Review Checklist TOWN OF YARMOUTH
� SEWAGE PLAN REVIEW CHECKLIST
� ,Location: A.M. ��� Lot �� Zone of Contri�ution: In_ Out� Acreage
� ` Commercial: Residential: �-
=5��: .z c Q � /
Village: / /� Floor Plan: �/ #Bedrooms:�
� �� �-
Owner: ��� �C�/�1 Installer:
Address: Phone:
Phone:
Builder: Engineer:�
Address: Phone: 4' L
Phone:
U �
�i�/ e�u�
N/A YES NO
1.R uired#of co ies received
2.Date of soils exam and colation test not older than 2 ears
3. 4-5 ft of naturall occurrui ious material,above water table �.�
4.Faundation 2 ft above hi int of rpad H.P.:. Fnd: Vaz.:
` 5.Water line 10 ft from s 'c com onents Var.:
� 6.Bencl�mazk indicated and shown-NGVD if near wellands
7. S 'c tank minimum 10 ft from foundation, deck Vaz.: ,
8. Lrachin minimum 20 ft full, 15 ft crawl, 10 ft slab Var.:
9.Leachin minimum 100 ft&om wetlands Vaz.: ��.
10. Leachin minimum 150 ft from drinkin weli/25 ft irri tion well Var.: `,�.
11.Tank/leachin minimum 10 ft from r line Var.: ��
12. S stem meets all other setback uirements Vaz.: ��
13. Uses ad'ustmeut for maximum hi oundwater Var.: I
14.Leachin set 45 ft above ad'. water or botto Vaz.:
15. S stem not in to or subsoil A,B horizons) 5'r�ov
16.Pr sed contours aze suitable
17. S stem meets sl e r uirements-min. 1/8", '/," referred
18. S stem meets breakout r uirements PVC liner: Wall: '
19. S ified tee sizes are r , baffle on outlet tee ,
20. Sewa e is under 1Q000 for I ,
' 21.No bage dis osal ;
. 22. S stem ad uatel sized for its intended use
, 23.Minimum 6"stone or com ted below tank and dbox
24.Manhole covers within 6"of e, chamber cov�to de
i
25.Ins ion rt on lastic chamb�s/leach field ��
26. Electricai ermit for um chamber/S e meter for du lexes ----.
27• stem-2"line,w hole,check valve,tee in dbox, size
28. S tic tank/ chamber to be factory wa fed � I
29. Vent rovided if leachin below 3 feex,unde,r drivewa / kin �
30.Buoyancy calculations for tank/ um chamb� � �
i
31. ' eer to ins ect and cert soils: wall: commercial: �-
32.En ' eer/Re ' ered Sanitarian and Land Surv or stam s/si ture `/ '
33.H-201oadin is subject to vehiculaz hafTic, oundwater /
34. Title V A lication and ermit fee,installer si ture
35.Foundation footin min 2 feet above ad'usted ound water for new house �
36.Deed Restricrion uired mvc. #bedrooms; ma�c, flow: i
37. Check area lots for oundwater/Label oundwater in Assessor's Ma I
Plan reviewed by: � �3