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TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
• Location: A.M. Lot 7t 3 Zone of Contribution: In Out Acreage
Commercial: Residential:
Street: 2- mm
Village: > 0Floor Pl. i: . :edrooms g z3 'Pei/
Owner: >,' 17/(4 ' Installer:
Address: Phone: lit/ n is -7/0 - 6
Phone: Ail gepeg �'
Builder: Engineer: �� �J
Address: Phone: �"'j ' ``'
Phone: /l/
�tt�G / . �,� QHS/��
p/tat(iik, N6
1.Required#of copies received C �
2.Date of soils exam and percolation test not older than 2 years L---'
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.: L---.
5.Water line 10 ft from septic components Var.: (._---
6.Benchmark indicated and shown-NGVD if near wetlands (._am- _
7. Septic tank minimum 10 ft from foundation, deck Var.: L..----'
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.: t.----
12.System meets all other setback requirements Var.:
13.Uses adjustment for maximum high groundwater Var.: 6,1r C-.), (--
14.Leaching set 4-5 ft above adj.water or bottom o o e ar.: c_..---
15. System not in top or subsoil(A,B horizons)o 5'remov
16.Proposed contours are suitable L/
17. System meets slope requirements-min. 1/8", '/4' preferred (�
18. System meets breakout requirements PVC liner: Wall: ��
19. Specified tee sizes are proper, gas baffle on outlet tee ti'
- 20. Sewage is under 10,000 gpd for parcel Lf
21.No garbage disposal L----""
22. System adequately sized for its intended use `./
` 23.Minimum 6"stone or compacted below tank and dbox 1/4.-----
24.Manhole covers within 6"of grade,pump chamber cover to grade •.----
25.Inspection port on plastic chambers/leach field c._-s
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.
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 1�,----"
36.Deed Restriction required max. #bedrooms: max. flow: gpd _ �,
37.Check area lots for groundwater/Label groundwater in Assessor's M. . L...�
IPlan reviewed by: 6/03/03