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0025 REID LANE - Health
25 Reid Lane Marstons Mills" A= 125-059 Town of Barnstable P# Department of Regulatory Services. enartarne r Public Health Division Date _. MA& ia1¢" 200 Main Street.Hyannis MA 02601 J4 �pIFG � Date Scheduled Time Fee Pd, D 1 Smil`Suitability Assessment for S e Dis ' Performed By:�U ' r1A Witnessed By: LOCATION& GENERALMYORMAT- ION- r Location Address ] h Owner's Name R �. tit Address (vLoirtyVIS. /4 c11S rMA= Assessor's Map/Parcel: �.�S-Q Engineer's Name NEW CONSTRUCTION x i REPAIR Telephone# 370g.m 12g3 y Land Use'4"g-(41,i C./ GZe S,q(e h "q' Slopes(96) 0��-1 Surface Stones Distances from: Open Water Body 2 �6 r- ft Possible Wet Area z g&1't ft Drinking Water Well ft Drainage Way ' ft i Property Line + ft Other ft SKETCH:(Street name d►mensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) z - `• a #2 se 10004 00 - / y Meg q�ov2 EL 55.3 bfOrOba $.-7 —L.c. : Parent material(geologic) V�WAS�i Depth to Bedrock ®D. s i . Depth to drodndwater..Standing Water in Hole: �'2 Weeping ftom Pit Race t Estimated Seasonal High droundwater (a.3 (U 487 1 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: T%oPl Depth Observed standing in obs.hole: Ei.Z In, Deptlt to soil mottles: Depth to weeping fromside of obs.hole: in. (3rtiuttdwntCP Adjustmentft. Index Well#STay 253gReadingDate:,wF 13 Index Well level �17,45 AdJ f'astbr I.9' AdJ,Groundwater Level PERCOLATION TEST Data: : Observation. t" t7 Hole# i 3 Time at_9" Depth of Pero 3.3 3 © Time at 6" . Start Pre-soak Time`@ 0 Time(4"-6") -/: 0 7fZG O End Pre-soak -: Rate Min./Inch 2 NO rn Site Suitability Assessment: Site Passed V/. 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 1001 of wetland,you must first notify the, Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTICTERCPORM.DOC � oF3 DE OBSERVATION HOLD' LOG ` Hole# . ! CL 55 00 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) j (USDA) (Munsell Mottling . (Stnueture,Stones;Boulders. onsistency:9b Oravell C IEL. s zs C ®q N+ SpAo� :s' /0 . �/ c�/�r i^P e Act Yg S AEEP OBSERVATION HOLE LOG Hole# 2 Et- sy 7 q Depth from Soil Horizon Soil Texture Soil Color Soil -- Other Surface(m) (USDA). (Munsell) Mottling" (Structure,Stones,Boulders.. onsis en v Z 1.'s / /-F boy G Et 5Z.o7 2?_. 3 Y ' /y Z 49^ So"( 'r+P s 4 l9 rl /- Io8 C 3 Coarse Sand o lea C / ,��s K DEEP OBSERVATION HOLE LOG Hole# r` s s:zy Depth from. Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) ?'` (USDA) (Munselq Mottling (Structure,Stones,Boulders. C .i to o c one S� Lam, toY2 s�6: 3Z.sLod., 'S� d �� �/5 es SG>s-ley , `3 Cba�se 5�,, 0�'R 6 w GfoVe� +-.R-,, • r : DEEP OBSERVATION HOLE LOG Hole# � 5` -11 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munselq Mottling (Structure,Stones;Boulders. onsi ten a 12 sa� eL lvY2 .. , 12 � LGA'YMw .SG ha1 147� f 3C' lrracP�-F'neS N SC,s"-1Q8� ! Co�rtc Sad lark �/3 G✓ � rv���el �F.�e S "' t;�ye.7 �1— Flood Insurance Rate Map; Above 50U year.floodf boundary ;No_ Yes y- 'boundary No l Yes,Wittun 500 ear boun - Within 100 year flood boundary.No Yes Depth of Naturally�Ccurrinl'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? y If not,what is the depth of naturally occurring pervious material? Certification l< .ZO I certify that on 2 (date)I have passed the soil evaluator examination approved by the - Department of En iroiimental.Protection:and that the above analysis Was performed by me consistent with the requited training,expertise and experience escribed in�10 CMIt 15.017. Signature Date 7 2�� / SEE ssvD\, o-vR lr _\A QtS S.A.(S Q-. EPTicWERCFORM.DOC Z 4 DEEP-OBSERVATION HOLE LOG Hole# . 5 eL %-(Og Depth from Soil Horizon Soil Texture Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. olisistencv:96 Gravel) 0-1O F1t_L 07ZI o - t-3 o t EL $3.-1 DEEPOBSERVATION'HOLE LOG Hole# �� s�•zG Depth from Soil Horizon Soil Texture Soil Color• Soil Other Surface(in.) (USDA) (Munsell) Mottling' (Structure,Stones,Boulders. Consistency, (rav o F(LL 300 L b°k EL4e.- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other . Surface(in.) (USDA) (Munscll) Mottling (Structure,Stones,Boulders. Consistcncy,%Gravel) DEEP OBSERVATION HOLE LOG Role# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency ; . f _ Flood Insurance Rate Mali: Above 500 year flood!boundary No— Yes ---- Wttwn.500 year boundary No,; Yes Within too year flood'boundary No _; Yes Depth of Naturally Occurrbia 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? _ Certification I certify that on G -(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 training,a pertise and experience described in 310 CMR 15.017. Signature Date Q:\SEPTIC\PERCFORM.DOC 3 ��3