HomeMy WebLinkAbout0587 PITCHER'S WAY - Health 584 Pitchers Way
Hyannis T
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Town of Barnstable P# 1��-
sd� � Department of Regulatory services
Public Health Division DateWA
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200 Main Street,Hyannis MA 02601 .
Date Scheduled
0 Time Fee Pd. °
Soil Suitability Assessment for Sewag Disposal
/� � PC Witnessed By: or'l,7W ^.
Performed By:
LOC JON & GENERAL INFORMATION
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/� Owner's Name
Location Address t`J ,�` � 1 C f � �"'�
A,jrtZ.V�- 5' 1vV" J Address
Assessor's Map/Parcel:
a-7 o_ 3� Engineer's Name Lao
NEW CONSTRUCTION REPAIR Telephone#
Land Use
C-S 15'- 1_74-f- Slopes(9'0) G z- Surface Stones
Distances from: Open Water Body —tt Possible Wet Area ff, Drinking Water Well ft
Drainage Way ft Property Line l p f ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
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Parent material(geologic)
4 Depth to Bedrock
Weeping from Pit Fact A� A
Depth to Groundwater. Standing Water in Hole:/ p g
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: E��P_ 6 o-m in, Depth to soil mottles: in,
Depth Observed standing in obs.hole: p ft.
Depth to weeping from side of obs.hole: in, Groundwater Adjustment
Index Well# Reading Date: index Well level
Adl.factor Adj,Groundwater Level
PERCOLATION TEST Date w Time 1=-'
Observation. Time at 4" ----
Hole#
Time at 6"
Depth of Perc
Time(9„-6")
--
start Pre-soak Time @
- --
End Pre-soak
Rate Min./Inch Z
e Failed: Additional Testing Needed(YIN)
Site Suitability Assessment: Site Passed Site "
Original: Public Health Division
Observation Hole Data To Be Completed on Back----- ----Y '
***If percolation test is to be conducted within 10W of wetland,you must first notify the
Barnstable Conservation Division at least one(1)week prior to beginning.
Q:\SEPTIMERCFORM.DOC
DEEROBSERVATION HOLE LOG Hole# I
Depth from Soil Horizon Soil Texture Sdil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling. (Structure,Stones;Boulders.
Consistency,% rave!
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td vat- 5 � h- ✓
DEEP OBSERVATION HOLE LOG Hole# 7-
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
toll Fl L.L .
A LS ,b Vq-'5/S
12 " C- R-C S
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. .
Consistency, o Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,
Consistency.
Flood Insurance Rate Mau:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No Yes
Within t00 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?
If not,what is the depth of naturally occurring pervious material? .�
Certification f e Jt AI certify that on (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 trainin a pertise and experience described in 310 CISM 15.017.
Signature Date
QASEFn0PERCFORM.DOC