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Home My WebLink About0145 GRAND ISLAND DRIVE - Health Id,d ,-OKW,�---- m ool No. •.� `j Fizz.... .......... ...... L�- THE F SA BOARD OF �-I ELTH TS ��, � k App iratiou for Dhipvii al Works Toutitrurtioat Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: // w ON 1/ . . ............................................. ........................................ - ........._...._. �I ation!]�Address ��//""]] ({pp.�� /j�p �/�p, o• �__.. �_ yC -! •=@�5 \ ' " .1 AW ® ......................................."-'- �� ss a ......... .. ......... % ne' .. ....._............_ ..................... -!`_-\.r...-------•--------.............._._._... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms-__.A.._ p ( ) g ( ) ., Other—Type of Building No. of persons nsion Attic. Showers (Gajba eCafeter a ( ) a' Other fixtures .................................. W Design Flow............................................gallons per person per day. Total daily flow...................:..._-__---__--------gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.........._......... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet_................. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.................................... --------------........................ Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit..:......__.._____. Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water................_....... R'+ •----------------------------•--•••-•-•---•----•-----....._..............•--•--••---••------••-_..................'----'-••-'•"•"-•------•---........... 0 Description of Soil........................................................................................................................................................................ V --------------------•-•-------------•--------- ------•. W ------------------------------------ ..................................................-------------------------------------- ------------ - ---- U Nature of Repairs or Iterations. Answer en.appli ble------1D®O ._ , ----- - -- -- •-- ..LDOO--- — .. ------------------------------------------------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI iE 5 of the State Sanitary Code-The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued y the board of health. t Signe ,�� _ � / Date Application Approved By......% -• ........................ -'-----1� -'" Date Application Disapproved for the following reasons:.....................................................................................-........................... ....................•--------..•....--------------•------------------........----.............---.......'.-----------------------•----------------------------------------------------------------.....-- Date PermitNo......................................................... Issued....................................................... Date No..........q� Fss...`.........:':...:....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1...............OF...,. ....: -` Appliration for Dhip rsal Marko Tonstrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (�' an.Individual Sewage Disposal System at cation Address or I of No a.� 4... v ..........:_ ..._ . fi f .... .---- .r ner dd ess a . .. .. .................... .. .......................................... Installer Address Type of Building♦ Size Lot............................Sq. feet aDwelling—No. of Bedrooms.....................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildin ....._..__. .No. of persons................:.......... Showers — a YP Building P ( ) Cafeteria ( ) Otherfixtures ...... ------------------------------------------------•---...------------------......--------••-•----•-............-•-••- W Design Flow............................................gallons per person per day. Total daily flow------------------_....__....................gallons. WSeptic Tank—Liquid capacity.............