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TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
Location: A.M. .390 Lot 6-'l, Zone of Contribution: In Out_ Acreage _
Commercial: 4.------- Residential:
Street: l
my c ; pa,
Village:
Floor Plan: # Bedrooms: '�-
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Owner ,incia.A.41.0....tLi Installer:
Address: ¢" ¢ v e I' $
_ Phone:
Phone:
Builder: Engineer: a C,
Address: __ Phone:
Phone:
N/A I YES I NO
1. Required#of copies received 1
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 .oint of road H.P.: End: Var.: e."---
5.
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.: I /
10. Leaching minimum 150 ft from drinking well/25 ft irrigation well Var.: /
11.Tank/leaching minimum 10 ft from property line Var.: -___, .--
--t--
12.
12. System meets all other setback requirements Var.:
13. Uses adjustment for maximum high groundwater Var.:
14. Leaching set t 4--5 ft above adj. water or bottom of test hole Van:
15. System not in top or subsoil (A,B horizons) or 5' removal
16. Pro.osed contours are suitable
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17_ System meets slope requirements-nun. 1/8", `,%"preferred
18: System meets breakout requirements PVC liner: Wall: I
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 -
23. Minimum 6"stone or compacted below tank and dbox i
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 .:.;'--
27.
r27_Pump system-2"line,weep hole,check valve, tee in dbox,pump size
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28. Septic tank/pump chamber to be factory waterproofed 1/
29. Vent provided if leaching below 3 feet,under driveway/parking V
30. Buoyancy calculations for tank/pump chamber _
31. Engineer to inspect and certify soils: wall: cominercial: I Apr.
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
35. Foundation footing min. 2 feet above adjusted ground water for new house
36. Deed Restriction required max. #bedrooms: max. flow: gpd
37. Check area lots for groundwater/Label groundwater in Assessor's Map I
Plan reviewed by: