: #Bedrooms: �
Owner: � Installer:
Address: Phone: --� -' '
Phone:
Builder: Engineer:
Address: Phone: --' '-
Phone: � � '
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N/A YES O
1.Re uired#of co ies received
2.Date of soils exam and ercolation test not older than 2 ears
3.4-5 ft of natura occurrin ervious material,above water ta.ble �..---
4.Foundation 2 ft above hi oint 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 a..---'J
7. S tic tank minimum 10 ft from foundation, deck Var.: ;
8.Leachin minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: `_,.�
9.Leaching minimum 100 ft from wetlands Var.: ,
10.Lea.chin minimum 150 ft from drinking welU25 ft irri ation well Var.: :
1 l.Tank/leachin minimum 10 ft from ro erty line Var.:
12.S stem meets all other setback r uirements Var.:
13.Uses ad'ustment for maximum hi oundwater Var.: �
14.Leaching set 45 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 osed contours are suitable ✓'
17. S stem meets slo e r irements-min. 1/8", '/a" referred
18. System meets breakout r uirements PVC liner: Wall:
19. S ecified tee sizes are roper, as baffle on outlet tee
20. Sewa e is under 10,000 d for arcel �-
, 21.No garba 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 ade, um chamber cover to grade
25.Ins ion rt on lastic chambers/leach field
26.Electrical ermit for um chamber/S arate meter for du lexes
27.Pum system-2"line,wee hole,check valve,tee in dbo� um size '
28. S tic tank/ um chamber to be facto wa roofed '
29.Vent rovided if leaching below 3 feet,under driveway/ arkin
30.Buoyancy calculations for ta.nk/ um chamber
31.En ' eer to ins ect and c " soils: wall: commercial:
32.En ' eer/Registered Sanitarian and Land Surve or sta.m s/si ture `,..i'
33.H-201oadin is sub'ect to vehiculaz traffic, oundwater �--�-''
34.Title V A lication and ermit fee, installer si ture �.,,...�'
35.Founda.tion footin min.2 feet above ad'usted ound water for new house :!
36.Deed Restriction r ired max. #bedrooms: max.flow: d �-
37.Check area lots for groundwater/Label oundwater in Assessor's Ma
Plan reviewed by: �o3io3