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TOWN OF YARMOUTH 701,,e, = ,
, ., .,.._,,,.w SEWAGE PLAN REVIEW CHECKLIST �� 17�,
Location: A.M. j 9 / Lot / Zone of Contribution: In c OOut Acreage a �*/�
+ Commercial: 'C Residential:
Z
Street:
trees: c� V/ I/? �`� 2
Village: g ry J Floor Plan: �! #Bedrooms: J
Owner: ,,iu a',_, etk-q)6/Q7d Installer: 7),9'.04-
Address:
/?Address: Phone:
Phone:
Builder: Engineer: /\��G e'1 j/ '.�%
Address: Phone: �2- _- _
Phone:
(G(llij yrl/ < q' IT(4P-4-1
N/A YES _ NO
1.Required#of copies received pV/
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 L------
4.Foundation 2 ft above high point of road H.P.: Fnd: Var.: t.----- '
5. Water line 10 ft from septic components Var.:
6.Benchmark indicated and shown-NGVD if near wetlands t__- '
7. Septic tank minimum 10 ft from foundation, deck Var.: Lam/
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: 1.-----
9.
l9.Leaching minimum 100 ft from wetlands Var.: L/'
10.Leaching minimum 150 ft from drinking well/25 ft irrigation well Var.: `/
11. Tank/leaching minimum 10 ft from property line Var.: Y
/1312. System meets all other setback requirements Var.: r t.......„....,--
13.
. Uses adjustment for maximum high groundwater Var.: 1./r
14. Leaching set 4-5 ft above adj.water or bottom of test hole Var.: l�
15. System not in top or subsoil(A,B horizons)or 5'removal (....------
16.
/16.Proposed contours are suitable
ar
17. System meets slope requirements-min. 1/8", 'A"preferred L/
18. System meets breakout requirements PVC liner: Wall: �/
19. Specified tee sizes are proper, gas baffle on outlet tee k....-r
• 20. Sewage is under 10,000 gpd for parcel t...---
21.
�21.No garbage disposal
_ 22.System adequately sized for its intended use 1�
23.Minimum 6"stone or compacted below tank and dbox 1
24.Manhole covers within 6"of grade,pump chamber cover to grade 1�
25.Inspection port on plastic chambers/leach field
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 ._i^
34.Title V Application and permit fee,installer signature C)
35.Foundation footing min. 2 feet above adjusted ground water for new house ✓"
36.Deed Restriction required max. #bedrooms: max. flow: gpd c_.------
37.Check area lots for groundwater/Label groundwater in Assessor's Ma _.-----
Plan
.- `Plan reviewed by: ��' 6/03/03