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HomeMy WebLinkAbout0037 PHEASANT PATH - Health 07//Uzi/vo1 � U1111 UI W (y,and Environmental Services Department of Health,Safe \Z 9 c Public Health Division Date d+ ► 367 Mein Street,Hyannis MA 02601 IWA I i o O Avh Fee Pd.' IOO` o0 Time� te�tw Date Scheduled �EG �. Soil Suitability Assessinentfor, Sewage Disposal t 6 . 11�A'ilnased By Performed By: LOCATIONON & GI,NERAL NFOsRMATI Name Pou� Ec.c.oN Location Address 3� ?µ t;:-A. /�,IV 'T qFAA-VA G jo Ao rnKto"J•a&A G i C t,ot +5 z): yST 1 t Ae soei Address A,,+,St'OS+'�sGJ►u.4 P ire Assesdor'a Mep/Parcel: •9 ' Z l't�1 Telephone fl q�.S'32.04A NEW CONSTRUCTION REPAIR f iZ+�S 1DGN•�*4 Slope$CA) Surface Stones Land Use I�O fl fl Possible Wet Area fl Drinking W Well Distances from: Open Water Body fl 0.— , fl Property Line Other - Drainage Way _.-- i Street name,dimensions of lot,exact locations of test holes&pPeretale,locale wetlands In proximitp to hold) SKETCH: OCT 133s*-Il + — N h ?14•«L tt I asa Pe.Ar+W Depth to Bedrock 300 i Parent material(geologic) ll''�w S Depth to Groundwater: Standing Water in Hole: a I o Weeping flom Pit Face Estimated Seasonal High Groundwater DCTEItM[ TION FOR SEASONA HIGH WA R TAB 1t�gZ h►►+2F-"f 4 4 t u a— rVl006c. Method Used: lb A>C 'gLE" in, Depth to soil mottle$: t. Depth Observed standing In obs.hole: in. Groundwater Adjustment fl } Depth to weeping from side of obs.hole: Ad.rector Adj.Groundwater Level f Rradin Date:_ Index Well level,,.r_ j � Index Well N_�-_._ • B :?• . Ion a qo 6s>Sc PERCOLATION TEST tir��t '. w'^ Zb"t'iAf.VO(�$ )'j�tM sS n+,:I•irrl +•r•i .,y chi .;.,r Observation 1 Time at 9"` Hole N �1 'l •� Time at 6"► — -- Depth of Pere f Tlme(9"4'7 f Start Pre-soak Time @ End Pre-soak Rate Min./Inch •'t+tiaS'C�tf4tN Z.VvI�J� )p �1GGt Site Suitability Assessment: Site Passed 3—,LbL_ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back--� ACEP OI3S ItVATIO O +E:EUCK, dole# ' » Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) I i Consistency-%Gravel) (Munsell) Mottling (Structure,Stones,Boulderes. O- $ NIEv �O`t2j �� Mc�T RpoTS map, G cG � 1,0-1l2 c-/ �v � � Etv c vrtsTE� X. AEEP:OBSERVATION HOLE LOG: Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. e A5%9 10�I12S� tM EO ZOO" lO�3Z W1-L? 1��Q. ZY• �RAVe�.. t 32.�Zp G I,o�I,R.G 0 St��.t,c ffle�•nu l�lo p Cta ourJ494 DEEP .OSERV�,' ZON HgE .00 : Mule ............. ...... Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG : Hots# Depth from Soil Horizon Soil Texture Soil Color Sod Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes K Within 500 year boundary No Yes Within 100 year flood boundary No,L Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervi us material exist in all areas observed throughout the area proposed for the soil absorption system? �ES naturally occurring pervious material? ' the depth of na g If not,what Is p Y Certification I certify that on Afal L 9S (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 trai 'ng,expertise and experience' described in 310 CMR 15.017. Signature O Date