Review Checklist (-//'-- ( TOWN OF YARMOUTH
} SEWAGE LAN REVIEW CHECKLIST
Location: A.M. 1 Lot ',.>.1g
Zone of Contribution: In Out +. A-creage
/
Veir
/ Commercial: Residential: LStreet: (49-2 ,[ J/ Lil
Vilage: k _ Floor Plan: #Bedrooms:
Owner: //,/(o �/'tfi, Installer: � C
Address: � Phone: ?� 7 7S--e2. -
Phone:
Builder: Engineer: 5.‘ /G �9!'
Address: Phone: L., � - ,'
Phone: 7,t l Z //(( ;c-e"-/ _(-c -..I
N/A YES NO
1.Required#of copies received tom'
2. Date of soils exam and percolation test not older than 2 years
3.4-5 ft of naturally occurring pervious material, above water table _ --a
4.Foundation 2 ft above high point of road H.P.: Fnd: Var.: .
5. Water line 10 ft from septic components Var.: .
6.Benchmark indicated and shown-NGVD if near wetlands t ,.,,---
7. Septic tank minimum 10 ft from foundation, deck Var.: .....----
8.
_-
8.Leaching 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 well/25 ft irrigation well Var.:
11. Tank/leaching minimum 10 ft from property line Var.:
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12.
., --12. System meets all other setback requirements Var.: ,k,....----
13.
k�13. Uses adjustment for maximum high groundwater .__._.Yar.: fr
14.Leaching set 4-5 ft above adj.water or botto of test hole\War.: --�'
15. System not in top or subsoil(A,B horizons)wal _-------
16.
16.Proposed contours are suitable
,......----
17.
�---17. System meets slope requirements-min. 1/8", 1/4"preferred C --
18.
18. System meets breakout requirements PVC liner: Wall:
19. Specified tee sizes are proper, gas baffle on outlet tee {--- -
20.
-20. Sewage is under 10,000 gpd for parcel t. _,/
21.No garbage disposal
22. System adequately sized for its intended use L,.,
23.Minimum 6"stone or compacted below tank and dbox .._---
24.
s24.Manhole covers within 6"of grade,pump chamber cover to grade
25.Inspection port on plastic chambers/leach field L..-
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 C
29. Vent provided if leaching below 3 feet,under driveway/parking ....---
30.Buoyancy calculations for tank/pump chamber ....-----
31.
---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 ----
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: 6/03iO3