HomeMy WebLinkAbout0510 MAIN STREET (COTUIT) - Health (3) ��� ®ic
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3 S TOWN OF BARNSTABLE
LOCATION SEWAGE #
VII.,LAG ASSESSOR'S MAP& LOT 0
E C U J'<<'
INSTALLER'S NAME&PHONE NO..Q 1 aP/ �dr�J/1c d
SEPTIC TANK CAPACITY
LEACHING FACII.TTY: (type) ) SY
NO.OF BEDROOMS G
j!W—blt It OWNER
PERMITDATE: ? COMPLIANCE DATE: z �"
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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Department of Health,Safety,and Frivironntental Services
Public Health Division Date _
367 Main Street,I lyannis MA 02601
MAW
Date Scheduled J� Z�p � '�'�""
--�_ Tirne ��/�rrv\ Fee Pd.
Soil Suitability Assessment for Seiva' ge Disposal
Performed 13y:A. 01:IQ
Witnessed By;-�
LOCATION & GENERAL INFORMATION
Location Address LOT- G 'PEW2y LA- Owncr's Namc
Address � �wtJ (�jCt�j► �',�qs�N lt,/'S
Assessor's Map/Parcel: Engineer's Name A•O_(o �p
NEW CONSTRUCTION __X1 RCPAIR Telephone# _ G'L
Land Use '4� Slopes(%) b "'_e7 Surface Stones
Distances from: Open Water Body v_11 Possible We Area Q Drinking Water Well ,� ft
Drainage Way ft Property Line 64/"-g Other R
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes)
14S.06' Z 1Q 223.58'
40' PRIVATE WAY -r ,\
0C _ 4Q
- - - -- ------ - u - - - - - - - - - - - - - --
--------------------
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275.00' -OP -- - - - -=—\ o- - —C - - - - - ------- - - - - - - WI RAVEL ROAD
----------------------
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6 ,
I 33 Ln 3 3� 56°36'50" E z �, COCA 98 7p. 0
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y��stir 0,9 �% o o s, •' ^c' o UA o Z
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No N 56*36'50" E S9)e
u u � .J S 9Af 9c-64
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25.31t Cy STD C MG�FG
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43.23' 475.17' TO C8 FOUND
S 57.01'55" W --_ 484't TO CENTER LINE S 56.59115" W
Parent material(geologic) lt Depth to Bedrock
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face N N
Estimated Seasonal High Groundwater _ NOT O(3$UM
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Methud Uscd: N%9 w� Fvw+'J O
Depth Observed standing in obs,hole: in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_
PERCOLATION TEST aatr2, Time NbJ
Ohservation
Hole 4 Time at 9"
N
Depth of Pcrc �0 Time at 6"
Start Pre-soak Time Q , Time(9""6")
End Pre-soak �`�--
Rate Min./Inch L'�►S `a �`�"`"
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Dioision Observation Holt: D, b To Be Complei.
Cony' Applicant
DEEP OBSERVATION HOLE LOG Hole # �(
Depth from Soil 1-1067on Soil Texture Soil Color Soil Other
Surface(in) (USDA) (Mansell) Mottling (Structure,Stones,Bouldcres.
° Qrayel
3 t► w 6 l' Loc"5 SaAc& va
..7 �� t to 5- 6
12v G MCA-yo
DEEP OBSERVATION HOLE LOG Hole# 2 _
Dcpt'h from Soil llorizon Soil Texture I I Soil Color Soil Other
Surface(in.) (USDA) (Munselq Mottling (Structure,Stones,Boulderes.
n c w °e vr►
YR.71
zy—17� c— 2.,G Gp
DEEP OBSERVATION.HOLE LOG Hole#
Dcpth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency_%Gravell,
DEEP OBSERVATION HOLE LOG
Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistcncy-°/aGraycll
Flood In u
Above 500 year flood boundary No— Yes
Within 500 year boundary No_ Yes
Within 100 year flood boundary No_ Yes
Depth of N.3turally Qccu rring pervious Material
Does at least four feet of naturally occurring pervious aterial 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
I certify that on fIC (date)I have passed the soil evaluator examination approved by the
Department of Env ironme.ntat rotection and that the above analysis was performed by me consistent with
the required training,expertise and experience described in 310 CMR 15.01'7.