HomeMy WebLinkAbout0127 WHITE BIRCH WAY - Health 127 WHITE BIRCH WAY,
A= 128-031 w• b6fOb
07 TOWN OF BARNSTABLE
LOCATION `fir I G/J�0' ,fi W A G E #
VILLAG9� ' 9f'�2/"'SK40 ASSESSOR'S MAP & LOT . Q
INSTALLER'S NAME & PHONE NOA�U-f
SEPTIC TANK CAPACITY
LEACHING FACILITY:(ty- q C�� (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: ^- �
VARIANCE GRANTED: Yes No
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-xt /a7 TOWN OF BARNSTABLE
LOCATION ��-�/�,�� ���C'�'�1 LI✓� SEWAGE # 7'
VILLAGEIMS57- ASSESSOR'S MAP & LOTZZ'k /
INSTALLER'S NAME 6i PHONE NO,/s 'a��[�-�-.✓ � ���r�„1$
SEPTIC TANK CAPACITY ��� w
LEACHING FACILITY:(type) ;L ��' � % (size) z6X
NO. OF BEDROOMS -5 PRIVATE WELL OR PUBLIC WATER I
BUILDER OR OWNER -6, eVll %
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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. ASSESSORS(SAP NO* -
No..q5 PARCQNO' Fes$....1AP..............
THE COMMONWEALTH OF MASSACHUSETTS t�C e� i�d� t;12 19I`P��
BOARD OF HEALTH Alfr,9
TOWN OF BARNSTABLE
Appliration for Diinpusttl Worlt,, Tomitrnr#ion Vrrmit
foit
APPlication is hPreb Yleder a Permit to Construct (x ) or Repair an Individual Sewage Disposal
System at: Lot 7 WHITE BIRCH WAY WEST BARNSTABLE
ROBERT WHITE 4224 GULL COVE NEW SMYRNA BEACH FL 32169
................................•-••-------•----------•---------................................. ••-•-------•-----•--------••-•....-----...•-------••--••----.........---..........----------------
ARCH CONSToCOddr Address or Lot No.
-•...................._......-----......--••-----...--------------------------------------•-•--- ---•-------•------------•---•---•----•.....--------------...•-----•....--•.......--------•--......
Owner Address
W
Installer Address
U Type of Building Size Lot___.-44686 Sq. feet
Dwelling—No. of Bedrooms----5-------------------------------------Expansion Attic ( ) Garbage Grinder )
004 Other—Type of Building .sing-Le---fam)e lyof persons____________________________ Showers ( ) — Cafeteria ( )
A4 Other fixtures ________________ ______________ _ _
Design Flow.............110 ------------------------------------------- ---------------------- ..............
•....................
W gallons per person per day. Total daily flow--------------------------------------------0---_-------_------------gallons.
WSeptic Tank—Liquid capa6ty 1500gallons Length_-_10 .5-_ Width5_r_5------- Diameter____ _________ Depth---4-75--
x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No...................... Diameter......6........... Depth below inlet..._............... Total leaching area---g02.-2-sq. ft.
Z Other Distribution box (x) Dosing tank ( )
Percolation Test Results Performed b .p_• ../16/8 5
WY-----R-----Fa-��ba-n-ks--- �-•--------------------- Date....------------••-•---------------•---
1 Test Pit No. 1_leas....2ninutes per inch Depth of Test Pit-1-56_"-------- Depth to ground water________________________
(14 Test Pit No. 2.le.s_s...2iinutes per inch Depth of Test Pit.1-5.6."---_.__. Depth to ground water........................
n+' --------------------- ........................................... ...........................................................................................
O Description of Soil---T'Pl.1....36"....5ab......37"./96"---sandand---gravel /___.96Y156!! sand
...............................A--'
v .... F#2...0.1..3 0.'' aub----3.10. 9 6•..... l.)--t-y... and--and...s a n d...9 6���15 6 �r a ye l•-----•-----------------------
W
U Nature of Repairs or Alterations—Answer when applicable----- 500_st.,___Dbox and ( 2 )
.......10 0 01-p-_v i th_.-1-- feet...stone-----------------------------------------------------------------------------------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The and igned furth agrees not to place the
system in operation until a Certificate of Come has been iss d th.
