Review Checklist TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
Location: A.M. / Lot / 5 Zone of Contribution: In Out V Acreage/61)D 6 0
Commercial: Residential: .tom
Street: .3 3 fi)CSG Sa Nrt .S-t
Village: Floor Plan: #Bedrooms: /
Owner: Pa How s /,,:lv Re✓ocL/z "ir„s1'Installer: S IP�Rl2via n7
Address: / �'X e A u c,7` u
Phone: co , 4/3,Q.-- S$ c
Phone:
Builder: Engineer:
Address: � j)01..E I,) CA pc. res r arse�, ,uy
Phone: Phone: !4.0 ? 3 6.).- S ys
- 4/
N/A YES NO
1.Required#of copies received
2.Date of soils exam and percolation test not older than 2 years bra✓"irk L)41 V
3.4-5 ft of naturally occurring pervious material,above water table �'
4.Foundation 2 ft above high point of road H.P.: Fnd: Van: V
5.Water line 10 ft from septic components Var.: V
6.Benchmark indicated and shown-NGVD if near wetlands ✓
7. Septic tank minimum 10 ft from foundation,deck 10 r. ✓
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab 4VA 17: 8/i
9.Leachingminimum 100 ft from wetlands Var.:
10.Leaching minimum 150 ft from drinking well/25 ft irrigation well Var.: V'
11.Tank/leaching minimum 10 ft from property line Var.: V
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.:
15. System not in top or subsoil(A,B horizons)or 5'removal
16.Proposed contours are suitable V.--
17. System meets slope requirements-min. 1/8", 1/4"preferred ir -
18. System meets breakout requirements PVC liner: Wall:
19. Specified tee sizes are proper, gas baffle on outlet tee 1/‘
20. Sewage is under 10,000 gpd for parcel
21.No garbage disposal
22. System adequately sized for its intended use _/
23.Minimum 6"stone or compacted below tank and dbox I V I
24.Manhole covers within 6"of grade,pump chamber cover to grade V
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 V
33.H-20 loading is subject to vehicular traffic,groundwater
34.Title V Application and permit fee,installer signature V
35.Foundation footing min. 2 feet above adjusted ground water for new house
IV
36.Deed Restriction required max. #bedrooms: max. flow: gpd V>
37. Check area lots for groundwater/Label groundwater in Assessor's Map �J
Plan reviewed by: _ 4, A
603 D3