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TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
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Location: A.M. / 3 Lot Zone of Contribution: In Out Acreages
1 /,1.4/- 4 1----/ -•
Commercial: Residential:
Street: 7.--- ----
1 Village: (/ /74-
Floor Plan: L --- #Bedrooms: --
Owner: ajaie41469 7.14(/,�' Installer: 7
Address: ��" Phone:
Phone:
Builder: Engineer: ! , /moi ,
Address: Phone: . /'
� 6 ) i
Phone: t/� � •'/e
1 014r02Aae-,1
N/A YNO
1.Required#of copies received v
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 [.----^
4.Foundation 2 ft above high point of road H.P.: Fnd: Var.: L1
5. Water line 10 ft from septic components Var.: �o>
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.: ` -,
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.Leaching set 4-5 ft above adj. water or bottom of test hole Var.: / (� ) c.�
15. System not in top or subsoil(A,B horizons)or 5'removal /,...---•
16.Proposed contours are suitable LSO
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 L------
20. Sewage is under 10,000 gpd for parcel �..
21.No garbage disposal �---•
22. System adequately sized for its intended use L_.-.
23.Minimum 6"stone or compacted below tank and dbox
C-----
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 �- ii,------.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
c.-------
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 j-
Plan reviewed by:
6/03/03