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TOWN OF YARMOUTH
. '; SEWAGE PLAN REVIEW CHECKLIST
Location: A.M. <57) Lot P Zone of Contribution: In Out `P Acreage
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Commercial: Residential: _)
j Street: (jc.-40161 �-1kVillage: )c- 4'/'- Floor Plan: L. r #Bedroom
Owner: 4c7S/ ,c /ia /266t Installer: /6-6,--U4-
Address: Phone: 4 W= `.'2 /Z)
Phone:
Builder: Engineer: ( q44
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Address: 7-
Phone: S - 776
Phone: %l/7L i' ie' C /o 'ti i t
N/AYES i 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 t.
4.Foundation 2 ft above high point of road H.P.:• Fnd: Var.: C./
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.: l//
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: \/
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.: L/
13.Uses adjustment for maximum high groundwater Var.: �/'
14.Leaching set 4-5 ft above adj. water or bottom of test hole Var.: i,/
15. System not in top or subsoil(A,B horizons)or 5'removal L/
16.Proposed contours are suitable '`,/
17. System meets slope requirements-min. 1/8", 1/4"preferred l�
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 t/
21.No garbage disposal L/
22. System adequately sized for its intended use /
23.Minimum 6"stone or compacted below tank and dbox `1
24.Manhole covers within 6"of grade,pump chamber cover to grade L_/
25.Inspection port on plastic chambers/leach field
26.Electrical permit for pump chamber/Separate meter for duplexes
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27.Pump system-2"line,weep hole,check valve,tee in dbox,pump size
28. Septic tank/pump chamber to be factory waterproofed
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
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
Plan reviewed by: VLA
6/03/03