HomeMy WebLinkAbout0035 HILL CREEK ROAD - Health (3) 35 HILL CREEK RD., OSTERVILLE
A=187-005
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I'fliirll of BalIIsl.l�)Ic P►► 96 Z �2
I)eparlluenl of I leallh,Safely,and kin,ironnlenlal services
p1"1 PT1lllic IIcs11111 Divisi011 Dale
Q 367 hiain Slrcel,I lymmis NIA(12601
nAnrrnr.sur� 1
FIA9S � ,l
�I►,7tor"� Dale scl►ednled N e-eq -'C�/q✓yj
lime hee I'd. Z
Soil Suitability Assessment,for Sewage Disposal
Performed Ily:— —_ WibresScd Ily.
LC)C/1'l'lON & clem;Rt\L INFORMATION
Location Address LL C12G—�ve- /Zak D Owncr's Name CA60 S
O S 7L-7z.1//ce Lam. /B l r///Y TZr PIA/Zr G N
Address G'4-W7- W V/L LG-r
oL63z
Assessor's hlap/Parcel: 18 7 Engineer's Name
NEW CONSTRUCTION r/ REPAIR Telephone 11 3 16C'7
Land Ilse Slopes(%) /z /O surface Sloncs
Dislanccs from: Open Wrrlcr(lady 11 Passible%Vcl Arca R Drinking%Valor%Veil fl
Draina c Wily / /
g Y /�!a II Ihopcuy Line _ Zo II OIher II
S K ETC 1 1: (Slrcel moue,dimensions of lul,exact localions of lesl holes&Acre lesls,locale wetlands in proximity la,holes)
9
/3 r
dZ a-or,
3 -
1AN
7 t3 1 IU
0
�oT 0s I s,
7hA/
� 1
Poll coil maleriul(geologic)— Dcplh to llcdrock — _-
Depth to(i roandwalcr. slnnding Wnlcr In I Iole: Weeping fiom Pil face
lislhnalcd scasonnl I ligh(boundwalcr N�
UETEI RA'IINATION YOR SEASONAL HIGH WATERTABLL
Method Used;
Depth Observed slnnding Ill ohs.hole:. _ in. Depth 10 soil 1110111es:
Depth 10 weeping fianl side of obs.hole: in. Groandwnler Adjustment
Index %Vcll# .. IlradbrR Dnlc: _ _ Index Well level. _ _-_ Adj.factor Adj.(iroundwnlcr Level-
PI!;IWOLATfON TLS'II iidle /2 r s flare 5:.00�iy
I lute a Z _ Time al 9"
Depth of fore �D~ Time nl 6"
Sind Presoak'l ime n 9%/� 'I I111c(9"•6")
• Had I're•sonk �' L�_
I(nic Min./hrch 66s5 n11JW 2 Ni.U1/wGN
Site Suilnbilily AsscssorcM: Sill:Passed Silc failed: Addilionnl"I'esliug Nccdcd(YM)
Original: I'ablie lknllh Division 011servalioa hole I)11111 To Ile Con►pleled oil Back j
Copy: Applicant
I)I!;1?,1' O13Si1ZVA'i'ION HULL'
Depth liaar Soil(lotizort Soil'rcxlutc Sail(:ulor Soil
Surlhcc(io) OIhcr
------ — (USDA) (Mlunscll) f,lollling (Shuclwc.Sloncs,nouldelcs.
- ------- — �.Ll!F151S11GY.1's Siifls-cl)
�_.._...._ t /
�. SAIVD /o
�o N c ' /yam, -SON
-
/ " G Z /a
DEEP OBSERVATION 1101.,1p I,OC Hole /I Z
Depth liant Sail Ilotizolt Suil'I'cslutc Gril Cuhrr Soil
Sill Fact:(in.) Olhcr
(IISUA) (hlunscll) Mottling (Slntclorc,Stones,Iluuldctcs.
y -S.!!!)i1F1S1LcJ',1q(lflt.Yl<I)
---� - — O
-- — -- -- — -------.... A,Y/Z
-- Z N— — --- 40AH 3..w /D y/Z _..—
z
C / M�•n.SAr/D /v //z YG
1)I;El OBSERVATION IIOI,II', L,U(► ----
Ucplh li11 Sall IlotIwo Soil'Icrlorc Soil Color
Sorratic(io.) Soil ( llict
----- OJSDA) (Alunscll) Mauling (Sltaeltlte,Sloocs,Ilouidctcs.
-- - ------- ----•------- --- — SJIIIIIICIISY..1sSililYel)
--------- --
1)II/L.1' UHSLItVA')'dON 11()I./IJ LOG Hole I/
Depth huttt Sail Ilorizatt Soil'fcxlule Sail Color
Batlitcc(in.) Soil Otllct
(IISI)A) (Mansell) Mulllin
_ g (Sltuchnc,Blanes,Ilaaldctes.
� -----•--•- --- <<tlll�li1s�11�Y..°ea.�illlysa)
I
Above 5(10 year Ilund bnundnr)' Nu Yes •/
Wilhin 500 ycnr bouathtty No— Yes
Wilhin 1(10 year flood boundary No Yes
i)clffluLlIalmidls.Orsurti))g1'gjYig)I56jil(criijl
Does M least four feet of n;t11u'ally occurring I)crvi(ms malclial exist iu all areas obsclvcd Ihioughool the
area proposal lirr Ille soil absorpliofi syslc1117
If not, what is the depth of naturally occurring pervious nullcrial'?
SLPLUHKIIHWI.
I ceilify Illat oll /L / �9 9 (dale) I have passed the soil evalualol.cxa110111 ion approval by the
Deparlfilcnl of I nvu'onnlalillalll'l-' leclinfi ;nld Il)al the above analysis was performed by file collsislcnt will)
the raluired Ira I it ex it' d expel icnce described in J I O Clvllt 15.017.
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