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TOWN OF YARMOUTH
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SEWAGE PLAN REVIEW CHECKLIST
31 T �
Location: A.M. Lot Zone of Contribution: In Out. Acreage
'` Commercial: Residen 'al: iG /,Street: .2- 7'.1 �.r H� /&/I/ 6 I' 4iSYt_ 2� -/0 L' 17,--7'
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Village: Floor Plan: , �#Bedrooms:
Owner: hitted F A A _4:e Installer: $e ,1'i 66 li
Address: 51.4cie_fie, Phone: 6/7 - 772- -- 1-0.,--400
Phone: (40 fiffriitrV2/ 6/7= $*I,'
Builder: Engineer: 42i ,-/ /6/,,4.,k,-4, .
Address: Phone: .1SI"- �9--3/4__
Phone: 7` -/6 //L µ2 t:�C: 1 A
N/A YES NO
1.Required#of copies received ls"/
2.Date of soils exam and percolation test not older than 2 years 1!-
3.4-5 ft of naturally occurring pervious material,above water table L/
4.Foundation 2 ft above high point of road H.P.: Fnd: Var.: i...----
5. Water line 10 ft from septic components Var.: E---'--
6. Benchmark indicated and shown-NGVD if near wetlands l.._.--- '
7. Septic tank minimum 10 ft from foundation, deck Var.: c__..------
8.
__..--..i8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: : t --------
•,..--
9.
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9.Leaching minimum 100 ft from wetlands Var.:
10. Leaching minimum 150 ft from drinking well/25 ft irrigation well Var.: `.. --
11. Tank/leaching minimum 10 ft from property line Var.: --��
12. System meets all other setback requirements Var.: L...,""
13.Uses adjustment for maximum high groundwater Var.: (.------
14.
14. Leaching set 4-5 ft above adj.water or bottom test hole'Var.: 1�'
15. System not in top or subsoil(A,B horizons)o ' remova r
16.Proposed contours are suitablLV e
17. System meets slope requirements-min. 1/8", 1/4"preferred
18. System meets breakout requirements PVC liner: Wall: -
- 19. Specified tee sizes are proper, gas baffle on outlet tee \-7
20. Sewage is under 10,000 gpd for parcel
21.No garbage disposal
22. System adequately sized for its intended use \-- '"
23.Minimum 6"stone or compacted below tank and dbox
24.Manhole covers within 6"of grade,pump chamber cover to grade �• �''�
25. Inspection port on plastic chambers/leach field
26.Electrical permit for pump chamber/Separate meter for duplexes
27.Pump system-2" line,weep hole,check valve,tee in dbox, pump size
28. Septic tank/pump chamber to be factory waterproofed -_-''
29. Vent provided if leaching below 3 feet, under driveway/parking ✓--
30. Buoyancy calculations for tank/pump chamber ----
31.Engineer to inspect and certify soils: ./ wall: commercial: ✓�
32.Engineer/Registered Sanitarian and Land Surveyor stamps/signature .�/
33.H-20 loading is subject to vehicular traffic, groundwater ',..---7',,......
34.Title V Application and permit fee, installer signature ��
35.Foundation footing min. 2 feet above adjusted ground water for new house
36.Deed Restriction required max. #bedrooms: max. flow: gpd
37. Check area lots for groundwater/Label groundwater in Assessor's Map
Plan reviewed by: 6/03/03