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width...................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----------_-------- Diameter.............____... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by..--•---------•---•-•-••••-••--••--=-••-•-------.......................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit................__._ Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.............._..... Depth to ground water........................ Q+' •-••••-•••••---•----••-•-••--••••-••••••••••••-••••-•••••-••--------------------- •-•-•------------•--------•--...----------------- •----------._.---------... 0 Description of Soil........................................................................................................................................................................ x U ------------------------------------------------------ •------------------- •-------- ------------- •------------------------- •------------------- •-------------- ------------------------------- W •••-•••---•--------•----••---------•---••------••••-----------•••-•••-••••--••-••-•-••--••-••-•--•-----•------•-••-•-•- .................... U Nature of Repairs or lterations. Answer en app ' able �Qa�__.._"�` .___. � �__:_.. .......... r' U•••••• - -••••• ...�_'--..sue .2 ......... ---- ------------- --------------- -------- ---------------------------------- Agreement: 4 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE: 5 of the State Sanitary Code—The undersigned further agrees not to place the system in ` operation until a Certificate of Compliance has been issued by the board of health. / Date Application Approved By....... ''- -- : .: .._..---••-•-•--•-••---•-- ...... "�--{7-�- Date Application PDisapproved for the following reasons:......................................................................................... ...................... .............................•••-•------•-•----•----•--••--•-•--••••••-•....-------•---•--•-••••....---••••••••••-••......--••-•••--•••••••••-••-••.....•----------------•-•--••---•--••-----•--•-••-•- Date Permit .............................................. Issued.. Date rw - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH. �rrtif irtt#le �f f�unt�rli�nrr THIS IS E,RTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired C" 1 =_ ----- --•-_ � --------------- •-•------ wat..-•-*:-- �- ==°'ram'-----��•- •- --=• .................' ................................ -- ........................... has been(Anstalled in accordance with the provisions of 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....__:__.._��_ ..__........ da.ted-... '.Z_/� "'............... THE ISSUANCE OF4THM,CERTIFICATE SHALL NOT BE CONSTRUED A C:UARANTEE THAT THE SYSTEM WIL.L�FU�ICTLON SATISFACTORY DATE - �, �---- --.... Inspector .......................................................................... A, . tis s, THE COMMONWEALTH OF MASSACHUSETTS -. BOARD OF HEALTH rr qqjj ........................0 F.. /�/J/1 ` . . No......................... FEE...... .... Disposal prhp notnrlinn �e ntt Permission is hereby. granted. ........ .t -.:.... ........................... ...................................................... to Construct ( ) r air an In a4 id S ' 'age Ili System at No � 1� _ :...._...�-b4 ,e .. 0 ......................................... Street as shown on the application for Disposal Works Construction-Pei No.___ Dated...` ------------------ ...-...