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TOWN OF YARMOUTH
- SEWAGE PLAN REVI�W CHECKI.IST ,,�� ,� ��
Location: A.M.� Lot� Zone of Contribution: In`� Out Acreage���
• � Commercial: Resi al.
Street: ��, !
�� Village: [ Floor Plan: #Bedrooms✓Y ����
��: ���� I���-zr s ��u�: � �� "' ��.�_�
I Address: Phone: �Z
Phone: ,
Builde�r: Engineer: � �!�/
Address Phone: 7 - 1 ����j}
Phone: �- /�✓���C' � ��, Ci1�� /
N/A NO
1.R uired#of ies received
2.Date of soils e�cam and colarion test not older than 2 ears
3.4-5 ft of natural occurrin ervious material,above water table
4.Foundation 2 ft above hi oint of road H.P.: Fnd: Vaz.:
5.Water line 10 ft from s tic com onents Vaz.: `f
6. Bencl�wark indicated and shown-NGVD if near wetlands
7. S tic tank minimum 10 ft from foundation, deck Vaz.:
8.Leaching minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: L/
9.Leaclrin minimum 100 ft from wetlands Var.:
10.Leachin min;mum 150 ft from drinking welU25 ft irri rion well Vaz.:
11. Tauk/leachin minimum 10 ft from erty line Vaz.:
12. S stem meets all other setback r uirements Vaz.: �J
13.Uses ad'ustmeirt for ma�mum hi groundwater Vaz.:
14.I,eachin set 4-5 ft abme ad'.water or bottom of test hole Vaz.: �,i�
15. System not in to or subsoil(A,B horizons)or 5' removal
16.Pro osed contours are suitable
17. S stem meeu slo e uirements-min. 1/8", '/d' eferred ;�
18. S stem meets breakout r irements PVC liner: Wall:
19. S ecified tee sizes aze ro er, gas baffie on outlet tee
20. Sewage is under 10,000 d for azcel ��
21.No garba e dis osal i.i
- 22. S stem ad uatel sized for its intended use
23.Minimum 6"stone or com acted below tank and dbox �/
24.Manhole cov�s within 6"of ade, um chamber cover to e
� 25. ion on lastic chambers/leach field �i
26. Elechtical ermit for chamber/S arate meter for du lexes
27.Pum stem-2"line,wee hole,check valve,tee in dbox, um size '�
28. S tic tank/ um cLamb�to be factory wat roofed
29.Vern rovided if leachin below 3 feet,under drivewa / azkin /
30.Buoyancy calcularions for tank/ ump chamber
31.En ' eer to ins ect and soils: wall: commercial:
32.En ' eer/Re ' ered Sanitarian and Land Surv or s/si ture `/
33.H-201oadin is sub'ect to vehicular lraffiq oundwater
34. Title V A licarion and ermit fee, installer si ture �/
35.Foundation footm min. 2 feet above ad'usted ound water for new house
36. Deed Restriction r uired maac. #bedrooms: .flow: �� d
37.Check area lots for oundwater/Label groundwater in Assessor's Ma ✓
Plan reviewed by: /,a�`'', ��