3/20/95
g �.. ............ a.................... - - ..................Sin .... -
WYJy/L✓� I?ace
SP •
ApplicationApproved By ... ---- --- - ----- ---6------ - - ------ ---. ..... .- --- ................... ........................................
Dace
Application Disapproved for the following reason - --------------------------------------------
.....--- --------------- - --- .--- ---- ------------------_------------------------------------------------------ ------------------------
Permit No. Issued ice......
—........... ------- ..............� Dace
No...., - -• . - FEB ..............
THE COMMONWEALTH OF MASSACHUSETTS �D�i✓� �f�?E 2 SA /e
f BOARD OF HEALTH ,4TA_._
TOWN OF BARNSTABLE
Applirativit for Diratltl3al Norks C outitrurtiun Prrutit
Application is.hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
System at: Lot 7 WHITE BIRCH WAY WEST BARNSTABLE
ROBERT WHITE 4224 GULL COVE NEW SMYRNA BEACH FL 32169
................_................................................................................ ••--••------•-•••-----••-•---------•••-------•----•-----...----------•----------•--•------••-•----
ARCH CO1�§ef'ob6ddr,'AYANNIS or Lot No.
......................-.......................................................................... -••-•------•--------•••-•--•-•--•--•--....------•--•--•---------•-----------....---------••-------
Owner Address
W
Installer Address
U Type of Building Size Lot..---44686 Sq. feet
Dwelling—No. of Bedrooms.--.5......................_...--_-.----..Expansion Attic ( ) Garbage Grinder (A )
aOther—Type of Building .Sirlgl.e....fJaM&b.yof persons---------------------------- Showers ( ) — Cafeteria ( )
dOther fixtures -------------------------------------------------------------------------••-•-----•----...-••----•-••-------•-------------•••-•-•-••......------.....
110 gallons per person per day. Total daily flow........-.._55.0
W Design Flow............. _______________ gallons. ,
W Septic Tank—Liquid capacity_1500gallons Length-_-10.5 Width_.__5-..---- Diameter...- -.._---- Depth...4._7.5..
x Disposal Trench—No. .................... Width.................... Total Length-------------------- Total leaching area....................sq. ft.
Seepage Pit No.... .............. Diameter------- ........... Depth below inlet-----6............ Total leaching area...4II?_<_7..sq. ft.
z Other Distribution box (x) Dosing tank ( )
aPercolation Test Results Performed by-._-_T�.----E_ -ix la t�ks_..i2...L'�I................... Date..--1/16/85
Test Pit No. I less---2ninutes per inch Depth of Test Pit.156-"-_....._ Depth to ground water........................
(s,, Test Pit No. 2.1ess----Minutes per inch Depth of Test Pit.l•56_"----_--_ Depth to ground water........................
9 ---------------------------------------------------------------•-----------------------------•------------------------------------------------
---------------
0 Description of Soil...TP#1---36!!-.-_sub•__-.37"_/9611 sandand gravel,_ 96y15611 sand
. . ----
U TP#2---0�30"----sub_.-30"_/96."__.si-1_t-y..sand_ and sand_ 96"/156" gravel ;
U
............. ........ ........ ............ ...... ... --- ------........-----------------...---------------------...-•----------•........-----......---........--•--•------.....}...
U Nature of Repairs or Alterations—Answer when applicable.... 15 0 0 s t, Dbox and ( 2)
--------------------------------------•---------------------------••---•--..
10001p with 1 feet stone
- -----------------------------------------------------------------------------------------------------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The and signed furthe agrees not to place the
system in operation until a Certificate ofgComplia�I� a has been iss ed t.e d� th.
