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TOWN OF YARMOUTH � �, ;
SEWAGE PLAN REVIEW CHECKLIST �C��- �
. Location: A.M. to� Lot �� Zone of Contribution: In�Out Acrea.ge � � �
Commercial: Residential:�Ll�
Street: _
Village: � Floor Plan: #Bedrooms: �
Owner: Installer:
Address: Phone: " '� �
Phone: �t� c� �(�i- c�'
t��°��ir(/�' �
Builder: Engineer: � �
Address: Phone: -- '- i
Phone: �'� �./ � �. f
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N/A YES NO
1.R uired#of ies 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 table ��--'' �
4.Foundation 2 ft above hi oint of road H.P.: Fnd: Vaz.: ✓"
5:Water line 10 ft from septic com onents Var.: �-'''
6.Benchmark indicated and shown-NGVD if near wetlands t,i.,�
7. S tic tank minimum 10 ft from foundation, deck Var.: �
8.Leaching minimum 20 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 Var.:
11.Tank/leaching minimum 10 ft from r line Vaz.: 1..�% '
12. S stem meets all other setback r irements Var.: '
13.Uses adjustment for maximum hi groundwater Var.: � ��
14.Leachin set 4-5 ft above adj.water or bottom est Var.:
15. System not in to or subsoil(A,B horizons) 5'remova
16.Pro osed contours are suitable �-�' ?
17.S stem meets slo e r irements-min. 1/8", 1/a" eferred I
18. S stem meets breakout r uirements PVC liner• �' all: �.,->>
• 19. S ecified tee sizes are roper, as baffle on outlet tee '
20. Sewa e is under 10,000 d for arcel i
21.No arba e dis osal `
� 22.S stem ade uatel sized for its intended use ;
23.Minimum 6"stone or com acted below tank and dbox �.�� i
24.Manhole covers within 6"of ade, um chamber cover to grade
25.Ins ection ort on plastic chambers/leach field ;
26.Electrical ermit for um chamber/S arate meter for du lexes
27.Pum system-2"line,weep hole,check valve,tee in dbo�pum size
28. S tic tank/ um chamber to be factory wa roofed
29.Vent rovided if leachin below 3 feet,under driveway/ arking
30.Buoyanc calculations for tank/ ump chamber
31.En ' eer to ins ect and cert' soils: wall: commercial:
32.En 'neer/Registered Sanitarian and Land Surve or stam s/signature
33.H-20 loading is sub'ect to vehicular traffic, 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 uired max. #bedrooms: max. flow: - ;
37.Check area lots for oundwater/Label oundwater in Assessor's Ma
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Plan reviewed by: �03�03