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TOWNOFYARMOU"FH / � �,��G�',�G�Z�
SEWAGE kLAN REVTEW CHECKI.IST ,��C,r;'C"- �
. Locariau: A.M.� Lot rb L Zone of Contn`bution: In� Oui Acrea�e__ke�� �
//////,`'�^` / Cammercial: Residential:_�_
Sueex:_�t__-��y-'��-�._�3�d'efCL�LC ' �
Village:___��(. ' ✓.., Ploor Plan: �-� #Bedrooms:
i �_��1.���GJ
! Owner. --� Installes: _
i Address: Pbone: u' �,`7i '"�G� "-
Phone:
� G //`�_,_ _�.P��(/i!Ca" l/G'G'✓�
i Builder: Engineer:
� Address: Phone: ��-- -
Phone: ��j%C /, �e- ��CS'
N/A YES NO
� 1.R ' ed#of ies received
2.Date of soils e�cam and lation test not otder tlian 2 years
i3.45 ft af natiara occurrin ervious material,above water table
4.Foundation 2 ft above hi oint of road H.P.: Fnd: Vaz.:
i 5.Wa2es Iine 14 ft fram s 'c com ne�s Vaz.: l-/
6.Benchwazk indicated and shown-NGVD if near wdlands
'7. 'c tank minimnra 10 S from faundatio deck Var.:
�I g.I,eachin minimu�um 20 ft full, 25 ft crawl, 14 ft slab Var.: � -''
� 9.Leachin minunum 100 ft from wetlands Var.: ""-
10.Leachin mininaum 1 SO ft from drinicin we2U25 it irrigatian well Var.:
11.Tanklleachin minimum 10 ff from line Vaz.: '"�
12.S stem meets all othes setback r irements Vaz.:
� 13.Uses adjus�Yment for rnaximum hi oundwates Vaz.:
14.Leachin set 45 �t above ad'.water or bottom of test hole Vaz.: �
I5.S em not in or subsoil A,B horizons}or 5'removal a-�
16. cantours aze suitabie '�-�
1�. .5 StCL31II�CfS51 C IfClIIeiltS'IIIlll. l�8"� I�4" eflCl� {- �
I8.S em meets breakrnrt ' ements PVC line,r: Wall: `-�
19.S ified t�sizes are , baffie on ouflet tee C..-�
20. S e is und� 10,000 far I
- 21.No 2 ��
22.S uatel sized for ats intended use
23.Minimum 6"stane ox com cted below tank and dbox
24.Manhole cov�s within 6"of e, chamber cov�to e
25. ion on lastic chambers/leach field
26.Electricat erm9t for um chamber/S mder for du lexes
27. ste�n-Z"Iine,w hole,check valve,tee in dbox, size
28. S tic tank/ chamber to be facto wa oofed
29.Vern vide�i£'leachin below 3 fe�,under drivewa 1 arian
30.Buayanc caiculations f� c}�ambes
31. � eer to ins ect and c ' soils: wall: commercial:
32.E ' e�/It ' ed Sanitarsan and Land Surv or slsiguature
33.H-241oadin is snb'ect to vehicular haffic, oundwater
34.Title V lication and ermit fee,installet s' tura
35.Fo�mdation footin min.2 feet above ad' aund wat�far new fiouse ,��
36.Deed Resh�iction ired max. #bedrooms: max,flow:
37.Check area lots for oundwatexJLabel undwater iA Assessor's Ma
Plan reviewed by: l �� �