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� � � TOWN OF YARMOUTH �
- SEWAGE PLAN REVIEW CHECKLIST✓�'��fl���� � ����
Location: A.M. ��`7 Lot_1�1� Zone of Contribution: In C�0"ut Acreage � ���
� Commercial: Residentia1:-���
Street:
Village: Floor Plan: #Bedrooms:�
Owner: �"(�. Installer: �
Address: Phone: - „�_- �
Phone:
Builder: Engineer: �`�
Address: Phone: --> � -�
Phone: _ �'?� 4� ��'- C�:�
N/A YES O
1.Required#of co ies 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 high oint of road H.P.: Fnd: Var.:
5.Water line 10 ft from septic components Var.:
6.Benchmark indicated and shown-NGVD if near wetlands L/
7. S tic tank minimum 10 ft from foundation, deck Var.: ��'
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: t:/�
9.Leaching minimum 100 ft from wetlands Var.: .
10.Leaching minimum 150 ft from drinking we1U25 ft irrigation well Var.: t�r�
11.Tank/leaching minimum 10 ft from property line Var.: '
12. S stem meets all other setback r uirements Var.:
13.Uses ad'ustment for ma�mum high groundwater Var.: •
14.Leaching set 4-5 ft above adj.water or bottom of test hole Var.: L�
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 uirements-min. 1/8", 1/4" referred
18. S stem meets breakout requirements PVC liner: Wall: �i-�
19. S ecified tee sizes are proper, gas baffle on outlet tee
20. Sewa e is under 10,000 d for parcel �..
21.No garbage dis osal ;
• 22. S stem ad uatel sized for its intended use �„i�'
23.Minimum 6"stone or com acted below tank and dbox
24.Manhole covers within 6"of grade, um chamber cover to grade �,�-
` 25.Inspection ort on plastic 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�pum size �..-�
28. Septic tank/ ump chamber to be factory waterproofed
29.Vent rovided if leaching below 3 feet, under driveway/ arking ��
30.Buoyancy calculations for tank/ um cha.mber
3 L En ' eer to ins ect and cert' soils: wall: commercial:
32.Engineer/Registered Sanitarian and Land Surveyor stam s/signature
33.H-20 loading is subject to vehicular traffic, groundwater ��
34.Title V A lication and ermit fee, installer signature '.
35.Foundation footing min. 2 feet above ad'usted ound water for new house L/' :
36.Deed Restriction r uired max. #bedrooms: max. flow: d
37.Check area lots for groundwater/Label groundwater in Assessor's Ma
Plan reviewed by: �`� sio3io3 I
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