HomeMy WebLinkAboutReview Checklist � �S J�� Towrr oF Y.�,xMau�rx ,
SEWAGE PLAN REVIEW CHECKLIST
Location: A.M. � Lot �S� Zone of Contribution: In_ Out� Acreage .
Commerciat: Residential:�,_.
Sireet: 'S t' / �
Village:-----��41o����a2 E����� Floor Plan: ✓ #Bedrooms:
OHmer: G �Rr..�l .- - LnstzCler: �lG�GP s �� " ` '� "
� Address:��� � Phone: ��' " Si�-�
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Phone: -
Builde.r: / EuSineeT: _/�'Yto`������'
Address: Phone: S�` 77 =�`�
', . . �/Ger�i� ��
Phone: �
-� f r 2. t+�i'�G3Yc�rY.�'S
N/A YES NO
1.R iced#of ies received �-�
2.Date of soils exam and colatian test n�otder than 2 e�ars
3. 45 ft of natural occurrin ervious mat�ia7,above water table �-�""
4.Faundation 2 ft above hi irn of road H.P.: Fnd: Var.:
5.Water line 1 Q ft from tic co nents Vaz.:
6.Benchmark indicated and shown-NGVD if near wetlands ✓
7. S 'c tank minimum IO ft from foundario de�k Vaz:
8.Leachin minimum 2o ft full, 15 ft crawl, 10 ft slab Var.:
9.I.eachin minimum 100 ft from wetlands Vaz.: 0 � �--�"'
20.Leaching miniucum 154 ft from�inkin wel]12S ft irri tion well Vaz:
11.Tank/leaching minimum 10 ft from r line Vaz.:
12.S stem meets atl other setback r uirements Var.: '
13.Uses adjustmenc far ti�cimum hi oundwaier Var.: •
14.Leaching set 4-S tt above ad'.water or bottam of test hole Vaz.:
15.S stem nok in ot suhsoil(A,B horiz.ons}or 5'remaval
16.Pr ed canLours are suitabSe il�.� ' '
17. S stem meets slo e uirements-min. 1/$", '/a" e1'ened
28.S em mcets breakaut irements PVC liner: Wall:
19.S ified tee sizes are ro er, baffle on outlet tee c.--"'
20.Sewa e is ander 10,000 d for cel � '
21.No bs e dis osaf �
22. S stem ad uatel sized for its inrtendul use
23.Minimum 6"stone or com acted below tank and dbox ._../ .
24.Manhole cove�s within 6"af e, um chamber cover to
25. tion ort pn lastic chambers/leach field
26.El�trical ermat.for um chamb�IS e meter fat du lexes
27.P stem-2"line,w hole,check valve,tee in dbox, size
28. S tic tank/ um chamber to lae facto wa raofed .�-�
24.Veut ovided if ieachin below 3 feet, under drivewa 1 arkin
30.Buoyanc calcalations for tank! um chamber --�
31. En ' eer to ins ect and cert' soils: wall: cornmerciaL•
32.Engin�llt 'stered 3anitarian and Iand Sure or stam si ture /
33.H-201oadin is sub'ect tc�vehiculaz traflic, oundwater f '
34.Title V A Iication and ermit fee, instaltez si ature
3S.Foundation footin min.2 fe�ahove ad'usted ound wat�for new house
36. Deecl ltestriction r ued max. #bedrooms: max. flow:
37.Check area lots for oundwaterlLabe( oundwater in Assessar's Ma ,
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Plan reviewed by: _ f�� ��
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