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�r�r�� TOWN OF YARMOUTH
� SEWAGE PLAN REVIEW CHECKLIST
; Location: A.M.�_ Lot� Zone of Contribution: In Out A-creage
�� Commercial: ResidentiaL• *�""-�
Street:
Village: - Floor Plan: � #Bedrooms: �
Owner: c1/�a li(i �f� �/ Insta.11er:
Address: Phone: �
Phone:
Builder: Engineer: � � (��
Address: Phone: -- �
Phone: ,�a,�- - �� ' ' �,��,
.�'�� I. .
N/A YES O
1.R uired#of co ies received
2.Date of soils e�.m and ercolation test not older than 2 years �---"-
3.4-5 ft of na.turall occunin ervious material, above water ta.ble `--�
4.Foundation 2 ft above high int of road H.P.: Fnd: Var.:
5.Water line 10 ft from septic com onents Var.: �,.../"
6.Benchmark indicated and shown-NGVD if nea.r wetlands c_.,,.�'
7. S tic tank minimum 10 ft from founda.tion, 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 irriga.tion well Var.:
11.Tank/leaching 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 4-5 ft above adj.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 `L,,..�
17.S stem meets slo e r irements-min. 1/8", '/<" referred
18. S stem meets breakout r uirements PVC liner: WaIL•
19. S ec�ed tee sizes are ro er, gas baffle on outlet tee L/'`
^. 20. Sewa e is under 10,000 for arcel �,�
21.No bage 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 cha.mber cover to ade (,J,/
25.Inspection ort on lastic chambers/leach field �,,./
26.Electrical ermit for um chamber/S azate meter for du lexes ...�--�'`
27.P s stem-2" line,w hole,check valve,tee in dbox, ump size
28. S tic tank/ um chamber to be factory wat roofed
29.Vent rovided if leachin below 3 feet, under drivewa / arkin i'��
30.Buoyancy calculations for tank/pump chamber r'J
31.En ' eer to ins ect and c ' soils: wall: commercial:
32.En " eer/Registered Sanitarian and Land Surve or stam s/si ture ,�,.--�'
33.H-20 loadin is sub'ect to vehicular trai�c, groundwater '
34.Title V A lication and ermit fee, installer si ature
35.Foundation footin min. 2 feet above ad'usted ound water for new house
36.Deed Restriction r ired max. #bedrooms: max. flow: d f'�
37.Check area lots for oundwater/Label oundwater in Assesso ' a
Plan reviewed by: �'J �03�03
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