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Home My WebLink About0046 MEADOW FARM ROAD - Health 46 MEADOW FARM ROAD CENTERVILLE A= 189 - 118 - 005 N S M EADR KEEPING YOU ORGANIZED No. 12534 2-153L0R SUSTAINABLE FORESTRY MIN.RECYCLED INITIATIVE C0NTENT10% Cer fiedFherSourcing POST-CONSUMER ® wmsfiprogrem.arg SHIM MADE IN USA GET ORGANIZED AT SMEAD.COM Town of Barnstable P# Department of Health,Safety,and Environmental Services �Im Public Health Division Date 367 Main Street,Hyannis MA 02601 eAxxereeu, AlF1639.01 Date Scheduled �u�y �� Z000 Time 2 P Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: A. OS A L►Q PLS, SE Witnessed By: NYJ N A ki o2 A MJ)J LOCATION & GENERAL INFORMATION Location Address Lb� / - b r Owner's Name ft'uL( 6(L Ff}12,NS FvLLE'(Z PA kis �4,i 1--in rd Address RSALT`� TguST CGOTERVILLGI QAQNSTAgL6 MA Assessor'sMap/Parcel: ?oaTI N OF 109/11$/Q(/� Engineer's Name •Down) G�P6 �►J6tN6E(LItI.IC� NEW CONSTRUCTION REPAIR Telephone# (Sbg) 31,A-,-f54 l Land Use \/A C A NT Slopes(%) 0-5 Surface Stones Distances from: Open Water Body — ft Possible Wet Area -' ft Drinking Water Well — ft Drainage Way — ft Property Line SY GTCH ft Other _ ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) LO T N T d t vo-r, 3Y1,o5, LOT Parent material(geologic) GLACIAL O Ji'W&H Depth to Bedrock Z o0/ Depth to Groundwater: Standing Water in Hole: N/A Weeping from Pit Face — Estimated Seasonal High Groundwater N'A Ufa &P,o1n1DL,0ATE R Fo,ly l7 TER1VYtNA�'tOl POR SEAS.UNAtttGI 'i?VA' R TAt;t ... ....... . Method Used: . Depth Observed standing in obs.hole: N/A in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment N A ft. Index Well# _ .Reading Date:.__.____ Index Well level. _ Adj.factor __ Adj.Groundwater Level NSA . 1'ERCOL,ATtON T'ES't' ]I1atc 7: tl Tame '.sr prn' Observation Hole# TRI TR Z Time at 9" Depth of Perc rJ(p it Time at 6" Start Pre-soak Time @ d Oo _0"00_ Time(9"-6") End Pre-soak 10 30 `�j:5 0-)q V a q RateMin./Inch L2 LoZ In G.'SO In S:So Site Suitability Assessment: Site Passed VIL Site Failed: Additional Testing Needed(Y/N) N Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant __ _ _ __ .. DEEP OBSERVATI011 HOLE LOG Hole#; Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistent %Gravel b- o -�} A 10 3 Lodonj &- "d a,s a 04- �� I Mc a s�,d a s __ __ ................................................... ........... --_ .......... ................... . ................._ ....... .. ........ .............. ....... ....... EEP OB 'ERV' 'T ON HOLE LO+ ' Hale.#>: .. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.% ravel n 6 Or nit �D yR 312 - y A m rtd 10 `312 -�l� B a a d a•S yQ -7/t C, Nled Saki -1-5 yQ ,V3 ................................................................................................................................................................................................................................... DEEP. OBSERVATION HOLD LOG Hole#..,.. < . .. .:. