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HomeMy WebLinkAbout0275 TREE TOP CIRCLE - Health 275 Tree Top Circle Marstons Mills -- -- I�� TOWN OF BARNSTABLE LCCI TION�a�J 7S rlre/tip 6, SEWAGE# 06-05-0 VI;LADE,�d1u/ �i ,1l�ir�' ASSESSOR'S MAP&PARCEL 150 INSTALLERS NAME&PHONE NO.Q���5 A Iki (S4 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) DSO �'�E/1�� • (size) /�2, X, x 1 NO.OF BEDROOMS X/Sh3§ OWNER PERMIT DATE: COMPLIANCE DATE: '2 4 J ©EJ Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY 14 r 3 -6Y r �f cn S 9�v,/ C 3 70 Town of Ba rnstable P# Department of Regulatory Services . , i Public Health Division Date MARS. 6 3 a 200 Main Street,Hyannis MA 02601 Date Scheduled - � ko Time Fee Pd. JnQ.Cn Soil Suitability Assessment for Se" Disposal ® O Performed By. A -4 � �l Witnessed By: LOCATION&GENERAL INFORMATION Location Address Owner's Name S i yy �7S-,T1 rye��� circle Frcn�li�i�•� Loe- O 4?b IC.:S / v. 1�\lS Address ;L.7 S' Tdee_ 'Tcp e ifd e Assessor's Map/Parcel: 15-0 C),51 Engineer's Name NEW CONSTRUCTION REPAIR _Z Telephone# Land Use ,Pex tdz I Slopes(%) �' Surface Stones Distances from: Open Water Body 2����ft Possible Wet Area 2 2-J D ft ft J Drinking Water Well 20 b Drainage Way a ft Property Line 2 l—Cl ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) 1 eL� UhTED Parent material(geologic) a-.-(.VJ ovthN,&_,3� Depth to Bedrock Depth to Groundwater. Standing Water in Hole: � Weeping from Pit Face Estimated Seasonal High Groundwater N �� DETERAHNATION FOR SEASONAL HIGH WATER TABLE E Method Used: .�_ t Depth Observed standing in obs.hole: In. Depth to soil mottles: Depth to weeping from side of obs.hole: in, Groundwater Adjustment Index Well# Reading Date: Index Well level Adj.factor— Adj.Groundwater'Level PERCOLATION TEST Date Time f a- Observation r— Hole# .c Time at 9" 7 c� Depth of Pero Time at 6" f!� Start Pre-soak Time @ // 15me(9114) End Pre-soak /®2,2— 1�3/y Rate MinJlnch Site Suitability Assessment: Site Passed )<_ Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back--------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:ISEPTILVERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. i tenGravel) v W -s " II DEEP OBSERVATION HOLE LOG Hole# 7— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenev.% ,�• , C_ DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Oravell DEEP OBSERVATION HOLE LOG Hole#— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency. Y '� l� N ,A 2,T♦, '!Nly 1l Flood Insurance Rate May: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary. No X Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pe ious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what,is the depth of naturally occurring pe ious material? Certification I certify that on 1 V �l (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` 6 arcing,experti and experience described in 310 CMR 15.017. e 1V"�_ Date • �L f Signature Q:\S.EVnCIPBRCFORM.DOC L L A T 10 Al,_ —7— j 5 E W A iG I PE R M 3 T NO. V-1L LAG E 6 115T A LLER'S M—A ME & ADDRESS r t DATE PERMIT 15SUE D LAZE aC0MPLIA4 C. Z ISSUED r . _�, �` �0 �u� .,� :�w� �. >� ,:�x�,� ' � � �. �:.