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HomeMy WebLinkAbout1250 SANTUIT-NEWTOWN ROAD - Health last Sc�.r�f- �-I� � >��i- / - -- - - U2.1� �03"I� 003 J - \ I S M EA® KEEPING YOU ORGANIZED No.10334 2-153L MADE IN USA GET ORGANIZED AT SMEAMOM _ 1V/Vto - -- ----_ Department of Health,Safety,and Environmental Services Public Health Division Date s I $ 367 Main Street,Hyannis MA 02601 /S za ► wuvarsar$, tei9. .� G �� Fee Pd. / OrFOM1d" Date Scheduled Q Time 303C2 -Soil Suitability Assessment for Sewage Disposal Performed By: Witnessed By: LOCATION & GENERAL IN:FORiVIATION Location Address 133� #-JQUJ*b W Al 11A AD Owner's Name f ezTU 1T t M-A SS - Address Assessor'sMap/Parcel: MArp 2t, fs%v1<eL '61-3 Engineer's Name QAgm szgc-,Tor.. STrV4Z Wo I.Sor l NEW CONSTRUCTION ✓ REPAIR Telephone# 9DS-42-9 ley 13/ Land Use1 -�11-►�1L Slopes(%) i�` Surface Stones Distances from: Open Water Body ft Possible Wet Area d ft Drinking Water Well A ft Drainage Way ft Property Line ft -'Other ft i SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) y ; r��,q Z zS LOT - " zA O �+ � or L oV EuC ?0 til tD Parent material(geologic) 'Ol9`1-W Sl/A t tJ Depth to Bedrock ��A- 9 Depth to Groundwater: Standing Water in Hole: (`•� Weeping from Pit Face C� Estimated Seasonal High Groundwater tlgj t 1VHNATION FOR SEASONAL HIGH WATER TA L Method Used. 4 C S'k y^'tyS t©� Depth f?bse ,ed standing in obs.hole: lam__ Z^in. Depth to soil mottles: in. Depth to weeping from side fobs.hole: in. Groundwater Adjustment ft• e . Index Well#` VZZ Reading Date: t Index Well level._. A-'1_2 Adj.factor A'�Adj.Groundwater Level�D r© :PER TEST pate me 9 A Observation Time at 9" Hole# v � Time at 6" Depth of Perc 4. ' Start Pre-soak Time Q 110 Time(9%6") End Pre-soak QQ r''1 "i RateMin./Inch Jj1�Ul'11� v'ysl►� 1 Site Suitability Assessment: Site Passed ✓, Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back-� Copy: Applicant _ _ r riEIP OBSEIt�AI'ION HOLE I.OG tole Depth from Soil Horizon Soii Texture Soil Color Soil Other Surface(m.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.°o Gra el) 1)& CA�b Ir7 "7/� �qo I pp G �- DEEP OBSERVATION HOLE LOG Hole#; ` Depth from 1 Soil Horizon Soil Texture. Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistengy.° 53/0 R-5 DEEP OBSERVATION HOLE LU;G Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.°o r el DEEP OBSERVATION HOLE LOG Hole#' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.°o Gravel) Flood Iris➢Irarme Rate i iap; Above 500 year flood boundary No_ es Within 500 Y ear boundary Noes Within 100 year flood boundary No_ Yes Depth of Naturals Occurring Pervious Material Does at least four feet of naturally occurring pervious'mat_ erial exist in all areas observed throughout the area proposed for the soil absorption system? g If not,what is the depth of naturally occurring pervious material? Certification I certify that on M 1019 (date)I have passed the soil evaluator examination approved by the Department of Enviro mental Protection and that the above analysis was performed by me consistent with the require train' g,expe 'se and a erience described in 310 CMR 15.017. Signature C Date 62b,