HomeMy WebLinkAbout0076 SIXTH AVENUE (HYANNIS) - Health 76 Sixth Avenue
a Hyannis
A= 246-130
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Town of]Barnstable P#
Departiment of Regulatory services
Public Health Division Date �� /
200 Main Street,Hyannis MA 02601
Date Scheduled `� Time Fee Pd.
Soil Suitability Assessmentfor Se a Disposal
Performed By:_ 0 CA D l j-LAC-- 1--s Witnessed By:
LOCATION& GENERAL INFORMATION
Location Address _ { Owner's Name
1"A GCS
Address
Assessor's Map/Parcel: 24 6 A 3 d ! Engineer's Name ,C�
NEW CONSTRUCTION REPAIR Telephone# �j(� 715
. (706
Land Use:' Slopes(96) Surface Stones n
Distances from: Open Water Body ft Possible Wet Area 4�—ft Drinking Water Well A/74--ft -
Drainage Way ft Property Line 2ja C ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands 1n proximity to holes)
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Parent material(geologic) ^�^ Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: AV' Weeping from Pit Face-- _ T
Estimated Seasonal High Groundwater
6 . DETERMINATION FOR SEASONAL HIGH WAT Xt AB
Method Us Yl D !it/',a�/i�- m/JP� /O �j Wj r0 O JG"o �G a
Depth Observed standing in obs.hole: I{ Deft to soil mottles: In.
Depth to weeping from side of obs.hole: n, Groundwater Adjustment
Index Well# Reading Date: Index Well level Adj.&Ctor _ Adj.Groundwater Leval,,
PERCOLATION TEST bate
Observation Hole# �/),/ `� Time at 9"
Depth of Perc 0"77Nrn, •4� h Time at G" Z-021
Start Pre-soak Time @ �D. r �7 Time(9"-6")
End Pre soak Q �D% 5
Rate Min./Inch L Zy7j n'
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) ,y
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 Conservation Division at least one(1) week prior to beginning.
Q:\SEPTICU'ERCFORM.DOC
DEEP.OBSERVATION HOLE LOG Bole#
Depth from Soil Horizon Soil Texture .Sdil Color Soil• Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,'Boulders.
Or.i ten_Y.96'Gravel)
0 6 % S /o M 34 o
22-72" Cl
'72-96 1' CZ 2 S
ne
DEEP OBSERVATION HOLE LOG Hole#-_
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) r r (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
ConsistencV.%Grave
'Z41/ /3
Z4 7Z
2` a C2
—�
DEEP OBSERVATION HOLE LOG Hole# _
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Graven
2_ZC/ ® S
Z - W G . 1 r
z'
Ir
6-1 G m - -Z
ZS
40 boo
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones'.Boulders.
Consi t n
7 ii. C s o
lZ - L G3 2, S 713
Flood Insurance Rate Map:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No Yes r r
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? IFS
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on NO 0•f 99 3(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 tra' ' rtise an x ri described in 310 CMR 15.017.
Signature Date
QAS.EPT10PERCFORM.DOC
TOWN OF BARNSTABLE
LOCATION 5 ►X f4 Avr SEWAGE# 201.2—. 6 2-
VILLAGE y�•r�f�-ASSESSOR'S MAP.&PARCEL ��6'"I 3®
yINSTALLER'S NAME&PHONE NO., " ,,i��,ss A&/MuN X�—�
SEPTIC TANK CAPACITY%,f 60 WeW
LEACHING FACILITY.(type) roo qa//o, —ZB 6"& (size) + '
NO.OF BEDROOMS
OWNER9�J�(,,a �<)ll�ut Nvw,'n R� Til.
PERMIT DATE: COMPLIANCE DATE:�IA
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist oii'
site or within 200 feet of leaching facility) Feet
Edge.of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BYP!/� /f%/*��
wU c,i w N
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Did
TOWN OF BARNSTABLE t/
LOCATION SEWAGE #
VILLAGE SESSOR'S MAP&LOIV
T ��� �3
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) O U (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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