HomeMy WebLinkAbout0000 OLD SHORE ROAD - Health I9 JF1UK Kl1Pi17;1V1AKJ l O1V J 1V11LLS�
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A=058-019
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Town of Barnstable P#
Department of Health,Safety,and Envir6nmental Services "
�1KE r Public Health Division Date 26 !
Q 367 Main Street,Hyannis MA 02601
BARNB [F CAB
a Date Scheduled � �j%� 4 , / G� „
"rEn i�nr" �a Time � '� Fee Pd. U✓, 3 V
q Soil Suitability Assessment for Sewage Disposal-
Performed By: Witnessed By: �*
I
LOCATION & GENERAL:INFORMATION
... �
Location Address �/ . �V7n, Owner s Name �I �ll 1�... + • .
Address �S
�1 Assessor's Map/Parcel: �'S� /(J�[ Engineer's Name
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NEW CONSTRUCTION / PAIR Telephone# k
n Land Use RESIbeNTk L Slopes(%) C)—J'0/p Surface Stones /1/b �.
V 1 NO Drinking Water Well NO J1
Distances from: Open Water Body R Possible Wet Area tt D g -.
r Nl�Drainage Way It Property Line tl Oche tl
g y NO P Y 10
SKETCH: Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
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Lq
9S
9D �
D /\
d O LA d.D� �► D 04
m (A .G C411- L)
W %D
V %\
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o ro
Parent material(geologic) t7vAwaSh 'P(6r\ Depth to Bedrock Al
Depth to Groundwater: Standing Water in Hole: No Weeping from Pit Face NIA
Estimated Seasonal High Groundwater FL a5� Veorn =iuw n 0 'P_;uc bro VC%CA W1A-P f f I14 e
:.
... .......:...
bTNATION FOY2 SEc.SONA ,HCG + L
.. ...: :::.:.::.::.::::..::.::.:::...::..:.. . . ....
Method Used: SE L At ojj ,
Depth Observed standing in obs.hole: in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment fl.
Index Well# __• _._ .Readin¢Date:____ Index Well level..,,—.--- Adj.factor_ Adj.Groundwater Level_
'
T. t T�m to oo ChMRO ( D
Observation
Hole# �_ Time at 9"
Depth of Perc c) Time at 6"
Start Pre-soak Time @tO�14 00 Time '-6")
End Pre-soak IO:a7:30 a5 �quon5 i\ IPSS ��wn �5�;� j
Z�1 � '-CI4�s t Mq�e�,a\ •
Rate Min./Inch — a,
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back j
Copy: Applicant
s
pEUP OB ERV -TIQN 11.0. L;QG
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) I i(USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Rcy,%Gravel)
PIN6 N�EpttsS
o �►��.
A tSANy FtNiE 1 !10
LOAMI (--lNE
hN4l 10 V (o
VERY FINS
f arA 0
. < DEEP OBSER ATION HOLE LOG Holy#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
°
PW6 NFE�tS r
— D lEAvc
taAtny T-AI
" Q SA 0 / f
it taAmy FINE
VEPl�
-Ida' C to 5
DEEP OBSERvATTON DOLE YO Hole ::
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistencv,° Gravel)
DEEP OBSERVATION HOLE LOG Hole
_..
.. .... .
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency,%Gravel)
Flood Insurance Rate Man:
Above 500 year flood boundary No_ Yes L—
W ithin 500 year boundary No '! Yes
Within 100 year flood boundary No ✓' Yes
Depth of Naturals Occurring Pervious Material
Does at least four feet of naturally occurring perv' us material exist in all areas observed throughout the
area proposed for the soil absorption system?
If riot,what is the depth of naturally occurring pervious material?
Certification ,�k
I certify that onAfe- S' (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 tr. ' ,expertis an xperience described in 310 CMR 15.017.
Signature Date�, a l