Sin 3/20/95
CtJA/.v- -------------- ----- ...........,------------------
Applicationt 2c)�/����h�i v , � -- --. .- � .. Dare
'Approved By ------- ---d C------ - ---- .�1. .........._...,..-. . ! .. .....Z.....-.
tDate
Application Disapproved for the following rearon . ............................_...._. .._--------------------------------------------- '---------------------......--
_----.-_....._--------------------...--- ...../-..-- i- ...._---_---..----....----............._.................................-.... --- ---- '�-_Date...................
..................
Permit No. 1 ..................�--... Issued f "...l...............................
Dare
r THE COMMONWEALTH OF MASSACHUSETTS
i BOARD OF HEALTH
TOWN OF BARNSTABLE
Te>r#tf rate of Tatuplianre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
ARCH CONST CO e
by -------------------------------------------------------- - ------------------- _-- -----------------------------------------..------------------------------ - ---- ---------- ---------------.-----..-------------. ----Installer ,
1
at ..--..LOT -.7..- WHITE..-BIRCH. WAY-WEST----BARNSTABLE._---------------------------------------------------...-----------------------------------------{
has been installed in accordance with the provisions of TITLE 5 �T-he S to E v' onmental Code as described id,
the application for Disposal Works Construction Permit No. _._. ✓ i t�-.- .._..- .. dated --.--_.-. ......................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO NSTRUE /�S A GUARANTEE THAT THE
SYSTEM WILL FUNCTION. SATISFACTORY.
2�—. '"
DATE ............................... .. - __ - - Inspector
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
r TOWN,OF BARNSTABLE 100
NoFEE........................
l
�i��nr��t1 nrk� �un�trtilan �prmtt
Permission is hereby granted........ ARCH CONST CO
-----
to Construct ( X) or Repair ( ) an Individual Sewage Disposal System
at No...........LOT- .7 WHITE--BIRCH-.WAY•--WEHT•.BARNSTAB�,�-.---- ---- __J/. �ROB.E`�...WiIT.a............
as shown on the applicati n for Disposal Works Constructio er it No� �'// ,fee U 0 ........
f�J Board of at h d
DATE............................ --• •--------------•--------------------
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS
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`( Bot er : 731801 Date: 05/08/95 ,
'�• BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT _
C7 SUPERIOR COURT HOUSE
Oj BARNSTABLE, MASSACHUSETTS 02630
A55 PHONE:362-2511
LAB 337
Client : WHTTE, ROBERT Collector: E MEEHAN
Mailiiig 4224 GULL COVE Affiliation: WELL DRILLER
Address : NEW SMYRNA BEACH
FLORIDA 32.1-69 Type of Supply:
Telephone : 888-54.58 LOCAL, Well Depth: , -.
Sample Location : 127 WHITE BIRCH WAY Date 06$ Collection 05/03/95
Town : W BARNSTABLE Date''of ,Analysis:., 05/04/95
PARAMF.TfiB-__.�------ r� „� f _ -- - MENDED LIMITS
--------- �� a = ----------- =-.--- --
Total Coliform Bacteria/100 mL `' � x ``0 g a„' `0
pI t b' i �s.. tN ;Wix 500
�.
(III c.00111liu.,/c rn) F
Iron P I.( ern) i }"> tra 0.3 F `..
.. t .
