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✓� C T OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
Location: A.M. �e Lot c.'77C9 Zone of Contribution: In/Out_ Acreage
Commercial: Residential: V
Street: . ;P/ fry /E?
Village: Sc ;,ty yam.✓. ,.,,,;A , Floor Plan: V #Bedrooms:
Owner: /,-a--r-`• . ---&,-i---trit.525 Installer:,,-•f C s v„�CO
Address: -f.e.- Phone:
Phone: Sem ;;O3- ci.3/
Builder' Engineer: %g,--,,yj /-t C
Address: j Phone: • , E--- -7).&;- /-.76;y.
Phone:
N/A YES NO
1.Required#of copies received
2.Date of soils exam and percolation test not older than 2 years
1/z-
3.4-
5 ft of naturallyoccurring pervious material,al,above water r table
4.Foundation 2 ft above high point of road H.P.: Fnd: Var.: >r
5.Water line 10 ft from septic components Var.: ,/'1
6.Benchmark indicated and shown=NGVD if near wetlands V
7.Septic tank minimum 10 ft fr•I foundation, deck Var.: e.r gw S.I-e ) 1
8.Leaching minimum 20 ft full, ' ft crawl, 10 ft slab Var.:
9.Leaching minimum 100 ft from wetlands Var.: 1/
10.Leaching minimum 150 ft from drinking well/25 ft irrigation well Var.: ,,
11.Tank/leaching minimum 10 ft from property line Var.: t9,/1)(65c,.,
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 Var.: i/
15. System not in top or subsoil(A,B horizons)or 5'removal t/
7 16.Proposed contours are suitable r,/
''t 17. System meets slope requirements-min. 1/8", 'A"preferred g .Q,Ido R:7, •
18. System meets breakout requirements PVC liner: Wall: V
19. Specified tee sizes are proper, gas baffle on outlet tee y-''
20. Sewage is under 10,000 gpd for parcel .7'
21.No garbage disposal V
22. System adequately sized for its intended use V/
23.Minimum 6"stone or compacted below tank and dbox V
24.Manhole covers within 6"of grade,pump chamber cover to grade t/
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 V
28. Septic tank/pump chamber to be factory waterproofed V
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 tZ
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 i/
37.Check area lots for groundwater/Label groundwater in Assessor's Map /
Plan reviewed by: 6103/03