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TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
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Location: A.M. �C Lot 7 5 Zone of Contribution: In_ Out Acreage
Commercial: Residential:
Street: I
Village: /l. # Floor Plan:*6-7( CD #Bedrooms:
Owner: )5 46 Ui4 $' �o Installer: i"(
Address: 0 2 tf i '& -, z 5 Phone: "CS-- 5-99::
Phone: I
Builder: 2i'-r4-(--Q Engineer: Y ' ;'/L
Address: Phone: i- 3 -2
Phone:
N/A YES N®!�
1.Required#of copies received
2.Date of soils exam and percolation test not older than 2 years 1
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.:
5. Water line 10 ft from septic components Var.: l/
6.Benchmark indicated and shown-NGVD if near wetlands 1/
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.: 1/
12. System meets all other setback requirements Var.: r/'
13.Uses adjustment for maximum high groundwater Var.: b/.
14.Leaching set 4-5 ft above adj.water or botto otest ar.: L...----;/
15.System not in top or subsoil(A,B horizons) 5'removal ✓
16.Proposed contours are suitable c./-
17. System meets slope requirements-min. 1/8", 'A"preferred 1/
18. System meets breakout requirements PVC liner: Wall: L/
,, 19. Specified tee sizes are proper,gas baffle on outlet tee ( '
' 20. Sewage is under 10,000 gpd for parcel
21.No garbage disposal 1
22. System adequately sized for its intended use 1�
23.Minimum 6"stone or compacted below tank and dbox i '
24.Manhole covers within 6"of grade,pump chamber cover to grade k./
25.Inspection port on plastic chambers/leach field 1/
26.Electrical permit for pump chamber/Separate meter for duplexes L/
27.Pump system-2" line,weep hole,check valve,tee in dbox,pump size
terproofed
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: k
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 1/.
35.Foundation footing min.2 feet above adjusted ground water for new house 1 /
36.Deed Restriction required max, #bedrooms: max.flow: gpd t-
37.Check area lots for groundwater/Label groundwater in Assessor's Map
Plan reviewed by: \'V 6/03/03