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TOWN OF YARMOUTH
_ SEWAGE PLAN REVIEW CHECKLIST
Location: A.M._��1--�- Lot � � Zone of Contribution: In Out �ge
Commercial: Residential:�'-
Street: �7� i�
Village: Floor Plan: `-f #Bedrooms: �
Owner: Insta.11er: � ��
Address: Phone: �7�-'-� -�--'
Phone: ~ ,1
Builder: � ��� � �� Engineer:
� ,
Address: Phone: � -+
Phone: - � � £ � � �L�j
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N/A YES NO
l.Required#of copies received
2. Date of soils exam and percolation test not older than 2 years ��
3.4-5 ft of naturall occurrin ervious material, above water table �--�
4.Foundation 2 ft above hi point of road H.P.: Fnd: Var.:
5.Water line 10 ft from s tic com onents Var.: C�
6.Benchmark indicated and shown-NGVD if near wetlands
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.Leaching minimum 150 ft from drinking welU25 ft irrigation well Var.:
11.Tank/leaching minimum 10 ft from ro erty line Var.: • �/
12. S stem meets all other setback r uirements Var.: L�'�
13.Uses adjustment for ma�mum hi oundwater Var.:
14.Leaching set 4-5 ft above adj.water or bottom of test hole Var.: �-t
15. System not in top or subsoil(A,B horizons)or 5'removal
16.Proposed contours are suitable
17. S stem meets slo e r uirements-min. 1/8", '/4" referred ��'
18. System meets breakout requirements PVC liner: Wall: '
19. S ecified tee sizes are roper, gas baf�le on outlet tee
20. Sewa e is under 10,000 d for arcel �-/
21.No arba e dis osal
, � 22. S stem ade ua.tel sized for its intended use
23.Minimum 6"stone or com acted below tank and dbox
24.Manhole covers within 6"of ade, ump chamber cover to grade
� 25.Ins ection ort on lastic chambers/leach field �1
26.Electrical ermit for um chamber/S arate meter for du lexes
27.Pump system-2"line,weep hole,check valve,tee in dbox, um size
28. Septic tank/ um chamber to be factory wat roofed
29.Vent provided if leaching below 3 feet,under driveway/ arking
30.Buoyancy calculations for tank/pum chamber
31.En ' eer to ins ect and cert' soils: wall: commerciaL•
32.Engineer/Registered Sanitarian and Land Surveyor stam s/signature
33.H-201oadin is subject to vehicular traffic, oundwater
34.Title V A lication and permit fee, installer si ature
35.Foundation footin min. 2 feet above adjusted ground water for new house ,
36.Deed Restriction r uired max. #bedrooms: max. flow: d
37.Check area lots for groundwater/Label groundwater in Assessor's M
Plan reviewed by: �o3io3