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TOWN OF YARMOUTH
SEWAGE/PLAN REVIEW CHECKLIST
Location: A.M. r Lot I)0 Zone of Contribution: Inj Out_ Acreage 12/ 34/C.F
� � r Commercial: Residential: X
p
Street: . A-0-4,-- Vv3
ali
Village: Floor Plan: #Bedrooms:
Owner: 014)4 1-61 Ind✓Lf SS4 Installer: 12D 1. DuX
Address: Phone:
Phone:
Builder: Engineer: 4t S Ri\/L✓ - Tc - 114°--1-41t14-v'
Address: Phone:
Phone:
N/A YES NO
1.Required#of copies received
2.Date of soils exam and percolation test not older than 2 years t./---
3.4-5
/'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.: ✓'
5.Water line 10 ft from septic components Var.: 1/
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.: ,.---- _
9.Leaching minimum 100 ft from wetlands Var.: J.
✓�
10.Leaching minimum 150 ft from drinking well/25 ft irrigation well Var.: t-
11.Tanklleaching minimum 10 ft from property line Var.: t .
12. System meets all other setback requirements Var.: s '
13.Uses adjustment for maximum high groundwater Var.: ,- •
14.Leaching set 4-5 ft above adj.water or bottom of test hole Var.: t
15. System not in top or subsoil(A,B horizons)or 5'removal t .
16.Proposed contours are suitable
17. System meets slope requirements-min. 1/8", 'A"preferred •✓
18. System meets breakout requirements PVC liner: Wall: 1/-
19. Specified tee sizes are proper, gas baffle on outlet tee
20.Sewage is under 10,000 gpd for parcel
21.No garbage disposal
22. System adequately sized for its intended use i,------
23.
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 chambers/leach field
26.Electrical permit for pump chamber/Separate meter for duplexes t/
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 t/-"--
35.
'35.Foundation footing min.2 feet above adjusted ground water for new house
36.Deed Restriction required max. 3 #bedrooms: max. flow: laft gpd
37.Check area lots for groundwater/Label groundwater in Assessor's Map
Plan reviewed by: ���ti�'" i7 6/03/03