HomeMy WebLinkAbout0042 FRAZIER WAY - Health (3) r
razier Way
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7- 006 - 004 �--- - - -
Town of Barnstable
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Department of Regulatory Services
RAMSUEL& : Public Health Division Date j 2'7 0-
i63¢ 16� 200 Main Street,Hyannis MA 02601
Date Scheduled r Time
Fee Pd.
Soil Suitability Assessment or Sewa e is
.f g posal
Performed By:
Witnessed By: v i, w,..
Location Address
LOCATION& GENERAL INFORMATIO /
[/ �� L f�� ��'✓/] Owner's Name
6( - Address .�{Z. rr c'2
;vl rf . M � O
Assessor's Map/Parcel: { t/ � ��
114O f 6-7 RC L D0 to jC�bT Engineer's Name a I."
NEW CONSTRUCTION �� S
REPAIR Telephone# 0 27 (0 D O .
Land Use .d Slopes(%) e '3 . a
Surface Stones_•_,,,
Distances from: 0�n Water fold ��lJd Taw
Pe y ft Possible Wet Area�ft Drinking Water Well'
el] � l(
Drainage Way ft Property Line _- ;— ft Other A'w Z</ ft
SKETCH:(Street.name,dimensions of lot,exact locations of tes oles&perc tests,locate wetlands in proximity to holes)
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fir. .
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�d- vz
N.')It
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Parent material(geologic)
Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: "`C Weeping from Pit Face
Estimated Seasonal High Groundwater
DETERMI TI N FOR SEASONAL HIGH WATER TABLE$
Method Used:
Depth Observed standing in obs.hole: �— in, Depth to Sall mottles: in•
Depth to weeping from side offq�s.hole: (n, Groundwater dJusttnent ft.
Index Well# Readin Date: 0 lndex Well evel
g AdJ,factor AdJ,C3rdundwater Level
y
fin_ � �
PERCOLATION TEST . bate� '-r o�ttne�
Observation
Hole# Time at 4"
Depth of Perc 1 �/l) Time at 6" �
` Start Pre-soak Time @ �d 'Time(9"•6")
w End Pre-soak -
2
L
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
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) we prior to beginning,
Q:\SEPTlC\PERCF0RM.D0C
DEEP:OBSERVATION HOLE LOG Hole# ,L_
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
Consistency,%Grvel
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistengy,% ravel
y 4 Z,
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stories,Boulders.
Consistency.%QiZygI
I
Flood Insurance Rate Map:
Above 500 year flood boundary No— Yes
Within 500 year boundary No= Yes
Within 100 year flood boundary No, Yes.,_
Death of Naturally Occurrinss Pervious Material
Does at least four.feet of naturally occurring pervio s material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring p rvious material?
Certification
I certify that on 12 (date)I have passed the soil evaluator examination approved by the
Department of nvironmental Protection and that the above analysis was performed by me consistent with
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the required tra' g,a per se a rience described in 310 CMR 15.017.
Signature a Date
Q:\SBPTiC\PERCFORM.DOC