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TOWN OF YARMOUTH
_ SEWAGE PLAN REVIEW CHECKLIST /�
Location: A.M._ X Lot� Zone of Contribution: In �/Out Acreage �� �t°,�'�'S
• Commercial: ,/ Residential:
Street:
Village: Floor Plan: #Bedrooms: � �S
Owner: `� Installer: ��
Addres�4 Phone: - -�
Phone:
Builder: Engineer:
Address: Phone: _ --
Phone: � �� .�. � . ` , , �
�' _ G �t`' ' �'� /�' ���
N/A YES NO '
1.R uired#of co ies received '
2. Date of soils e�cam and ercolation test not older than 2 years
3.4-5 ft of natura occurrin ervious material, above water table �-
4.Foundation 2 ft above hi oint of road H1'.: Fnd: Var.: c...�-�
5.Water line 10 ft from septic com onents Var.: �.,-�- '
6.Benchmark indicated and shown-NGVD if near wetlands '
7. S tic tank minimum 10 ft from foundation, deck Var.: !
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: r . '
9.Leaclung minimum 100 ft from wetlands Var.:
10.Leaching minimum 150 ft from drinkin welU25 ft irri tion well Var.:
11.Tank/leaching minimum 10 ft from roperly line Var.: t-�---�'
12.S stem meets all other setback r uirements Var.: ;._,_,..
13.Uses adjustment for ma�mum hi oundwater Var.: '
14.Leachin set 4-5 ft above adj.water or bottom est Var.: �_ ;
15.System not in to or subsoil(A,B horizons)0 5' remova �
16.Pro sed contours are suitable t`____
17. S stem meets slo e r uirements-min. 1/8", 1/4" eferred
18. S stem meets breakout r uirements PVC liner: Wall:
19.S ecified tee sizes are ro er, baffle on outlet tee �,,,,.r-- !
20. Sewa e is under 10,0U0 for arcel .�
21.No ba e dis osal
- 22. S stem ade 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 ade
25.Ins ion ort 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/pum chamber to be factory wat roofed
29.Vent rovided if leaching below 3 feet,under drivewa / arkin -
30.Buoyancy calcula.tions for tank/ um chamber -
31.En ' eer to ins ect and cert' soils: wall: commercial: r`� ',
32.En ' eer/Re 'stered Sanitaria.n and Land Surv or stam s/si ture � } C t7 � �
33.H-201oadin is subject to vehicular tra.ffc, oundwater '
34.Title V A lication and ermit fee, installer si ature
35.Foundaxion footin min. 2 feet above ad'usted ound water for new house �--�----
36.Deed Restriction r uired max. #bedrooms: ma�c.flow: d =----�
37.Check azea lots for oundwater/Label oundwater in Assessor's Ma
Plan reviewed by: �� �o3ros