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TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
Location: A.M. 02 0Lot7gZone of Contribution: In Out V Acreage C�73 f `
Commercial: Residential: V''
Street: 6 6 Pa,r k _0 v 2
Village: Floor Plan:_ #Bedrooms:
3
Owner: fl I c c 3 q rV clf Q Installer: C A Pi CcJ -5 e pfi c• Ser Vic 4
Address: Phone: .3 D 716 - a eci.S"
Phone: 4 / 7 3a 9 9/ 6 0
Builder: -
Engineer: A� k C A �� S c Pf i G
Address: Phone: 5'0 771 1/a 0 O
Phone:
N/A YES NO
1. Required#of copies received
2. Date of soils exam and percolation test not older than 2 years ✓
3.4-5 ft of naturally occurring pervious material,above water table 17
4.Foundation 2 ft above high point of road H.P.: Fnd: Var.: ✓
5.Water line 10 ft from septic components Var.:
/
--- 6.Benchmark indicated and shown-NGVD if near wetlands !1
7. Septic tank minimum 10 from foundation,deck Var.:
8.Leaching minimum 2 ft fu915 ft crawl, 10 ft slab Var.: 3` V/
9.Leaching minimum 100 ft from wetlands Var.: /6 ' >s-
10.Leaching minimum 150 ft from drinking well/25 ft irrigation well Var.: V
11.Tank/leaching minimum 10 ft from property line Var.:
12. System meets all other setback requirements Var.:
13.Uses adjustment for maximum high groundwater Var.: V
14. Leaching set 4-5 ft above adj. water or bottom of test hole Var.: V--
15. System not in top or subsoil(A,B horizons)or 5'removal ✓
16.Proposed contours are suitable
17. System meets slope requirements-min. 1/8", 1/"preferred V
18. System meets breakout requirements PVC liner: Wall: V.
19. Specified tee sizes are proper, gas baffle on outlet tee F/
20. Sewage is under 10,000 gpd for parcel
21.No garbage disposal V
22. System adequately sized for its intended use I .
23.Minimum 6"stone or compacted below tank and dbox V
24. Manhole covers within 6"of grade,pump chamber cover to grade 1,---
25.
/25. Inspection port on plastic chambers/leach field
26. Electrical permit forpump 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 V
29.Vent provided if leaching below 3 feet,under driveway/parking V
30. Buoyancy calculations for tank/pump chamber V
31. Engineer to inspect and certify soils: wall: commercial: u----
32. Engineer/Registered Sanitarian and Land Surveyor stamps/signature _ V
33.H-20 loading is subject to vehicular traffic,groundwater I/
34.Title V Application and permit fee,installer signature V
35.Foundation footing min.2 feet above adjusted ground water for new house V
36. Deed Restriction required max. #bedrooms: max. flow: gpd
37. Check area lots for groundwater/Label groundwater in Assessor's Map
Plan reviewed by.x____„,r.,f__s5cu._,s 6oa 03