HomeMy WebLinkAbout0121 WINDSWEPT WAY - Health 121 Windswept Way
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Town of Barnstable P#
Department of Regulatory Services
11AM z„S,i : Public Health Division Date
200 Main Street,Hyannis MA 02601 �n 1
Date Scheduled �.9—parime FeeIT
Soil 'Suitability Assessment for Sewage Dis osal
Performed By:- s>L�` �.,�S Witnessed BypJ/`-"m �J
OCATION& GENERAL INFORMATION
Location Address � r Owner's Name�� 1ra�y�ytri;►� ��J�:�
AddressJ �{� k I �A
Assessor's Map/Parcel: Engineer's Name eo
NEW CONSTRUCITON -!�— REPAIR Telephone#
Land Use — Slopes(%) �. Surface Stones 'r
Distances from: Open Water Body 1 G ft Possible Wet Area ft Drinking Water Well _ft �` 1
r
Drainage Way4 TJ ft Property Line _ft Other ft
;5
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proxirrut :'to holes) i
a. G
"_ �✓� to L� - ....`, ,`
Parent material(geologic) Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: J Weeping from Pit Face �+
Estimated Seasonal High Groundwater
DE ERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: r-i u"
Depth btseirved standing to obs.hole: _ ___ in, Depth to soli mottles: In,
Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj.factor— Adj.groundwater level,,,
PERCOLATION TEST bete Time
Observation
Hole# _ _ 3. . Time at V
Depth of Perc k �El Time at 6"
Start Pre-soak Time @ O/ b'. Time(91'.6") r
End Pre-soak LD°, 7 LD'.1k �' 0
L:int�,r fu
Rate Min./Inch _ =
Site Suitability Assessment: Site Passed 1:!�_ Site Failed: - Additional Testing Needed(Y/N)•
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one(1)week prior to beginning.
Q:\SEPTICIPERCFORM.DOC
DEEP-OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
ConsistencZrav
DEEP OBSERVATION HOLE LOG Hole# t
Depth from Soil Horizon Soil Texture Soil Color Soil Cher
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
D .
, 11Consistency.
IPA
DEEP OBSERVATION HOLE LOG Hole#
l7 Depth from Soil Horizon Soil Texture Soil Color Soil they
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
c::) Consistency.%Gravel)
lk—
rat= Z
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Cher
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
Consistency,
F�'`G � �lam. \0�(•� '� 2- \ = L+%v�"r
Flood Insurance Rate Map:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No= Yes '
Within 100 year flood boundary No— Yes
Depth of NaturaHv Occurring Pervious Material
Does at least four feet of naturally occurring pervl us material exist in all areas observed throughout the
area proposed for the soil absorption system? LL----
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on _ (date)I have passed the soil evaluator examination approved by the
Department of Envii o mental Protection and that the above analysis was performed by me consistent with .
the required training,exp tise and experience described in 310 CMR 15.017.
Date
Signature '
Q:\SPPTIWERCFORM.DOC