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TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
Location: A.M. 3 8 Lot Zone of Contribution: In Out " Acreage
Commercial: Residential: ir
Street: 9 cairce, Raz{.
Village: L,/l sf- fetr a Floor Plan: V #Bedrooms: 3
Owner: Ma r/ &-,0 sfr Installer R--v6LElr (�. 5 Co .
Address: Phone: Cis-be) 'i o53c6
Phone: �S 49-79'/7
Builder Engineer: Dowel ['4
Address: Phone: (5'08 .4,a- / •
Phone: ///
N/A YES, NO
1.Required#of copies receivedI/
2.Date of soils exam and percolation test not older than 2 years /I
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.: l0
5.Water line 10 ft from septic components Var.:
6.Benchmark indicated and shown-NGVD if near wetlands L ,tip f✓
7. Septic tank minimum 10 ft from foundation, deck Var.: /
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: V
9.Leaching minimum 100 ft from wetlands Var.: V
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.: I
13.Uses adjustment for maximum high groundwater Var.: VV
14.Leaching set 4-5 ft above adj.water or bottom of test hole Var.: _ 1 `, '
15.System not in top or subsoil(A,B horizons)or 5'removal Z (?,.
16.Proposed contours are suitable _
17. System meets slope requirements-min. 1/8", 'A"preferred V
18. System meets brgdkout requirements , PVC liner: Wall:
19.Specified tee sizes are proper, gas ble on outlet tee
20. Sewage is under 10,000 gpd for parcel .1,,
21.No garbage disposal t�
22. System adequately sized for its intended use V
23.Minimum 6"stone or compacted below tank and dbox
24.Manhole covers within 6"of grade,pump chamber cover to grade
25.Inspection port on plastic chambersach 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 t/,
29.Vent provided if leaching below 3 feet,under driveway/parking 1/
30.Buoyancy calculations for tank/pump chamber 1(/
31.Engineer to inspect and certify soils: wall: commercial: V
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 1/7
36.Deed Restriction required max. #bedrooms: max. flow: gpd _
37.Check area lots for groundwater/Label groundwater in Assessor's Map
Plan reviewed by: i -5 e›epl"ll 9. 6/03/03
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