•.... • *7 ... . .. ` a ^� Board of Health DATE. r FORM 1255 HOBBS & WARREN., INC., PUBLISHERS "?," a FOX 1 File Edlt Vew Favorites Tools Help 10 Back - � - u � f1) I P Search Favorites - ® - Address Chttp:/lissgl2lintranetlhealthMasterlHealthMasterReports.aspx fir. ®!Go �' • ' y Health Master a l Report: Fuel Tanks 10.13,15,17,19,20+Years which Require Testing Il of 2 G Gl + 100% j Find I Next 1§02ct a format___ _ Expert N r� J� 4/16/2009 Town of Barnstable Page 1 of2 1 Fuel Tanks 10, 13, 15, 17, 19, 20+ Fears Old which Require Testing I Tank Owner Tank Age in 61ap Parcel Property Location Owner Address No Tag No Years Install Date Test Date 070009004 17 INDIAN TRAIL MELLON,RACHEL L 5 00233 20 6/17/1988 5/8/1997 _ Osterville 8554 OAK SPRING RD 5l` 'tie 13erp 'rests XoGV ze,-,its UPPERVILLE,VA 20184 071004001 145 GRAND ISLAND DRIVE 1 OYSTER HARBORS CLUB,INC 3 01187 15 5/4/1993 Osterville 1 GRAND ISLAND RD , OYSTER HARBORS,MA 0265531u°>CZ p l T d Fb 2-06 gS yz,S 072010 275 NORTH BAY ROAD i WINCHENBAUGH,CHRISTOPHER F 1 00213 29 1/1/1980 8/14/1991 Osterville { &ANGELA F 49 E 86TH ST UNIT 7C /{&I)JIAL-m-11 c" NEW YORK,NY 10028 078069008 115 LOVELL'S LANE MILLER,JAMES 0 JR& 2 01270 27 1/1/1982 12/5/1994 Marstons Mills 115 LOVELLS LANE MARSTONS MILLS,MA 02648 rG y rj 093009 122 BRIDGE STREET OYSTER HARBORS YACHT BASIN 9 01326 13 3/16/1996 Osterville 122 BRIDGE ST i OSTERVILLE,MA 02655 141 Done 'r FFFFF-7ALocal intranet djStart , _1 Ipswitch IM I.4.E Health Master Reports...... I V 4:15 PM f i File Edit View Farontes Tools Help j nor 1 Back - - % ' �7 I Search Favorites - kddress �http:I/issgl2lintranetlhealthMaster/HealthMasterReports.aspx I- ®Go 093009 122 BRIDGE STREET OYSTER HARBORS YACHT BASIN 10 01327 13 3/15/1996 Osterville 122 BRIDGE ST OSTERVILLE,MA 02655 i 093009 122 BRIDGE STREET OYSTER HARBORS YACHT BASIN 11 01328 13 3/15/1996 Osterville 122 BRIDGE ST OSTERVILLE,MA 02655 104002T00 1000 RACE LANE BARNSTABLE,TOWN OF(LB) 2 00931 19 7/6/1989 NIarstons Mills 367 MAIN ST HYANNIS,MA 02601 104003T00 1460 ROUTE 149 BARNSTABLE,TOWN OF(MUN) 1 01052 19 1/1/1990 Marstons Mills 367 MAIN STREET HYANNIS,MA 02601 104003T00 1460 ROUTE 149 BARNSTABLE,TOWN OF(MUN) 2 01053 19 1/1/1990 Marstons Mills 367 MAIN STREET HYANNIS,MA 02601 115022 379 PARKER ROAD WIANNO CLUB 3 01299 16 4/30/1992 Osterville P 0 BOX 249 OSTERVILLE,MA 02655 116013 330 WEST BAY ROAD EGAN,RICHARD&AUDREY TRS 1 01008 19 1/1/1990 Osterville 72 CROSBY CIR OSTERVILLE,MA 02655 116053 93 WEST BAY ROAD BARNSTABLE,TOWN OF(SCH) 2 01311 10 8/20/1998 Osterville PO BOX 955 HYANNIS,MA 02601 117026 981 MAIN STREET(OST.) CALLAHAN,RICHARD P TR 7 00205 16 11/9/1992 Osterville %HOSTETTER,DANIEL 770 A MAIN ST Done j'I-F-F-f T-1191.ocalintranet l 4:15 PM f�E Start j _t Ipswitch IM I �Health Master Reports I_ J File Edit View Favorites Tools Help y 1 10 Back - - L Search Favorites ® - w t Address It http:llissgl2lintranetlhealthMaster/HealthMasterReports.aspx ®Go i 117026 981 MAIN STREET(OST.) CALLAHAN,RICHARD P TR 9 00205 16 11/18/1992 Osterville %HOSTETTEI;,' DANIEL 770 A MAIN ST OSTERVILLE,MA 02655 140134 19 WOODLAND AVENUE MILLER,CARYL LOCKETT TR 3 01176 16 8/4/1992 Ostende P 0 BOX 2450 OLYMPIC VALLEY,CA 96146 165079 159 MAIN STREET(OST.) HANS,PATRICK R&GAYLE B 1 00416 23 1/1/1986 10/25/1996 Osterville 7 LITTLE COMFORT RD SAVANNAH,GA 31411 187030 658 BAY LANE BARNSTABLE,TOWN OF(SCH) 3 01302 10 8/14/1998 Centerville 658 BAY LN BARNSTABLE,MA 02630 189058 1875 FALMOUTH ROAD/RTE 28 CENTERVILLE/OSTIMM FIRE DIS 1 01014 19 1/1/1990 Centerville 1875 FALMOUTH RD CENTERVILLE,MA 02632 189058 1875 FALMOUTH ROAD/RTE 28 CENTERVILLEIOSTIMM FIRE DIS 2 01015 19 1/1/1990 Centerville 1875 FALMOUTH RD CENTERVILLE,MA 02632 189058 1875 FALMOUTH ROAD/RTE 28 CENTERVILLEIOST/MM FIRE DIS 3 01016 19 1/1/1990 Centerville 1875 FALMOUTH RD CENTERVILLE,MA 02632 189058 1875 FALMOUTH ROAD/RTE 28 CENTERVILLE/OSTIMM FIRE DIS 4 01017 19 1/1/1990 Centerville 1875 FALMOUTH RD CENTERVILLE,MA 02632 189132 1734 FALMOUTH ROAD/RTE 28 MOBIL OIL CORP 2 01078 26 1/1/1983 3/18/1993 Centerville CORP-EMB-2305A Done Local Intranet '0jStart y 1 Ipswitch IM 14L)Health Master Reports-...I e' 4 d 4:16 PM Fi'e Edit View Favorites Tools Help g 1 Back Search Favorites JJJ Address http:Ilissgl21intranetlhealthMasterlHealthMasterReports.aspx E- ®Go 189132 1734 FALMOUTH ROAD/RTE 28 MOBIL OIL CORP 3 00564 26 1/1/1983 3/18/1993 Centerville. CORP-EMB-2305A P 0 BOX 53 HOUSTON,TX 77001-0053 192244 354 WHITE OAK TRAIL JONES,KATHLEEN J 1 00434 29 2/l/1980 8/6/1991 Centerville 354 WHITE OAK