HomeMy WebLinkAbout0080 LOVELL'S LANE - Health ;0 LOVELUS LANE
Marstons Mills
A = 078 — 040
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Town of BAi astable. P#
Department of Regnlatory Services
' Public Health Division Date
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200 Main Street,Hyannis MA 0260 I
Date Scheduled L-` Time Fee Pd.
oil' Switabirity Assessment for Sew is osal d Dn
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Performed By:
�,� v t,✓� U'�t` ',e- Witnessed By:
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- LOCATION & GENERAL INFORIVIATIOyN
Location Address �. ��S �� ' Owner's Name t 1 Zj tq,(cQ
l$ I Address See
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Assessor's Map/P4rcel: / fJn I Engineer's Name I-h4r d P"A
J-4Jv- 3311
Telephone
NEW CONSIRU 70N REPAIR #
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Land Use Ll� �'1 �r � Slopes(9'o) '(✓ ' Surface Stones
Distances from: Open Water Body —6 D ft Possible Wee Area V ft Drinking Water Well ft
i)reinage Way
Property Line L-ft Other ft
SKETCH:($treet name,dimensioris'of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
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Parent material(gerilogic)
�` ) 1 Depth to Bedrock
Depth to Groundwater. Standing Water in Hole:* i Weeping from Pit Face
Estimated Seasonal Nigh GroundwaterLE
DItTERMINATION FOR SEASONAL HIGH WATER TAD
Method Used: I In. Depth 10 Sall tnOttics: In.
Depth ObPerved standing in obs.hole: I in. Oroundwhter Adjustment tk
Depth toiweeping from side of obs.hole: i _ Adj.factor �- Adj.0roundwaterLeVul,,.
Index Well# _ Reading Date: Index Well levd --
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PERCOLATION TEST natpe
Observation I Time at 9" - -�
Hole#
Time at 6" --
Depth of Pere
�1� 0 7 _ Time(9.�_6$#)
Start Pre-soak Time.@ 1---- -
End Pre-soak
Rate ItMmAnch
Additional Testing Needed(Y/N)
Site Suitability Assessment: Site Passed _
Site Failed;
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Original:,Public I;e;ilth Division Observation Hole Data To Be Completed on Back—
***If percolalibn test is to be conducted within 100' of wetland,you must first notify the
Barnstable C40servation Division at least one (I weak prior to beginning.
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DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
.Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistenc %Gravel
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DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistenc %Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistenc 3b Gravel
DEEP OBSERVATION HOLE LOG Hoe# N
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency, ra I
Flood Insurance Rate Map:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No V 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? __ C'$ -
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 Environmental Protection and that the above analysis was performed by me consistent with
the require fining,expertise and experience described in 310 CUR 15.017.
Signature �. Date
Q:\SEPTIC\PERCFORM.DOC