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HomeMy WebLinkAbout0040 ORCHARD ROAD - Health 4.0 RYAROAD, CENTERVILLE 207-021-004 J'RE�Y�«o�o UPC 12534 No.2�, -153LOR �Posr•ceNS°�` Town of Barnstable r# U °VIA nor,o Department of Regulatory Services )AarraT aus ivision Date Public Health.D , M 200 Main Street,Hyannis MA 02601 A*N Date Scheduled l) Time f!U _ Fee Pd. Soil Suitability Assessment foY ,5e' age isposal I F � .N Witnessed By: a�� w' `� n Performed By: /•>GNA�.� J 6 v► LOCATION& GENERAL INF ON URMAT� Location Address v ( �� n �j Owner's N Address 1ame +tb A/) t 0�cv`iNa �{ 7 V ✓8t� A!��: IQ � �r/� L t,' Assessor's Map/Parcel: 2 U�, �' t10q Engineer's Name NEW CONSTRUCTION REPAIR Telephone# ��7i e G 3�O S Surface Stones Land Use �iA G'�iL'i lopes(%) 7./S /A A ` -> ft Possible Wet Area >'�Ora ft Drinking Water Well — s)U ft Distances from: Open Water Body — ft Other WAfd� Plaol"��i }t Drainage Way > ' ft Property Line av�%. A,✓ fJ�S r��,v SKETCH:(Street n4me,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) l z I i1 joi + N ' O,ea 141*12 n G� w f71- Parent material(geologic) :/ ��z c l Sc, .r��i-, ,4 C 1`� f�c%1�i/`� Depth to Bedrock �d �- Depth to Groundwater: Standing Water in Hole: il. Weeping from Pit Face it Estimated Seasonal High Groundwater '7 7,c) DETEMMINATION FOR SEASONAL HIGH WATER TABLE Method Used: in. 1 ------------- Depth Observed standing in obs.hole: _in. Depth to soil mottles: _ ft p �- in. , Groundwater Adjustment Depth to weeping from side of obs.hale: - 'Ad' Groundwater Level Index Well#' Reading Date: Index Well level Adj.factor j• PERCOLATION TESTl4 Date1:R_y/Time YO Observation Time at 9" Hole# Time at 6" Depth of Pere j Time(9"4") Start Pre-soak Time @ a End Pre-soak + i r ; ? Rate Min./Inch G Z Z 3/vG�r& /.Y� iO'S (, f( Additional Testing Needed(Y/N) Site Suitability Assessmentt Site Passed Site Failed: j 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 Conserlvation Divisiou at least one(1)Week prior to beginniug. f; Depth.from Soil Horizon Soil Texture Soil Color Soil utoer Surface(in.) (USDA) (Munselp Mottling (Struettlr),Owes,Boulders. Conststandv °/at3rnvall .� A/ (, �j !1A�y' ,Ar✓ 1 O IL' �I13 �z•i�f3�D J••� Ji v/,}�1• �r ��n/V l �l �} j1 a°+'• l6�'1< fL Ffllf•.�•.. .1e, DEEP OBSERVATION HOLE LOG Hole# Ot er Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) (USDA) (Munsell) Mottling ,(Structure, tones,�Boulders. Consiefonrb %Gravel) r ) Ye A/r �� �l�ca3.s/ter r ac'>"asG '� rI jib �ti Y ]ayyl,' ✓ t) a i.t -'J �� �'�� �yUAn.. V P/!`".".AN'/> jIC.��a"�4.• !� p� ��I'.jf�'"'D�/��ya����.71c>`.IirlYG4s. ,/ L� ✓1C� '414 !L'" �./IrVry v t3 C:.✓i-`°'.`s'1 6...(}a„�:/' 6/P'11 / Qr' 1„}.a- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color' Soil Oth r Surface(in.) (USDA) (Munsell) Mottling (Structure, tones,Boulders. onsis nc °° ra el DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Surface(in.) Consistency %Gravel) Flood Insurance Rate Man: Above 500 year flood boundary No___ yes ' I i Within 500 year boundary No Yes within 100 year flood boundary No yes Depth of Naturally Occurring Pervious Material` Does at least four feet ofnaturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? pervious material? /yi4 If not,what is the depth of naturally occurring Certif cat)°n I certify that on date 1 have passed the soil evaluator examination approv0d by the ion and that the above analysis was performed by me consistent with Department of Environmental Protect the required training,expertise and experi ce described in 310 CMR 1.5.017. en Date Signature Q:HEALTH/W P/PERCFORM I i i - i i • i \� _A.Sp:t-lAL-a�-ooF .5t-tlNGLF-SJ i ! � 1 Effl lift) - Y2 24t0• FFR \ -TrL �14to• A.L.u! 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