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HomeMy WebLinkAbout0131 PINE RIDGE ROAD - Health dig' - U3I -- - i i I, TOWN OF BARNSTABLE Ld ATION e, SEWAGE # 2060—106 VILLAGE� ASSESSOR'S MAP & LOT o2 INSTALLER'S NAME&PHONE NO. t/r Q 8-,3 Za- �� SEPTIC�TANK CAPACITY 'I, , V_,P, ff LEACHING FACILITY: (type) rMU (size) NO.OF BEDROOMS BUILDER OR OWNER V , e PERMITDATE: A COMPLIANCE DATE:. Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility e� 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 Fumished by �G% �g V1f 10 ,� � �G ' 7a�� �� _..:: �► Town of Barnstable P# Department of Health,Safety,and Environmental Services �VE Public Health Division Date ov 367 Main Street,Hyannis MA 02601 Z BARNBPABLK a MAS& f• - Date Scheduled I':96k 0,4/efij :32 000 Time jy� Fee Pd.oe`00 Soil Suitability Assessment for Sewage Disposal Performed By:-?,914 AJ4&—Z i a Witnessed By: 0 IVIV,17- 4�//J/Z,t�/1�l LOCATION & GENERAL INFORMATION . .... _. - Location Address �//�/E�/I�GE� �D�ll�. Owner's Name z��/,l� _.: Address Assessor's Map/Parcel: 62 O `0 3/ Engineer's Name<C� PV,�L�rl�J, P•�_ NEW CONSTRUCTION /REPAIR Telephone# Land Use s I Q ln_�JT I ✓-1 L Slopes(%) 6 _ 3 Surface Stones NCAI E O(3 S wd Distances from: Open Water Body ft Possible Wet Area�R Drinking Water Well WAr /Z Drainage Way N/A ft Property Line 5_0_ R Other R SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) 41 PAOce-L . 36 o / (Et 31 f PA11L-=L3q � s ' o • 1�/to'1Ci'2 3 8 �/}(1cCL p6 aci_(_ 3d 33 ROAD - 5 Parent material(geologic) e­'14 C-,Q I ©tll�aS� Depth to Bedrock AJOYf — N I{"OL$. Depth to Groundwater: Standing Water in Hole: ND 1o`e Weeping from Pit Face_ /\)O Y)-P Estimated Seasonal High Groundwater 1 `t NA'.-,—.10 i; 'DR SEASONAL tG 'VGA' Ett TA1 Y ........ .. :.. ::.. .......... Method Used: _......:........::............:...:. 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 .... . 'ERCOI.ATION TEST ....:::........................:: Observation Hole# Time at 9" �� Depth.of Perc Time at 6" c Start Pre-soak Time @ 11:17 Time(9"-6") End Pre-soak �9 Rate Min./Inch lY1G� l� o�q��tlf DES i ri yv►,htJ��'$ Site Suitability Assessment: Site Passed V/L Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant DEEPOSSERVAIION IO>r,E LOG >Clole# Depth from Soil Horizon Soil Texture Sod Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistent %Gravel sa vjj 4 Ykl f rq ed OF S'1 10 k n ) C San 1© 4V°/6 yaveI " u .A, DEEP OBSERVATION HOLE LOG .Hole#.:' X. De.P th from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.° Gravel DEEP:OBSEIZ �1'TO1�tI OLE L`OG. XX:Hole.# .. .; Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. onsistenc % ravel ti.. � OTELOEEPO D R ._._. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistent °o ravel Flood Insurance Rate Maa: Above 500 year flood boundary No_ Yes Within 500 year boundary No_ Yes 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? e� S If not,what is the depth of naturally occurring pervious material? Certification I 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 training, expertise and experience described in 310 CMR 15.017. 1 / a 3 9w Signature f�.�`, ►'V� � Date