Nitrate-N:i.t.rt)Ljo1i (�,prn) F� h <u, � 10 .0
Sodium (ppin) 3 y 20.0
Copper: (ppm) { �' '°* ---1-3
BASE[) ON THE ANALYSES PERFORMED, 1HE FOLLOWLNG ADVISORIES ARE GIVEN:
This 1s a Retest
y Wat-er siuriple meets the recommended l rinking water
of all above tested parameti`ers
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''•.x n st a € � `»' '`"q y{`R `' sq .k ^. st ,,Lf1` "?�'�' ,r:..4 > s; r ,i�M`' "n,"y `
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om'as FBpurne; LaboratoryrDir e ct'6
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Barnstable County Health and Environmental ,Laboratory
Superior Court House, Route 6A
P.O. Box 427
Barnstable, MA. 02630
(508) 362-2511 ext. 337
Volatile Organic Analysis Analytical Method: 502.2
Collection Date: 04/26/95 Date Received: 05/03/95 Analysis Date: 05/03/95
Client: ROBERT WHITE
Mailing ROBERT WHITE Sample Location: 127
Address: 4224 GULL COVE WHITE BIRCH WAY
NEW SMYRNA BEACH FL 32169 WEST BARNSTABLE
Sample ID: 725102 Laboratory ID: 725102
Sample Description: PRIVATE WELL
Compound Amount Detected (ug/L--)--- .......... Detection Limit
Benzene BDL 0.5
B.romobenzene BDL 0. 5
Bromochloromethane BDL 0. 5
Bromodichloromethane BDL 0. 5 _
Bromof.orm BDL 0. 5
Bromomethane BDL 0 . 5
n-Butylbenzene BDL 0. 5
sec-Butylbenzene BDL 0.5
tert-Butylbenzene BDL 0.5
Carbon tetrachloride BDL 0.5
Chlorobenzene BDL 0. 5
Chloroethane BDL 0. 5
Chloroform 3.5 0.5
Chloromethane BDL,;,, 0. 5
2-Chlorotoluene BDL 0.5
4-Chlorotoluene BDL 0.5
Dibromochloromethane BDL 0.5
0..5
1 , 2-Dibromo-3-chloropropane BDL "�'y�
k e
12-Dibromoethane 0:5
Dibromomethane BDL'' ` p`- 05
1 , 2-Dichlorobenzene BDL 0.5
r^-^^-1;3 Dichlorobenzene•..._,.,_...,..,,..._�.._,.................BDL-�^.�,.,. ;,.�.�......-..m....,.., ,,.. � ._.__. ,.�,.p;�r�,.a,...e,,...,,.,,Y....�..,....__..,._....e......
1 , 4-Dichlorobenzene BDL 0.5
Dichlorodifluoromethane BDL 0. 5
1 ,1-Dichloroethane BDL 0.5
1 , 2-Dichloroethane BDL 0.5
1 , 1-Dichloroethene BDL 0.5
.cis-1 , 2-Dichloroethene BDL 0.5
trans-1 , 2-Dichloroethene BDL 0. 5
1 ,2-Dichloropropane BDL 0.5
1 , 3-Dichloropropane BDL 0.5
2 , 2-Dichloro ro ane BDL 0. 5
P p
1,1-Dichloropropene BDL 0. 5
cis-1 , 3-Dichloropropene BDL 0. 5
trans-1 , 3-Dichloropropene BDL 0. 5
Ethylbenzene BDL 0.5
Hexachlorobutadiene BDL s 0.5
Isopropylbenzene BDL 0.5
4-Isopropyltoluene BDL 0.5
BDL: Below Detection Limit
C
page 2
Sample ID: 725102 Laboratory ID: 725102
Compound Amount Detected (ug/L) Detection Limit (ug/L)
Methylene chloride BDL 0. 5
Naphthalene BDL 0. 5
Propylbenzene BDL 0. 5
Styrene BDL 0. 5
1 , 1 , 1 , 2-Tetrachloroethane BDL 0. 5
1 , 1 , 2 , 2-Tetrachloroethane BDL 0. 5
Tetrachloroethene BDL 0.5
Toluene BDL 0. 5
1 , 2, 3-Trichlorobenzene BDL 0. 5
1 , 2 , 4-Trichlorobenzene BDL 0 . 5
1 , 1 , 1-Trichloroethane BDL 0. 5
1 , 1 , 2-Trichloroethane BDL 0.5 -
Trichloroethene BDL 0. 5
Trichlorofluoromethane BDL 0.5
1 , 2, 3-Trichloropropane BDL 0.5
1 , 2, 4-Trimethylbenzene BDL 0.5
1 , 3, 5-Trimethylbenzene BDL 0. 5
Vinyl chloride BDL 0.5
Total Xylenes BDL 0. 5
os"y3-y Jo"
BDL: Below Detection Limit
Remarks: NON-TARGET ANALYTES FOUND/APPROX 350 PPB
Thomas F.' Bourne, Laboratory Director
��-=� ----_-No.-- --- - - ----t�- Fee---
OF HEALTH
TOWN OF BARNSTABLE
0(pplication-*rVell C on5truct ion Permit
Application is hereb made for ahpermit to Construct ( ), Alter ( ), or Repair ( mdividual Well at:
ocation — Address Assessors Map and Parcel
--------------------- ----------------
e Owner � JAddress
��Z-114 -------O f /° -
Installer — Driller Address
Type of Building
Dwelling------—---------------------------------------------------------
Other - Type of Building------------------------------ No. of Persons--------------------------
-----__________
