HomeMy WebLinkAbout0010 BLOMIDON CIRCLE - Health 10 Blomidon Cirele j
Marstons Mills ►''
A= 058 -011
Town of Barnstable Ptt
Department of Health,Safety,and Environmental Services
Public Health Division Date
q� 367 Main Street,Hyannis MA 02601
S seanareat8. _
gees. �1
Date Scheduled //gl-1'l /0, a. 00/ Time 00 Fee Pd. 4/QO. D D
' � L
Soil Suitability Assessment for Sewage Disposal
Performed By: Sl)lI/yak) er�' Z7u Witnessed By: Y1so IM A/ 5eJAC-T-131E
:''''":':;:;';:'' :>':'" :.: ...;':':.`.:LQC '�'1 OkV &Ca�: l!T> RAL INFORMAT4N,
- ..
Location Address �6 7— Owner's Name
1/95 Gel &i-e t-
,6/0 m)-,i00 e.,- /e Address L%; Crvj j/1, /riA Od�G�S
me z716 a Mi//S
5�/per f O f �Oa rC� o// Engineer's Name
Assessor's Map/Parcel: 0
NEW CONSTRUCTION __2L /REPAIR Telephone# 50Je—L/a f-- 3 3 '1
Land Use RGS l Ib.ENZ I A( Slopes(%) 0—5 o/U Surface Stones A/WE
Distances from: Open Water Body 5(3 U + R Possible Wet Area 0{ It Drinking Water Well SOO fl
Drainage Way N ft Property Line 10 n Other NMI ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locale wetlands in proximity to holes)
4(18
• ti I. i•�
T
O`
a 'P4 t 0
CJ
• ., a . . ,
Parent material(geologic) UUTL,JASti 11LAV Depth to Bedrock !)06 t
Depth to Groundwater: Standing Water in Hole: NO Weeping from Pit Face
Estimated Seasonal High Groundwater B_ ZS FROM ZOWN OF FJ�&LL (-VX0V V-3k-%E& MR
.... .......
DE' ) NAT'TO F(312Sl✓ASONALHY�IT'VV
_...
Method Used: '�EE �bOVC
Depth Observed standing in obs.hole: in. Depth to soil mottles: in.
Depth to weeping from side ofobs.hole: in. Groundwater Adjustment tt.
Index Well#_._ Reading Date: Index Well level. _•_ Adj.factor Adj.Groundwater Level
:: ..:.::. PERCOLATLOIY:TES......T.:. ; ;::::::::.:. T�ne...�.
Observation
Hole# Time at 9"
"
Depth of Perc Cos Time at 6"
"
Start Pre-soak Time Q ZS (elI S Time(9"-6")
End Pre-soak �S MIn
Rate Min./Inch
Site Suitability Assessment: Site Passed C .o Site Failed: Additional Testing Needed(Y/N) 1� _
Original: Public Health Division Observation Hole Data To Be'Co.mpleted on.Back
-�
Copy: Applicant t ;'.
PEEP OBSER, TLO�i OY,
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%Grayeh
7 �� vu-j FR\A'(�
lu �► b
V E KN Wo:,L-
7-IZU CONKSEI 0
DEEP`QBSERVATION HOLE;LOG
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes.
%
QttiRTLy DE30MP `•L
0-4096AUIC..MAT I LEAVES-Twt&S
SINrdE (_,itkAi, LoO5
— A N) 10 & —tom f- et me u ooT
VEIN <=R►mbf-c-
-7 F=W F%NE t MFAw c,<rt 5
I Z.0 �•.. vc0.y
DEEP 4aSEVATX4N T OI,E LOG
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Bouldcres.
%
DEEP OBSEHVATI0. HOLE LOG'. Hole.#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes.
%
Flood Insurance Rate Mao:
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? YC—S
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on P\ N1 ..._I`q;(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 ' ing,expertise an erience described in 310 CMR 15.017.
Date
Signature
l� '
Icl t Uj lUN !'UIZ 1'ER(;ULA'1'1(1N TEST ANU BSERVA'1'ION 1'1TS
LOCATION
VILLAGE No.
APPLICANT y DATE �'7,
ADDRESS I G !�`'t l��/ FEE l
ENGINEER TELEPHONE NO. (Non-refundable
TELEPHONE N
DATE SCHEDULED —
Applicant' s signature
LbyAbi . . . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
a '9 1111�54 S-.L Loa
SUB—DIVISION NAME . '
�
ir� �
C.L DATE —� ys TIME .�.G'�.-JT-�
EXPANSION AREA: YES 2 _ l
TOWN WATER_ RIVATE WELL - ENaINELR !;
-- E6 HOARD OF HEALTH
EXCAVATOR
SKETCH: (Street name, etc. ,dimensions of lot, exact location of teat Doles, and
percolation teats, locate wetlands in proximity to test holes)
.'.-NOTES:
N87°I8'10"E
215.61Nam.
0
co
C Q
• (p to 45,988 SF my
°? y �c I S,N. 15.4 a '
_/
106.57
S84'19'16"E - 69,43
B L �� M ' ` R 281.135
D O N C'
(PRIVATE_ 50' WIDE)
.PERCOLATION RATE: Z v_� 11 AD
'VEST HOLE NO: 1 ELEVATION: ��'�S`1' HOLE NO:
n I ELEVATION.
2 Lv�����vg�; c L, 1
4
3
CL eA�v 4 sc� �- k7
Wl c= 5
7 6
s5� 7 •'
9 8
9
10 10
11
11
12 0\J ABC 12
13 13
14 ; 14
15* 15
16
SUITABLE FOR I
SUB—SURFACE SEWAGE: LEACHING FIELD K I,EAC11I14(3 PITS
LEACHING TRENCHES
1NSUITABLE FOR SUB—SURFACE SEWAGE. REASONS:_ �,AA-
10TE: ENOINEE�RIN(3 PLANS MUS'P SHOW NUMBER ASSIONED ON PEI(C TEST AP1'1,1CA`1' oll —
MI(IINAf,: COMPLETED tj jII3ETY_H_I-';-1�,_AH1L11�'1'!!I?I�
:(IPY; RETAINED BY APPLT('.AN`t' ---------