TRAIL CENTERVILLE,MA 02632 208086 156 SOUTH MAIN STREET LUTHER,ALLEN R JR&SUGDEN, 3 00000 11 11/17/1997 Centerville STEPHANIE F 156 SOUTH MAIN STREET CENTERVILLE,MA 02632 215027002 2155 IYANNOUGH ROADIRTE132 MID CAPE SERVICE CTR INC 9 01027 19 1/5/1990 West Barnstable 2155 IYANNOUGH RDIRT132 W BARNSTABLE,MA 02668 215027002 2155 IYANNOUGH ROADIRTE132 MID CAPE SERVICE CTR INC 10 01028 19 1/5/1990 West Barnstable 2155 IYANNOUGH RDIRT132 W BARNSTABLE,MA 02668 227140 390 ELLIOTT ROAD LONGSTRETH,WILLIAM 1 0 29 1/l/1980 11/19/2001 Centerville P 0 BOX 1239 CENTERVILLE,MA 02632 249105 830 WEST MAIN STREET GOODWIN,ROBERT H TR 6 01308 12 11/l/1996 8/21/1997 Hyannis 830 W MAIN ST —' HYANNIS,MA 02601 254016 1800 IYANNOUGH ROAD/RTE132 BARNSTABLE,TOWN OF(MUN) 1 11 4/5/1998 Barnstable 367 MAIN ST HYANNIS,MA 02601 269002 549 WEST MAIN STREET BARNSTABLE,TOWN OF(SCH) 3 01114 19 7/1/1969 Hvannis Done .� �' Local Intranet d1 Start } i Ipswitch IM I �Health Master Reports-...) ` w 4:16 PM SOIL EVALUATOR& PERCOLATION TEST FORMSPage I of 4 P�oFtHETp�,� Town of Barnstable t BARNSTABLE. • Department of Health, Safcty, and Environmental Services 9 MASS. 039. Public IIealth Division prED►AA( 367 Main Street, I lyannis MA 02601 UI'lice: '09-790-6265 ,:AN: 509-775-3344 T S . � lent fol� ,.Sewa e Dls �os��l Ir ess ,SOl1 ,SUlt.�2,��1f1 ASSMORS NO �! MAP PARCEL NO- �~� Date: �' 'Ti NOJ 9�J,ftat're�"�— Datc: Performed By: Witnessed By: V 1JN t U owncr's Name Location Address e/��S CL-ue) Gy tj" 19f o�s� j��3sa2S �61a2S G d�Ss^t� �t Address,and Lo(a: ray 6 I7 t-4 715C f �relephm,c e Assessor's Map/Parcel: "7/ •/ NEW CONS"I'RUC"rION 1/ REPAIR nra�tev(ew Yes ✓ � �� Published Soil Survey Available:Pu lication Scale / 9_ 0o Soil map unit �i�— Year Published /t Drainage Class EXcl3_ �/�E Soil Limitations 3� able: No Yes Surficial Geological Report AvailPublicat on Scale / Zoe Year Published LII Geologic Material(Map Unit) LK3iN Landform cv Flood Insurance Rate Map: Yes ✓ Above 500 year flood boundary No ✓ Within 500 year boundary No 4V Yes Within 100 year flood boundary No ✓ Yes Wetland Area: National Wetland Inventory Map(map unit)Wetlands Conservancy Program Map(map unit) -' Current Water Resource Conditions Month D�� Below Normal(USGS): Range: Above Normal Other References Reviewed: DEP APPROVED roaM- 12/07/95 Ok1�9 11 - SUII, 1-NAI,UATOR FORM I 1'agc 2 of 4 Location Address or Lot No. On-site Review Deep Hole Number �' Date: / /y 47 Time: /O At-, Weather Location (identify on site plan) Z3erwaw 4 kawj � �7 TB. r Land Use gZ&yp, OA) Slope (%) 0— Surface Stones 0 . Vegetation 61PL4Z- 2SZ "i0urW�) 5 Landform 007W43t1 A'w Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area �Z90 feet Property Line — feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material(geologic) L,4/ DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: V8 Weeping from Pit Face: Estimated Seasonal High Ground Water, i DEP APPROVED FORM• 11/07/95 � i i ' , F0K1\9 11 - S011, EVALUATOR 1"0101 Page 3 of Location Address or Lot No. 43 D h etennination or easonal Hi Water Table Method Used: � ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of observation hole inches �� ❑ Depth to soi l mottles 4 i c feet El Ground water adjustment ' Index Well Number M Tw7g Reading Date ..... Index well level Adjustment factor Adjusted ground water level . De th of Natural) Occurrin Pervious Material area Does at least four feet of naturally occfor the soil bso pt aerialexist system?in �Ils observed throughout the area propos If not, what is the depth of naturally occurring pervious material? Certification sis I certify that on (date) I have passed the soil evaluator examination approved by the De ar me�tof Environme tal Ptection training andexpertise pe that ise and he above experaencE was performed by me consistent with therequired described in 310 CMR 15.017. Signature - ate k I bF.P APPRO167-1D FORM.12ro7/9S f FORM 12 - PERCOLATION TEST Page 4 of 4 '7 Location Address or Lot No. �C / -3' ��/aI 4*r 13lk COMMONWEALTH OF MASSACHUSETTS Massachusetts ]Percolation Test* .Date: /y9` 9-7 Time:, Observation Hole # Depth of Perc ��' Start Pre-soak End Pre-soak Time at 12" Time at 9" Time at 6" Time (9"-6") EE Rate Min./Inch v I = Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed 0 Site Failed ❑ ........................... Performed By: DGI �. Witnessed By: Comments: ... . ........:::.:.:.....:::::::.:........ DET APPaoVED FORM.12/07/95 1 L/ SOIL EVALUATOR & PERCOLATION TES' FORM � oFTNEIp Town of Barnstable 1 pARNSTABLE. De nartincnt of 1-1ealth, Safety, and Environincntal Services 9 MASS.039. public Health Division plED►AAA• 367 Main Street, I lyannis MA 02601 Orlicc: 509-790-6265 I:AX: 508-775-3344 .. � III ASSeSSI r1 erll- ,�OI� ,S'e wa e Dls oral ,Soli ,Sulmh ASSESSORS MAP NOS 2L PARCEL NO• �� Date: C16 NU. Date: Performed By: [ ' Witnessed By: owner's Name I.ocalion Address /_LI CE 0YS•T(a- kla,14 Address.and Lot a: 1.3 �EF 'relephonc N Assessor's Map/Parcel: �� .—�' NEW CONSTRUCTION ✓ REPAIR nrrre It ve iew Yes ✓ Published Soil Survey Available: No Soil ma unit CV 8 Year Published /9 Publication Scale .2 DD p Drainage Class Ex�'Sy/cfe Soil Limitations lreYERE Surficial Geological Report Available: No Yes � Year Published /975 Publication Scale /_?= Geologic Material(Map Unit) r»I— Landform Flood Insurance Rate Map: Yes ✓ Above 500 year flood boundary No Within 500 year boundary No ✓ Yes Within 100 year flood boundary No ✓ Yes Wetland Area: I National Wetland Inventory Map(map unit) Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(U GS). Month Normal itange: Above Normal Other References Reviewed: I)LP APPROVED DORM- 12/07/95 FORM I I - so IIII?N'AMATOR FORM Page 2 of 4 Location Address or Lot No. ze /535Z'! -/oS to r - /'Zes On-site Review Deep Hole Number Z Date: 1- 9-17 Time: �_� Weather Ca;Aft Location (identify on site plan) �wrs� � �"-' 04- AW Land Use C9O 4'arl' .5 Slope (%) 0`-,3 Surface Stones 0 Vegetation Meiv-116D IfZt---A Landform 607Z,1,,311�49L Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, % Gravel) D 2" O N �9(p �f^� y�6lertC�J� � ►'n� �/��/d e F2i�e� , Ale 1VArM !mil C-0 VJIJ � �2 �-�,,,►-ram MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material(geologic) 'gora lS4 AL"yii ,� DepthtoBedrock: /u/ Depth to Groundwater: Standing Water in the Hole: Nr� Weeping from Pit Face: 0 _ Estimated Seasonal High Ground Water: aano4x' DEP APPROVED FORA• 12107/9S I e� 5U1 DORM 11 - 1, EVALUATOR 1"0101 Page 3 or Location Address or I,ot No. _Vfil ^/oS k7 Det ermination or Season I Hi h Water Table Method Used: hole OIA inches ❑ Depth observed standing in observation hole A11 inches ❑ Depth weeping from sid of observation De th to soil mottles � A inches ❑ p /�- feet 6,7, ❑ Ground water adjustment ...... ... . Index Well Number M I1•U. `Z`� Reading Date ......�t� Index well level Adjust ment factor Adjusted ground water level . De th of Natural) Occurnn Pervious Material Does at least four feet a naturally occurring the pervious absorption rial system? in all areas D hout the area propose observed throng th of naturally occurring pervious material? If not, what is the dep Certification certify that on w► 9 /99� (date) I hav�apP Protection and thatsed the soil uator examinatior theabove analys Ic Y II approved by the Department of Environmen ertise and experiencE was performed O me 15.017.consistent with the required training, exp described in 3 Date Signature 1 DF.P APPRO16'F.D FORM-12/07/95 3o FORM 12 - PERCOLATION TEST Page 4 of 4 Location Address or Lot No. �� 46 /535*~/03 COMMON OF MASSACHUSETTS &,04)q%ac e , Massachusetts Percolation Test* .oat®: ; - 9 97 Time% lD � Observation Hole # ----------------- Depth of Perc o� Start Pre-soak End Pre-soak Time at 12" Time at 9" Time at 6" Time (9"-6") Rate Min./Inch t performed in both the primary area AND Minimum of 1 percolation test must be reserve area. d Site Failed ❑ Site Passed ................ Performed By: IG6� Witnessed By: Comments: .. ..:...::.:.. DEP APPROVED FORM-12/01/95