Type of Well--------------�'�-�-------1� _-�____—- Capacity-- -- — - — - -
--_
Purpose of Well--------------------^----------------------— — —-
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation until a Certificate .of Compliance has been issued by the Board of Health. F
Signed L/too — -/_zl - ---------- - --r-----`�_
date q
Application Approved By --------------_____— _ -�'__L_ __
date
Application Disapproved for the following reasons:-----------------------------------______________—_______—______—_
----------------------- — ------------------------------------------------------------------------------------
��J . date
Permit No."—'=-- _ --- -- - - ---- - — — --------------
�-a,rL�---__—_____ Issued date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate Of Compliance
THIS IS TO CERTIFY, That the Individual ell Consr ucte ( ), Altered ( ), or Repaired ( x�
fInsta er
has been installed in accordance with the provisions of the Town of BarnstaFile Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No.V_J_1y__4y_Dated-----------------________
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE —-- --- —-- ------- — -- Inspector---------------------------------------------------------—
,:--�"'�,�,.,,r..,�..:�.•-0�,,..^.w�.:�''?i' �lr ,w1y���.7..r- r. 'n�s���"i -:.r'�..«-fi�y'`". �--�� �'���. r� � �_�'�•,,,rl;.,Y'��,.' .�4.
No.- Fee----- ---------
BOARD OF HEALTH
TOWN OF BARNSTABLE
U Application-*rVei[ CongtructionAermit
Application is hereby, rpade for a�permit to Construct ( ), Alter ( ), or Repair ( L1 individual Well at:
—— — --------- — — ----—— --- ----
^ ocation — Address Assessors Map and Parcel
/,^ — ----------------—— — — -----------
// rrII�� Owner — / Address
Installer — Driller Address
Type of Building
Dwelling-------------------------------------------------------------
Other - Type of Building----------------------------------- No. of Persons------------------------------------------------
Type of Well— -- - - -l`--4-C'--— -- - Capacity--------------------— - - ---------------- —
Purpose of Well---------— - —------------------------ —-
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation until a Certificate .of Compliance has been issued by the Board of Health.
Signed &�- — - - -- — -- ---1
g /-
date
Application Approved By ?l'�
date
Application Disapproved for the following reasons:---------------------------------
--------------------------------
f, 1 _ date
Permit No.VV-7v— ---------- Issued--------------------------------- — -------------
date
BOARD OF HEALTH
TOWN OF BARNSTABLE r
(Certificate ®f Compliance
THIS IS TO CERTIFY, That the Individual Well Conructe .( ), Altered ( ), or Repaired
bY- - __- - ---------- --- -- ---------------------------------------------
Insta er
at- - -- -�--'�� - ✓-` ----- - - ' -- AM-
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No.Y'019 `-�___-y-Dated-------------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE- ---- --——-- — - - — — -- Inspector------------------------------------------------------------—
BOARD OF HEALTH
TOWN OF BARNSTABLE
Well ( onoructionA3ermit
No. -- - -= � Fee-- � ---
Permission is hereby granted-- --------___________________
to Construct ( ), Alter ( ), or Repair an Individual Well at:
- — —
No. 111t/1'I i'_ �I
Street
as shown on the application for a Well Construction Permit
No. ---------—-- -- — -------- ---- - Dated -------------------------------
"�^-
-- — --- — --------rd of Health----------------------- _------
- Boa
DATE----_____—�_='�'�I-_
L
Town of Barnstable P# vo
Department of Health,Safety,and Environmental Services
o,Im Public Health Division Date 3-
367 Main Street,Hyannis MA 02601
e,�wareerB,p�
+6&
RFD Mld� Date Scheduled �E_ f 3 ~ 7 Time Fee Pd.