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistent %Gravel DEEP:OBSERVATION:HOLE LOG HXe Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistent %Gravel) Flood Insurance Rate Man: / Above 500 year flood boundary No_ Yes V Within 500 year boundary No_ Yes 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 absorption system? - I65 If not,what is the depth of naturally occurring pervious material? tJ/A Certification I certify that on Nov 9S (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 training,expertise and experience described in 310 CMR 15.017. Signature ( '' Ul �j Date- (� D� J --------- Town of Barnstable Department of Health,Safety,and Environmental Services Public Health Division Date 367 Main Street,Hyannis MA 02601 MAM 195 Date Scheduled z000 Time Fee Pd, Soil Suitability Assessment for Sewage Disposal Performed By: Witnessed By: D—J14A kIORANZI _DAWICL A. o;jALA pLs,SjE R TRUST ev 5M LNGG-gitI Telephoned CSbZ; +S'4 1 06A ' Land Use \/A cn wr Slopes(°.) Surface Stones Distances from: Open Water Body ft Possible Wet Area Drinking Water Wall it Drainage Way Property Line SKSTCN ft Other it 3 SKETCH:(Street name,dimensions of lot exact locations of test holes&pert tests,locate wetlands in proxi proximity to holes)mi LT N' T14 IA... 71H I Parent material(zcoI GLACIAL 0 LjI H Depth to Bedrock Depth to Groundwater.Standing Water in Hole: NIA Weeping from Pit Face Estimated Seasonal High Groundwater MO &2,VIJDLAA Depth Observed standing in obs.hole: A in. Depth to sell mottles: Depth to weeping from side ofobs.hole; in. GroundkaterAdjustm- In. index Well#-_._ Rnading Date: index Well level �W��& Adj.factor Groundwater Lev,Adj. ro ndwa r at-N/A . ............. Observation Hole# —TR I TFt Z Time at 9" Depth of Pere Time at 6" Stan Presoak Time @ 0!00 O"oo Time(9%6") End Pre-soak Rate MinAnch ;L La' in G.'SO in Site Suitability Assessment: Site.Passed V-1' Site Failed: Additional Testing Needed(YIN)N Original:Public Health Division Observation Hole Data To Be Completed on Back Copy: Applicant 'x�.w•.c z �� >� � c-.� - ��°.,c.><h -°� :�.s., , ,.s ��::{j.'rx�v e`¢�aa�`m..zsz+..kMi Asp...✓a v: m 5..Soil Ewa it ColowiS3 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in) (USDA) (Munsell) Mdtding (Structure,Stones,Boulderes. —ansistency. Graven b 0 DI&AIC to R 3/,. L-4 R a'nj IDyR 3). 13 ,e a4 3� C1 N GwE „�.,:...,.k:< f'a4u, :gVry`�. C..501.,:c., it Te'PKMJxG.h90 <Cbik i6.•.�x 3FtC.n.dY.w..„ar c. fr L..M..a.:r..�S Depth fromoii Ijorizon Sod Texture Soil Color Soil Other Surface (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Gravel) 0-a 0 Or nli �oyR3A a-q — S��a 10 ip '3lz a d �.S yR -7/ D-l.-144 C, 4'21 Sad a,5 IS 3/3 N GwE .�J�.• ».Y1�n � d.r'w. ...0Soi'Cot oil r.: Other GYo! Depth from Soil Hariion Soil Texture Soil Color Soil Surface(in.) ) (Munsell) Mottling (Structure,Stones,Boulderes. ( (USDA i armton o .:: S44 l0`1�31z -7/6 'Ls-131 C N /v1..a "V-A 7-5 ?f N&WC i . ext on o Soil d Depth ck�r' ,., a 616r— S•.�A s's':,: des;. u � sc x�::k..z:k? from Sa Hriz $ol Ture Soil Color Soil Other Surface Cur.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. loyN3lz Z-� A Lot»rr S°�d LO N3/i `4-Z� 3 lo�v� Sc•,l 2-5 arc - a C\ (.%�4 2.5`1n713 Flood Insurance Rate Mao- Above 500 year flood boundary No_ Yes Within 500 year boundary No— Yes_ 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 absorption system? y F S If not,what is the depth of naturally occurring pervious material? N/A Certification I certify that on Nov 95 (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 training,expertise and experience describedin 310 CMR 15.017. Signature— ?%