Review Checklist /,--2 --(.9 TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
y , Location: A.M. / / / Lot )--,‘ Zone of Contribution: In Out-Acreage
Commercial: Residential:
Street: 2g X4i,/ealefie, jeivVillage: // Floor Plan: L✓ #Bedrooms:
Owner: (v4lr' &f.' ,d4.,(4/ Installer: - 4' 4.(:).517
Address: Phone: -1,,4) -•> --‘2 J /
Phone:
Builder: Engineer: ?/00440.-e-
1
Address: Phone: CC#- ,
Phone: /12/41,1(., f �G
-ev�{ j6 /GlQ7� 671 Sfb7l
N/A YES NO
1.Required#of copies received L.....----'
2. Date of soils exam and percolation test not older than 2 years 1.-----
3.4-5
✓'3.4-5 ft of naturally occurring pervious material, above water table _ C....--""
4.Foundation 2 ft above high point of road H.P.: Fnd: Var.: (..---
5.Water line 10 ft from septic components Var.: V-
6.Benchmark indicated and shown-NGVD if near wetlands .--------
7. Septic tank minimum 10 ft from foundation, deck Var.:
8. Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: t...---
9.
./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.
12. System meets all other setback requirements Var.: c-----
13.Uses adjustment for maximum high groundwater Var.: fek;f'eJ GG K ....----
14.
.._-14. Leaching set 4-5 ft above adj.water or bottom • _. •. e Var.: t.....------
15. System not in top or subsoil(A,B horizons) • 5' remov. 1/4...---
16.Proposed contours are suitable k.,..----
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 ‘..-----
20. Sewage is under 10,000 gpd for parcel k._....----
-'
._.�-' 21.No garbage disposal L----
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
k._--
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 moo.
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. 11-20 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: 6/03/03