Review Checklist VItt: TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST�/ 1-
Location: A.M. Lot Zone of Contribution: In ✓� Out Acreage
Street: I 4S eke
K.�'�, Mirt
11 l(, ( Commercial: Residential:
Village: Floor Plan: /C5 #Bedrooms: 3
Owner: Installer:
Address: Phone:
Phone:
Builder: Engineer: S V/ ,t /✓
Address: Phone:
Phone:
I 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
4. Foundation 2 ft above high point of road H.P.: Fnd: Var.: 1.-.'---
5. Water line 10 ft from septic components Var.:
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.: t
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.: •-------
13.
j13. Uses adjustment for maximum high groundwater Var.: ,/-
14. Leaching set 4-5 ft above adj. water or bottom of test hole Var.: ..-----
15.
/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", 1/4"preferred t.-------
18.
18. System meets breakout requirements PVC liner: Wall: g-----
19. Specified tee sizes are proper, gas baffle on outlet tee
20. Sewage is under 10,000 gpd for parcel .------
21. No garbage disposal v I
22. System adequately sized for its intended use ✓
23. Minimum 6"stone or compacted below tank and dbox
24. Manhole covers within 6" of grade, pump chamber cover to grade 1 .-
, 25. Inspection port on plastic chambers/leach field i/---
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 -0X/51114y-
29.
p)(/', 14 y-
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: s.--"'"
32. Engineer/Registered Sanitarian and Land Surveyor stamps/signature s
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 V
36. Deed Restriction required max. 3 #bedrooms: max. flow: gpd
37. Check area lots for groundwater/Label groundwater in Assessor's Map
Plan reviewed by: /1/01/t.
6/03/03