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TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST �(
Location: A.M. Lot Zone of Contribution: In Out Acreage
f S D�/, � /_�I /L� Commercial: Residential: �- /
Street: K �J 3-A G
Village: Floor Plan: #Bedrooms:
Owner: Installer: *PK 11/1 ii ci u
Address: Phone:
Phone: //A, � II �j
Builder: Engineer: <" '-/ YW� M
`
Address: Phone:
Phone:
N/A YEy 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.: ✓
.,, 5. Water line 10 ft from septic components Var.: V
dr;P:enchmark indicated and shown-NGVD if near wetlands / ,)(
7. Septic tank minimum 10 ft from foundation, deck Var.: .L YjS-h N.J ✓
8. Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: ✓✓ s
9. Leaching minimum 100 ft from wetlands Var.: ✓
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.: V
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 t/
16.Proposed contours are suitable
17. System meets slope requirements-min. 1/8", '/"preferred ✓/
18. System meets breakout requirements PVC liner: Wall:
19. Specified tee sizes are proper, gas baffle on outlet tee +/,
20. Sewage is under 10,000 gpd for parcel V
21.No garbage disposal ✓�
22. System adequately sized for its intended use ✓
23.Minimum 6"stone or compacted below tank and dbox t/
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.Pump system-2"line,weep hole,check valve,tee in dbox,pump size 4
28. Septic tank/pump chamber to be factory waterproofed
29. Vent provided if leaching below 3 feet,under driveway/parking 1730.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 /
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 groundwat i A sessor's Map ✓
Plan reviewed by: 6/03/03