HomeMy WebLinkAbout0111 CENTERVILLE AVENUE - Health 111 CENTERVILLE;DRIVE' .
Centerville
A = 226 - 131
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5 M E A D
No.2-153LOR
UPC 12534
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CERTIFlED
SOURCING VVMIWSFYfiOGRAM.OR(i
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Town of Barnstable P
Department of Regulatory Services
�t�LK r Public Health Division Date
tagy 200 Main Street,H annis MA 02601
Date Scheduled_ /�(�
Time Fee Pd.
Soil itahi>lity Assessment for Se is o r
Perfbrmed-By: � rrr�
. Witnessed By: �
� n
LOCATION GENERAL ORMATION
Location Address��� P o �� Owner's Name-�j� Q 5
�pyrvll r/ ri CI�2`crrre( '1 Y5
`� Address 'r`'-`'a�'el t
S�
Assessor's Map/Parcel Engineer's Name
J
NEW CONSTRUCTION /n REPAIR Telephone# szjB S 2 —~IaCfi�0
Land Use- lT�d( /r g_ /r QaS.S WIAFO
J� Slopes(96) Surface Stones �yu`��'a' 0 0• e�Yv�
Distances from: Open Water Body N14 ft- Possible Wet Areal__- ft Drinking Water Well �� ft �'�1e4gP�
Drainage Wa
g Y 'y�'� ft Property Line /6 ft Other t 2 L$`- ft
� Awr c fLa r FIVE
SI ,TCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
WEL.i3M
T*Z
* 3
Parent material(geologic) 45�'I�QS�/�924-1UV9 Depth to Bedroelt
t
Depth to Oroundwater. Standing Water in Hole: ' Weeping ft'om Pit Face
Estimated Seasonal High Groundwater ,3•`7
M r. '
DETERMINATION FOR SEASONALEIGH WATE,R TABU -i= Z2
Method Used: GCS�1�fZi✓ at. 1Z- U/ ,7 d
Depth Observed standing in obs.hole: a4 In. Depth to loll mottles:_ . 4/ A j
Depth to weeping from side of o� ole: /✓ 4 o Groundwater Ad��uatment ` ' ' �'� efr. -
Index Well I/tt/29Reading Date: Index Well levol Ad,},factor 3.3 A dti4idwater l cval iq?
'..7= 5
PERCOLATION TESL' ]DaitlV/-�8�t��.��wf
Observation
Hole# Z 04- Z -4?-'44? :'J
Time at 4"
Depth of Pero 40
Time at G"
I Start Pre-soak Time @ 9•S7 Time(9"-611)
End Pre-soak 2¢
Rate Min./Inch . 2- _
Site Suitability Assessment: Site Passed _ Site Failed: Additional Testing Needed(Y/N) 40 its
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Consel'vation Division at least one(1) week prior to beginning.
Q:\SEPT[C�PERCFORM.DOC
f
DEL'ROBSERVATION HOLE LOG Hole# �'`
Depth from Soil Horizon Soil Texture Sdil Color Soil• Other
Surface(in.) (USDA) (Munsell) Mottling (Stnucture,.Stones;Boulders.
onsistency.46 aravel)
-------------------
]DEEP OBSERVATION HOLE LOG Hole
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsisten % rav
41f
24 /2G'� e dema 2,SY 71 /f
� N a � crcQ�¢" .f •
DEEP OBSERVATION HOLE LOG Hole# 3 Y /2.e
Depth from Soil Horizon Soil Texture Soil Color Soil , Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Conslsteuc Gravel)
2Z* g gSYes� `fie
ac�w �►' tri -lee,a Ca 9D" *-Jr
DEEP OBSERVATION HOLE LOG Hole#�!K /z•o
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders,
Consistency.
Flood Insurance Rate Man:
Above 500 year flood boundary No— Yes _
Within 500 year boundary No Yes U•
Within 100 year flood boundary No.,____- Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorptibn system? 4��al?
�
If not,what is the depth of naturally occurring ��d
Ceitification r
I certify that o (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with .
the required traininVesee/ i ce described in�10 CMR 15.017.
Signature
V -� Date 17— 1 �¢
Q:\SEPTlC\PERCPORM.DOC