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TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
Location: A.M. c'C' Lot I/ Zone of Contribution: In_ Out%reage
Commercial: Residential
Street: g
Village: } /.0 L • Floor Plan: #Bedrooms:
Owner: ,." 1-'t,e/ 42„.C/ v Installer:
Address: Phone: - -
Phone:
Builder: Engineer: ��-®r�� 1-d�
Address: Phone: �j'Z�' !�-�-���Z 7 j C
Phone: ,i1,�'' / �_/Ni
N/A YES NO
1.Required#of copies received
2. Date of soils exam and percolation test not older than 2 years L/
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.:
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.:
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. 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
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 �.-
21.No garbage disposal
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
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
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: ( '" 6/03/03