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-�° '7'7
TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
1
Location: A.M. /?2_ Lot -714 Zone of Contribution: In Out !/Acreage
Commercial: Residential: (r/
Street: 6 ( kPla 5-1(?ceilelf
Village: Floor Plan: ./ #Bedrooms:
i /
Owner: Installer: r -1 f� T!
Address: Phone: 9a-g, - 1'k---.)-7/
Phone:
Builder: 7 Engineer: dilYt a3zoee?(/‘-6,
Address: Phone: . ---b.:-- '77 c- ' rtD
Phone:
(W795-€7-4A?-17
A YES NO
1.Required#of copies received (_/''
2.Date of soils exam and percolation test not older than 2 years i------"'
3.4-5 ft of naturally occurring pervious material, above water table
4....-- -
4.Foundation 2 ft above high point of road H.P.: Fnd: Var.: 4......----
5.
f5.Water line 10 ft from septic components Var.: C�
6.Benchmark indicated and shown-NGVD if near wetlands
7. Septic tank minimum 10 ft from foundation, deck Var.: r�-��
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.:
9. Leaching minimum 100 ft from wetlands Var.: t..----
10.
�10.Leaching minimum 150 ft from drinking well/25 ft irrigation well Var.: L._.------
11.Tank/leaching minimum 10 ft from property line Var.: ..-------
12.
.--/12. System meets all other setback requirements Var.: t...-------
13.Uses adjustment for maximum high groundwater Var.: �� •
14.Leaching set 4-5 ft above adj.water or bottom of test hole Var.:
15. System not in top or subsoil(A,B horizons)or 5'removal 07..„../`- 1f /,,077("6rz2I
16.Proposed contours are suitable .L.------
17. System meets slope requirements-min. 1/8", ' "preferred L-----^
18. System meets breakout requirements PVC liner: Wall: - J
19. Specified tee sizes are proper, gas baffle on outlet tee 7, ,,,,t--------
20. Sewage is under 10,000 gpd for parcel t ..--�
. 21.No garbage disposal
22. System adequately sized for its intended use ls„--/
23.Minimum 6"stone or compacted below tank and dbox �/
• 24.Manhole covers within 6"of grade,pump chamber cover to grade L/7
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 l
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 cf
34.Title V Application and permit fee, installer signature ✓"
35.Foundation footing min. 2 feet above adjusted ground water for new house �--'1
36.Deed Restriction required max. #bedrooms: max. flow: gpd _��7,....----
37.Check area lots for groundwater/Label groundwater in Assessor's Map
Plan reviewed by: CO
6/03/03