HomeMy WebLinkAbout0172 PEPPERCORN LANE - Health 172 PEPPERCORN LANE
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Town of Barnstable P# 9 37.
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Department of Regulatory Services
6A8N8TA8I.S. : Public Health Division Date i _c 1— l q. irb
MAPA
��FD UAAt a`� 200 Main Street,Hyannis MA 02601 a
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Date Scheduled f Time i l 04 4 rt,,�_� `Fee Pd.
SoiF Suitability Assessment for Sew74 e Disposal
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Performed By: �� ��\ Witnessed By: ✓ U '�N` y^A
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LOCATION ,GENERAL INFORMATION
. �' $ l� J _
Location Address 1 �- 4.. lC � _ Owner's Name � , ���� Y��
1 Address 36 ���y -5119-fei
Assessor's Map/Parcel: B�' d `��� Engineer's Name 005T oY4 1 M J
NEW CONSTRUCTION REPAIR Tele hone# 5139D `Z—
� _ r7 w.a 3�N o Aef-V1 y e ,root
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Land Use �.f65t C1�`L � lopes(%) ! Surface Stones AMC,-C,-
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well AAft
Drainage Way ft Property Line 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) Q(�-L `(/11 A"�5 r^ Depth to Bedrock
u
Depth to Groundwater: Standing Water in Hole: v Weeping from Pit Face 14
Estimated Seasonal High Groundwater- �h1Tr
DETERMINATION FOR SEASONAL HIGH•WATER TABLE
Method Used:
Depth Observed standing in obs.hole: f7� 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 x_ Bate
Observation
Hole# v Time at 9"
Depth of Perc � �2 Time at 6''
Start Pre-soak Time @ ly r� of J� Time(9"-6' 1
End Pre-soaks 33
n
Rate Min./inch �2 Ih r �W111�t lYl
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)week prior to beginning.
Q:\SEPTIC\PERCFORM..DOC
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
1 Consistency,%Gravel)
o=b ID V+�f�AI e 1p. 2 2 A)dhe
ON
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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,%Gravel)
-t le-
ZI `t � G _SkW D k 10*1 R b nhe
tv" va- �'Dht 5_X10
s -,�D
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)
�Az owe
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)
W1 pb�10
Flood Insurance Rate Map: TM
Above 500 year flood boundary No Yes
Within 500 year boundary No—k Yes
Within 100 year flood boundary No_ Yes
Depth of Natur`ally.OccurrinE Pervious Material
Does at least four feet of naturally occurring pervious terial exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pe ious material?
Certification
I certify that on (date)I have passed the soil evaluator examination approved by the
Department of nviro mental Protection and that the above analysis was performed by me consistent with
the required tra nin expertise d ex erience described in 310 CMR 15.017.
Signature � � Date Z�l
g C
Q:\SEPTIC\PERCFORM.DOC
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