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HomeMy WebLinkAbout2085 MAIN ST./RTE 6A(W.BARN.) - Health 2085 Main Street West Barnstable A= 216-- U74 r i I g � 9- /3 7 �f Town of Barnstable P# 2�� Department of Regulatory Services • Public Health Division Date �y • rutwerest.t:, 200 Main Street,Hyannis MA 02601 y ArFD M1A'l� Date Scheduled + v Time ) Fee Pd. Soil Suitability Assessment f or• Sejv ge ¢sposal Perfonned By: 1. R C �� Witnessed By: v LOCATION& GENERAL W ORMATIOl7 Location Address l 1� 6/ Owner's Name - A.._/,4 /'ll tl ce Address 1 Assessor's Map/Parcel: OZ / / Engineer's Name WO W L- NEW CONSTRUCTION 1f1 REPAIR Telephone If 6d_0 J 260- I J_�n�n' , Land Use-. , nM-\ _"� Slopes(%) Surface Slones 4fQ� �rlQC-4 U Distances from: Open Water Body ft Possible Wet Area ft Drinking Waster Well ft Drainage Way ft Property Line 1 L - ft Other Z-?,- ft ` SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands�n proximity to Boles) 1�0, �4 ,b� T a lb 0 e �5 Parent material(geologic) ��(ZR1N� Depth to Bedrock Depth to Groundwater: Standing Water in Hole: f.,lq N Weeping from Pit Pltce �N Estimated Seasonal High Groundwater DE.TERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: In. Deplll In 5011 tzlottls: Depth Observed standing in obs.hole: _ a Depth to weeping from side of obs.hole: a In, Oroundwnter Adjustment Index Well# Reading Date: Index Well level A(l,f:.letor_ Adj.Croundwater Level PERCOLATION TEST Date Time Observation �xt► Time lit 9" _ __-- Hole# Time at 6" Depth of Pere Start Time:(9"-6")Pre-soak Time @ `S 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 Coinpleted on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify tile_ Barnstable Conservation Division at least one (1) weelc prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Depth from `]HOIe# Soil Horizon Soil Texture Soil Color Scri;l'' Surface(in.) (USDA) Other (Munsell) Mottling (Structure,Stones;Boulders. Z Con istenc % ravel � id. . �L'A.6 L va5"ts XJ/1 HI I 5` v DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Hole Surface(in.) Soil Color ' Soil(USDA) Other(Munsell) Mottling (Structure,Stones,Boulders Consistency %Gravel) 1~� Z (T qt cg DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Hole# Surface(in.) Soil Color Soil Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Co siste cY. Gravel) DEEP OBSERVATION IIOLE LOG Hole# Depth from Soil Horizon Soil Texture ' Surface(in.) Soil Color Soil Other (USDA) (Munsell) Mgttlln g (Structure,Stones;Boulders, Consi ten a l Flood Insurance Rate MR Above 500 year flood boundary No Yes Within 500 year boundary No_ Yes Within 100 year flood boundary No Yes . Depth o� f Nnturall.V Oceurrine 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 Occurringpervious 1 s matertal7,,. ___,,, Cent--_fieatlon I certify that on cC'4 (date)I have passed the Soil evaluator examination approved Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and exp fence described in�10 CAIR 15.017. Signature A �j s. . q Date � Z'/ �/G • >r QAS13 PTICU'ERCFOR M.DOC z . . r f C� 5 M C's Y\ �j i �• LC.1.�r�J��i—U \Qi -. � i I S �e `._.�' " - _�i' ��i_OlJ y -\ 2„ 7. pi k � ,� ; i 4 { ♦ � '�� �,5"fr7fc � �✓ �'� sue. �ICJ:+�:c��''�P� i j a� ��