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21112,/--(2 TOWN OFYARMOUTH` V
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SEWAGE PLAN REVIEW CHECKLISTPC"' yr
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Location: A.M. l"f Lot /5 �Z Zone of Contribution: In_LOut_ Acreage
Commercial: Residential: L/
Street: 62 6$ ,e��� 47
Village: Floor Plan: #Bedrooms:-1
Owner: A t L/wifr(,á.. Installer:
Address: Phone:
Phone: 1-7`'62.^ 7 i/ 7, -
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Builder: �� Engineer:Address: Phone: � ,3 , IPhone: 40 0/ge#
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f 14 M / l--1°14 Vii
N/A YES NO
1.Required#of copies received L,✓
2.Date of soils exam and percolation test not older than 2 years ,1/4-
3. 4-5 ft of naturally occurring pervious material, above water table ..-----
4.Foundation 2 ft above high point of road H.P.:(p.( Fnd: (j Var.:/f.C, (----'
5. Water line 10 ft from septic components Var.:
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.: l
9.Leaching minimum 100 ft from wetlands Var.: c....--,
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.: cy.
13.Uses adjustment for maximum high groundwater Var.: \
14.Leaching set 4-5 ft above adj.water or bottomo`l -yar.: .!
15. System not in top or subsoil(A,B horizons or 5'remote
16.Proposed contours are suitable Z.. --�'
17. System meets slope requirements-min. 1/8", 'A"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 �- -
21.No garbage disposal t.-----"'
22. System adequately sized for its intended uses
23.Minimum 6"stone or compacted below tank and dbox ��./
24.Manhole covers within 6"of grade,pump chamber cover to grade .,;.i'°'
25. Inspection port on plastic chambers/leach field c/'
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.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 .-
36.Deed Restriction required max. #bedrooms: max. flow: gpd ,,,./
37.Check area lots for groundwater/Label groundwater in Assessor's M ----'
Plan reviewed by: 6/03/03