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0030 INDIAN TRAIL - Health
Iho�'c r,-6Z., l Town of Barnstable ►'r� q�� 3 Department of Health,Safety,and Environmental Services �,►+E> Public Health Division Date 99� . 367 Main Street,I lyannis MA 02601 S a" a '$ ' 2i=�saf oxen S�v. l S 1990 rF%6,79 " � Date Scheduled 11q U qUS . /9� /99 9 Time /O:00 H1" Fee.l'd. 46 10Q. 00 Soil Suitability Assessrizent fog• Sewage Disposal Performed By:S LA 1 yQx1 L 1'141 h l°t•°r l rjg one.Wilnessed`By.. ,V � 102g>�l D LOCATION& G)JNI It�1L'INFORMATION - Location Address 3 p nd�at7 7r/Cc./•/ Owner's Name V d /ion . /)') 0 G/SfF r J rb ors Address RoKr hy Forms J3f0 ,Mill /Qee�f'/�d. a?? ✓"Id, V A 22176 Assessor's Map/111rcgl: , 'L d 7 0 IOUr&L L•ngmeer's Name Joe-�r-sv/ii wl Pe NEW CONSTRUCTION REPAIR Telephone H 5 01 q Land Use k C-f7�es t 9�^-� Pry- Slopes(%) 5 %� Surface Stones ]NAo&-I ram, Distances from: Open Water Body Il - Possible Wet Area _11 Drinking Water Well _ 1t Drainage Way k10 11 Property Line 11 Other It SKETCH:(Street name,dimensions of lot,exact locntions of test holes&perc tests,locate wetlands in proximity to holes) �.I���•ter ___ 40 tea • � �o � IJ�1_ a W w / N: IV . Zo t j ZVI os00- •ss�s 9113 al _ Np� (4a0o .wide)sas4-4, N0N40'/0V D4 9 AN Parent material.(geologic) �e,rv.�x4sN �L/'<<►-J. Depth to Bedrock Depth to Groundwater: Standing Water in Bole: lyo�E, Weeping from Pit Pace o r—1 E Estimated Seasonal)ligh Groundwater E L Z-3 OEN 9 U G � VA E Al TJTVr RS ISONAH� Method Used: U S S CrtPc[c�,�Co�M •ss c o wv Depth Observed standing in obs.hole. in. Depth to soil mottles: A ► in. s Depth to weeping from side of obs.hole: in. Groundwater Adjustment � �It, Index Well N___ Rending Date:_•.___ Index Well level _ Adj.factor Adj.Groundwater Level i'ERCO!LAT11 TEST ::: t 1)al,e iJ Iiiitt, ld,.'3C� Observation Hole H ( Time at 9" Depth of Perc Time at 6" Start Pre-soak Time @ I O 32.: L S C%—^A, �S Time(9"-G') End Pre-soak 4� Rate Min./Inch LE55 'TN .A&- Z.tAto tPc-2 l to L-t Site Suitability Assessment: Site Passed YES ES Site Failed: )dG Additional Testing Needed(Y/N) V Original: Public Health Division Observation Hole.Data To Be Completed on Back j Copy: . Applicant llEiJP:013S1 RVATION 110LI; LOG Male# I. Depth from Soil Horizon Soil'Texture Soil Color Soil Other Surface(in.) (USDA) (Munscll) Mottling (Structure,Stoncs,(louldcres. Consistency.%Gravel) Z © O NtiA i�Lt A 4o ftw.,.�t to`le2/z �^ p $^ C b yes ?' /SA' 30-�20 G tox to 65 or, SI 6 La Az^, I 7y- rLloa c N DEEP OBSERVATION HOLE LOG Hole # Z Depth from Soil Ilorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munscll) Mottling (Structure,Stones,noulderes. Consistency, tDYdLZ tb- 28 $ edemas� �•sit�.sl b n�o�+; wrty�i3ouw�� Z.o'�•� �, »CLIF. Ate? o ti� AY DEEVIOBSERVATIOMHOLE LOG Hole Depth from Soil I lorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munscll) Mottling, (Structure,Stoncs,Iloulderes. Consistency,o Gravel) .DEEP OBSI RVATION;HOLE LOG Depth from Soil Ilorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stories,!louldcres. Consistency..o Flood Insurance Rate Man: 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? __Lr--5__— If not,what is the depth of naturally occurring pervious material? Certification i. I certify that on APaVL 97 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was perforn)ed by me consistent with the required training,expertise d experience described in 310 CM 15.017. b 9� Signature Date t o/ z