HomeMy WebLinkAbout0396 YARMOUTH ROAD - Health 396 YARMOUTH ROAD
Hyannis
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Town of Barn' s.ttable r#�y� 1
Departinent of Regtilatory Services
Public Health Division DateMAft
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�p 165q ���. 200 Main Street,Hyannis MA 02601.
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Date Scheduled � � ! Time `' Fee Pd.. 1 aV r
Soil Suitability.Assessment for S` e Disposal
Performed'By: Le l e /�-C l }�� SE—1�`/Z Witnessed B
Y
LOCATION& GENERAL INFORMATION
FAS.se,ssor's
.3�f(o �t°tr✓jrt�.f Owner's[lame:
u7anhi $ Address: fZ. Mar';n�� Coane
MGo�►px_e MR O Z(. Y 9
rcel:. 3 L —e Engineer's Name�nS,�Qp'' �S f/UC1r�t J � C
NEW CONSTRl1CI10IJ ttEPAIR Telephone# 5OF
Land'Use' �Slopes(�Yo} Z��_ Surface Stones
Distances from: Open Water'Bcdy 7Zg� ft 'Possible Wet Area/,VA— ft Drinking Water Well 7(W ft
Drainage Wayft Property.Line ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&'pere tests,locate wetlands in proximity-to holes)
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Parent material(geologic) (JJ_ j Depth to Bedrock ' " 'I
Depth to Groundwater.. Standing Water in-Holey-! U - Weeping from Pit ftnCe �j r_�
Estimated Seasonal.High Groundwater. `
DETERMINATION FOR SEASONAL HIGH WAITER TABLE
'Method Used:
Depth Observed standing in obs.hole:. in. Depth to soil mottles:
Depth to weeping from side of obs.hole:.. (n, Groundwater Adjustment tt.
Index Well#_ 'Reading Date: Index WeH ie.,j Adj,factor •Adj,GroutidwaterI-evel
PERCOLATION TEST Datr•�. Tttne .�
Observation,
Hole# 2 1 19me at V
Depth of Perc J Y6 `A C7�4l`d"y Time at 6"
n '
Start Pre-soak Time 0' . -- .(��. lime(9"-6")
End Pre-soak
�, 2
Rate MinJIn'ch. /
Site Suitability Assessment: SitrPassed Site Failed: Additional Testing Needed(YIN)
Original: Public Health"Division Observation Bole.Data To Be'Completed on Back ---.-----
***If percolation test is to be conducted within 100' of wetland,you must first notify the;
Barnstable Consery'ationDDivision at least one(1)week prior to beginning.
QaS EPTIOPERCFORM.DOC
DE EP,.OBSERVATION HOLE LOG Hole#r
Depth from Soil Horizon .Soil Texture S60 Color Soil Other
Surface.(in.) (USDA) (Munsell) Mottling: (Structure;Stones;Boulders•:
(acts �G (LY( -
Consistency.
ravel
ta''(rL s
c
DEEP OBSERVATION HOLE LOG Hole# �
Depth'from Soil Horizon Soil Texture Soil Color Soil Other
Surface.(in.) (USDA) (Munsell) Mottling (Structure,-5tones,Boulders.
Cons' en % rav
Q - A. 54' fa«- la y� ylz
-30
DEEP OBSERVATION HOLE LOG Hole#
Depth.from Soil Horizon. Soil Texture Soil Color Soil Other
Surface(in.) (USDA) {Ivlunsell) Mottling (Structure,Stones,Boulders:.
ti` to c G v
DEEP OBSERVATION HOLE LOG. Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(ins) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsi teti ra 1
Flood Insurance Rate Man:
Above 500 year flood boundary No Yes "?
Within 500 year boundary No Yes....
Within A yearflood boundary No_ Yes.
Depth of Naturally Occurring Pervious Material
Does:at least four feat of naturally occurring pervious material exi5t in all areas observed.throughoutthe
area proposed for the soil absorption system?If not,what is the depth of naturally occurring pervious material t..._
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 train' g,' . peruse and experience descr"ibed in 10.CMR 15.017.
Signature .
Q;\SEv ICIPERCFORKDOC ,
ASSESSOR'S MAP NO.O IV PARCEL
L CAT 10N <ii��- K RMiT NO.
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VILLAGE
INSTA LLER'S AME i ADDRE S S (`'�(J �� ,
B U I L D E R OR OWNER
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DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED
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