HomeMy WebLinkAbout1500 OST.-W.BARN. RD - Health 1500 Ost.-W. Barnr , ._a -
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Marstons Mills
S M E A D
No.2-153LY
UPC 12934
smead.com • Made In USA.
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SUSTAINABLE
FORESTRY
INITIATIVE
Certified Fiber Sourcing
www.sfiiprogram.org
Town of Barnstable Pam
Department of Health,Safety,and Environmental Services
�IHE Public Health Division Date 5-. / 3 - 91
Q, 367 Main Street,I lyannis MA 02601
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rE ►�� Date Scheduled S ^ I6"- Time . Fee Pd. �OC�
Soil Suitability Assessment for Sewage Disposal
Performed By: ri'2N£- �i��-� Witnessed By: ✓err A,,i v 4`
LOCH ION & GENERAL INFORMATION: '
Location Address A5 J / � �( Owner's Name oJ� M t L K"
Address -2i Z A t.sv onC D r,
f r es` d4Ltk K404&4Y
Assessor's Map/Parcel: l � Engineer's Name
NEW CONSTRUCTION REPAIR Telephone M
Land Use /"`� 1' Slopes(%) d—$ 6 Surface Stones
Distances from: Open Water Body ft Possible Wet Area y44—ft Drinking Water Well ft
Drainage Way ft Property Line 40'*'42.2AQO ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes)
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Parent material(geologic)&SM 0741z, Depth to Bedrock
Depth to Groundwater: Standing Water in Hole: $V Weeping from Pit Face ,
Estimated Seasonal'ttligh Groundwater -
DETERjvIINATION OR SEASONAL HIGH WATER TABLE
Method Used: I/
Depth Observed standing in obs.hole: v _in. Depth to soil mottles: _in.
Depth to eeping from side of obs.hole in. Groundwater Adjustment ft.
Index Well N��"' Reading Date:_ Index Well level Adj.factor Adj.Groundwater Level (J
PERCOLATION TEST Date " Time
Observation
Hole N Time at 9"
Depth of Pere �s5( Time at 6"
t
Start I're-soak Time C �w/`f�'e 'Time(9"-V)
End Pre-soak / ��
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed:_ Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back------�
Copy: Applicant
DEEP OBSERVATION HOLE LOG Hole # /
Depth front Soil I lorizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,noulderes.
%
o Ar 4,6,G t S/LTLon rM YES A
//-27F �. Z f/4f C/.`a Y /�j3 M$ •'1rt a
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon soil'rexturc Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,noulderes.
%
3 20 t gic.�o �75/a Y y-f 5 t c{Y'4V
DEEP OBSERVATION HOLE LOG Hole# 3
Depth from Soil Horizon Soil TCxt0re Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.% el
5 foN c/
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lei S/O
1444-f-y
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Ilorizon soil'rexture Soil Color Soil Other
Surface(in.). (USDA) (Munsell) Mottling (Structure,Stones,noulderes.
7 -Consistency.%
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 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?
If not,what is the depth of naturally occurring pervious material?./SON£ 06912
Certification
I certify that on 1_G (date)1 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 training,experti a and experience described in 310 CMR 15.017.
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Signature%�'_ �-� `--� date
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