HomeMy WebLinkAbout0221 STARBOARD LANE - Health 221 Starboard Lane
Osterville
A= 166 044 004
Town of Edarnstable I'►: L BLS
Department of Health,Safety,and Environmental Services
�,nE►a Public Health Division Date 'j
367 Main Street,Ilyannis MA 02601
OARNMOIF
yq- MARS -
r4DMA�� DateSchedtiled --JGL/1,—5raoo- _ Time �. 00/�1� I'cc I d. /00. 0'0
Soil. Suitability Assessment,fog• Sewage Disposal
Performed ll C U JJr VQ)") L))6 i lIce l i l N J)')c ' Y �ptU ll7 SI AN T(�n/
Y /-. _ WilncsscJ 1.1
LOCATION & G1,NLRAL INI�O1tMA'I`lUN <:-
Location Address Owner's Name SC0}f C 4- mu l7C e. ry I
�230 S/a'-beet ret ka &c_
Address c P�j Ua6,-!;�
Qa ter vi flL'
Assessor's Map/Parccl:nJlz/p �(��j p re, O if y'0 G it Engineer's Name Abe vj1 ✓6-i) f t .
NEW CONSTRUCTION / RE-PAIR Telephone H v Of-
Land Use -RE5lDLAJVI Slopes("/") 3—t5% Surface Stones_I JVNE
Distances from: Open Water Body JOO } It Possible Wet Area 3ON-` fl Drinking Water Well �J}—it
Drainage Way 300 i It Properly unc 7b 1l Other Il j
SKETCH:(Street name,Dimensions of lot,exact locations of test holes 8e perc tests,locale wetlands in proximity to holes)
1
0.
to
T
Je 3
Parent material(geologic) pU j WA�tt pV�Iti Depth to Ilcdrock. JO
Depth to Groundwater: Standing Water in I tole: NONE- Weeping from Ili(Pace
Estimated Seasonal lligh Grounchvaler _EL, 3. ----
b t'ICIt11 IN�'I'Ic)1V:FORSEASQN�L IY xY 'W�i"LIt'Y'AI3 , t
_.:
Mellwd used: /A?o`!lr
Depth Observed standing in obs.hole: in. Depth to soil nurtllcs:
Depth to weeping from side of obs.hole: in. Groundwater Adjustment n,
Index Well 1!_ _. Rending Date:, Index Well Icvcl _-_ Adj.factor Adj.Groundwater Level
X'.Put c6 xI'IOIV'I LS'I' a)aae z I ? ;
Observation
(tole 8 1 Timc it 9" -
Depth of Pere Timc al G"
Start Pre-soak Time a Time(9 -G')
T N ^
Ind I'rc-soak l i� rn,
Rate Min./Ilrch
Site Suitability Asscssmcnt: Site Passed_ 'f. Site Failed: Additional Testing Needed(Y/N)
Original: Public health Division Observation hole Data To Be Completed on Baclt j
Copy: Applicant
i
I)EEI,::oj3s u1 Ii,�WA 1 IOIV 110LL LC/G I1 't#.: l
Depth from Soil Ilorizon Soil'fcxUrrc Soil Color Soil Other
Surface(ill.) (USDA) (Munscll) Mottling (Structure,Sloncs,nouldcres.
Cmrsislcnev.",o Gravel
A LOAf)y S4vb I G,IR z/ I
a
11-Icl B mt�. SAND &IK LI/Z Arr\E FrN6°,
mtD./LOARS>=
1`�-3o L, SANS
CZ lv�
n)o w�TtP�
llL]C1' OBSER:V.ATION LIOLL;LOG
�_ _
Depth from Soil Ilorizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munscll) Molding (Structure,Stones,noulderes.
�ortsigfjI j ,ravel
FAKC�y 'DEcorviPo;,r�ti
—z" 0 [
Co - 31 L, mrD,/c.oaese s
s N� IoyR
A)
)T.
103LZAiION I>10L LOC IIIe#
Depth Gon Soil Ilorizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munscll) Mottlin
g (Structure,S(oncs,llvuldcres.
Consistcnc "o Gravel
0- 1
PARTLY L�Cc>rr;t'�SED
A L.
CoAm. �ArrD 10`! y�l U.
IS- y8,. 3 MG-1). SANb 1DyR S,(, _
loq- 7`I
A/a A =
:DLM OOS>L;IZVAI TUN MULE LCjG Ii )<c# -
Dcplh from Soil Ilorizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA)
(Munscll (Structure,Mottling Stones,ISotrIcI cres.
Consistency ^/b iravel
Flood Insurance Rate Majs
Above 500 year flood boundary No Yes
W ilhin 500 year boundary No f Yes
Within 100 year flood boundary No ✓ Yes
e th of Naturally Occurri ig perviulls 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? YC-S
If not,what is lire depth of naturally occurring pervious material?
CcrtiGcatiuu
I certify that on r)PP,h 1 t`'1, (date) 1 have passed the soil evaluator examination approved by the.
Department of Environmental Protection and that the above analysis was performed by file consistent with
the require ,If in ,expertise an vrieuce described in 310 CM 15.017.
Signature _ �_ _ Date
1