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Review Checklist
' O 5 r��VGrO�ce 44w- TOWN OF YARMOUTH © 14.s-et VA,, o-'c e. SEWAGE PLAN REVIEW CHECKLIST " to t se's Location: A.M. a€9 Lot 5 Zone of Contribution: In Out Acreage / Commercial: Residential: I/ Street: '"7 8_crEtlj Village: Avec j- V�„,y,r, Floor Plan: / #Bedrooms: 5" Owner: 2Installer: <° -0 Address: Phone: Phone: gin Cr.,A-nOi7�r4 ' Builder: Eneer: Address: Phone: 5y f w/A sr y S( �-- Phone: 9o/ -a-73-- Gl000 N/A YES NO 1.Required#of copies received > 2.Date of soils exam and percolation test not older than 2 years (p130 1��� IV 3.4-5 ft of naturally occurring pervious material,above water table I 'moi 1/ 4.Foundation 2 ft above high point of road . H.P.: Fnd: Var.: Vj 5.Water line 10 ft from septic components Var.: 11// 6.Benchmark indicated and shown-NGVD if near wetlands ///'r 7. Septic tank minimum 10 ft from foundation, deck Var.: CrJa..5"') 8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: - S rot. Q 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.: !-- y c ' (..) 12.System meets all other setback requirements Var.: 13.Uses adjustment for maximum high groundwater Var.: 14.Leaching set 4-5 ft above adj.water or bottom of test hole CJ - g 5' D 15.System not in top or subsoil(A,B horizons)or 5'removal �' 16.Proposed contours are suitable ,/*r 4✓ 17. System meets slope requirements-min. 1/8", 1A"preferred 18. System meets breakout requirements PVC liner: Wall: 1/, 19. Specified tee sizes are proper, gas baffle on outlet tee i :/, 20. Sewage is under 10,000 gpd for parcel 21.No garbage disposal tV 22. System adequately sized for its intended use 23.Minimum 6"stone or compacted below tank and dbox 1/ 24.Manhole covers within 6"of grade,pump chamber cover to grade I✓ 25.Inspection port on plastic chambers/leach field 1.7- 26. 26.Electrical permit for pump chamber/Separate meter for duplexes 27.Pump system-2"line,weep hole,check valve,tee in dbox,pump size AZ„. 28. Septic tank/pump chamber to be factory waterproofed ,/ 29.Vent provided if leaching below 3 feet,under driveway/parking t/ 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 V 33.H-20 loading is subject to vehicular traffic, groundwater 34.Title V Application and permit fee,installer signature O 35.Foundation footing min.2 feet above adjusted ground water for new house ./i 36.Deed Restriction required max. #bedrooms: max. flow: gpd ✓ 37.Check area lots for groundwater/Label groundwater in Assessor's Map Plan reviewed by: 10 1 `0 . C'li' 6/03/03 0 //y" /acm, alS,,/j 'V' u i ' 2S 1'