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_ �� TOWN OF YARMOUTB
: _ : SE�VAGE YLAN REVIEW CHECKLIST
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y Location: A.M. 1 7 Lot� Zone of Contribution: In Out� Acteage
Commercial: Residential:�_ ',
s�: �S /�w�S
Village: /,(j� / �r Floor Plan: � #Bedrooms: � i
Owner: �Tt2.P�C. Cl/� Installea�: ��
Address: � Phone: '
Phone: � � Z�-.
Builder: � � Engineea:
Address• p Phone: Z-
Phone: � G'� � ,� � 7�� � -�i �/ .
/ .B?/L
N/A YES NO
1.R fred#of ies received
2.Date of soils e�cam and lation test not olda than 2 �rs
3.4-5 ft of� occumn 'ous mataiat,above water table
4.Fauidation 2 ft above hi i�of rpad H.P.: Fnd: Var.:
5.Wat�line 10 ft from s 'c com Var.: '
6.Benchmark indicated and shown-NGVD if near wetlands
7. S ' tank minimum 10 ft from foundation,deck Var.:
8.Leachin minimum 20 ft full, 15 ft crawl, 10 ft slab Var.:
9.I.eaclun minimum 100 ft from wetlands Vaz.:
]0.Leachin minimum 150 ft from ' we1U25 ft ' ' tion well Var.:
I 1.Tank/leachin minimum 10 ft from line Vaz.:
12.S stem maets all other setback irements Var.: �
13.Uses ad' ent for maximum hi oundwater Var.: ;
14.Leachin set 45 ft abwe ad'.water m'bottom of test hole Var.: '
15. S not in or subsoil A,B horizons ac 5'r�oval
16. ed cmit�rs are suitable
17.S stem meets sl e irements-min. 1/8", '/," ared
_ 18. meets breakout ' ements PVC liner: Wall: �
19. S ified tee sizss are , ba$le on auU�tce �/
20. e is under 10,000 fa I ,
21.No dis
22. S uatel sized for its intended use
23.Minimum 6"stone or com ed below tank and dbmc
24.Manhole covers within 6"of e, chamb�cover to e
25. ion on lastic chambers/leach field
26.Ekctrical �mit for chamb�/S mete�far du leares
27. em-2" line,w hole,check valve,tee in dbox, size '
28.S ' tank/ chamb�to be factory oofed l/ !
29.Vent ovided if leachin below 3 feet,undea drivewa / '
30.Bu anc calculations for taok/ chamba
31. ' eer to ins and c ' soils: wall: commercial:
32.En ' e�/R ' ed Sanifatian and Land Surv or s/si ,
33.H-201oadin is sub'ect to vehicular traffic, undwat� ,
34.Title V lication and e,�mit fee, installer si !I
35.Foundation foot min.2 fe�above ad'us[ed ouud water for new hause
36.Deed Restriction ired max. #bedrootns: max. flow:
37.Check area lots for dwat�/Label t�in Assessor's M �
Plan reviewed by: �t� �
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