Review Checklist r
,. � TOWN OF YARMOUTH
� � � SEWAGE PLAN REVIEW CHECKLIST
Location: A.M._��� Lot �� Zone of Contribution: In Out� Acreage
'/ Commercial: Residential:�_
�t�eet: Z � (,C � /
Village: ' Floor Plan: t/ #Bedrooms:�_
' � ���%y�/1 � G�+�
' Owner: Installer:
� Address: Phon�: -
.
Phone:
Builder: � Engineer: ���� � ,�:�'Ial ���%��./
E Address: Phone: � ��� - 7��-�/77�
Phone:
i
N/A YES NO
1.Required#of co ies received
i 2. Date of sails exam and colation test not older than 2 years
', 3. 4-5 ft of natural occurrin ervious material, above water table �/
f 4.Foundation 2 ft above hi int of road H.P.:� Fnd: Var.:
� 5. Water line 10 ft from s tic com onents Var.: �
� 6.Benchrnark indicated and shown-NGVD if near wetlands ✓
( 7. Se tic tank minimum 10 ft from foundation, deck Var.:
i 8. Leachin minimum 20 ft full, 15 ft crawl, 10 ft slab Var.:
f 9.Leachin minimum 100 ft from wetlands Var.:
i
I 10.Leachin minimum 150 ft from drinicing welU25 ft irri tion well Var.:
'' 11.Tank/leachin minimum 10 ft from ro line Var.: i�-��
i12. S stem meets all other setback r uirements Var.: =--r,
� 13. Uses adjustment for maximum hi groundwater Var.: '
i . 14.Leachin set 4-5 ft above ad'.water or bottom of test hole Var.: "-�
� 15. S stem 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", '/4" eferr�d
18. S stem meets breakout r uirements PVC liner: Wall:
19. S ec�ed tee sizes are ro , s baffle on outlet tee
20. Sewa e is under i 0,000 for arcel `-''
'21.No ba e dis osal ti �/
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 chamber cover to ade -
25.Ins tion ort on lastic chambers/leach field
26.Electrical ermit for um cha.mber/S arate meter for du lexes �----
27.Pum s stem-2" line,wee hole,che�k valve,tee in dbox, um size �
28. Septic tank/pum chamber to be factory waterproofed ��-
29.Vent rovided if leach�n below 3 feet, under drivewa / arkin /
30.Buoyancy calculations for tank/pum chamber .�'"
31.En ' eer to ins ect and cert' soils: wall: commercial: �-'
32.Engineer/Re 'stered Sani�arian and Land Surveyor stam s/si ature ,____
33.H-20 loading is subject to vehicular traffic, oundwater
34.Title V A lication and ermit fee, installer si ature ,�----
35.Foundation footin min. 2 feet above adjusted ound water for new house -�'
36.Deed Restriction r uired max. #bedrooms: maac. flow: d
37.Check area lots for oundwater/Label groundwater in Assessor's Ma
r
Plan reviewed by: ( t� �osios