Soil Suitability Assessment for Sewage Disposal
Performed By: 1?G2A11Qe1:> Z `/o Witnessed By: ut2o JO t��a1NlAlt/Vdg
a
LOCATION & GENERALINFORMATION
Location Addressf — Owner's Name Jp�A/ rv1G:J2l.t;s 6'VA
Address . p� Veil
w� ��ftn✓S'4'nf'st,t3 t^M4
oZ - �'
Assessor's Map/Parcel: Engineer's Namet7.�n} St�f'k►r+«nAnl G"`''r`°"s'f
NEW CONSTRUCTION REPAIR Telephone#
Land Use LoIWC-Aly' Slopes(%) 1— /5 Surface Stones
Distances from: Open Water Body > " ' R Possible Wet Area > a Q, tt Drinking Water Well —7/1 y tt
Drainage Way ' Z S R Property Line ! i ft Other n
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
7Z "'V
��` .. a
ss
Parent material(geologic) Depth to Bedrock 300 ±
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face /Vd
Estimated Seasonal High Groundwater &L G o Al 14-L«.J
DETERIVIINATION'FOR SEASONAIHIGH WATER'Y`ABY�IE;
Method Used: &r, 00^;1Q JivpTi'�',' /vo7" �niGo'tn ivTc'2dC�
Depth Observed standing in obs.hole: in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level._ Adj.factor Adj.Groundwater Level_
PERCOLATI me s z r
Observation
Hole# Z Timc at 9" Z*3:�} a^ s1
Depth of Perc l 8y uJ� nZ�� Time at 6" 30
Start Pre-soak Time Q Time(9"-6") 4:58
End Pre-soak ! O�
Rate Min./Inch
Site Suitability Assessment: Site Passed X . Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back-�
Copy: Applicant
PEEP:'OBSERVATION:'I10LE LOG Hole#"
/
Depth from Soil I lorizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulderes.
%
F�rYAr�L.LT .
Yk' cz��r� o� t3dY��r �w c twos"
�> - w��rtst�.cs s��r.�Ar3v3
►v►iOCTt J�� y$rra Pl�O
C, �, a is Fin: l c)y r /c7� /►� �aa� uw t,L l�S Q t 5 a 4(4�
sY C, J ivt`/ t:LA y'r
pp
C, hOR*`wY JhYu� lSVr �'7P7 L/a�/O I�l1wW.�C��S 4� S�CW D
- `t•3�,Ki rti/tS iN�rvR'q MvxFy'i T��: ^
9/aw, W �yi°IPTN
DEEP.OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Cther
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
- 0 Consistency.o
AA L. °QA 0-- l O
1. Nav4t•t V^HSS/L^3 F21�t(3Lr3
e%e 5/S I o% s TIO-„ems'
P y. G L aro}<y v 2`
4ilkf^. 1') lV14n53Fr✓3 -rRIAa 3
Vvc1S3, S//-cw'
i., r '3 I-w sc v��y" �/ar4A I��12 /s/3 2�°/u Gdl9�s� C�e o t/vL
C S
DEEP OBSERVATION HOLE LOr Hoe
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
oGravel)
DEEP OBSERVATION-HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%
Flood Insurance Rate Map:
Above 500 year flood.boundary No_ Yes
Within 500 year boundary No X 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 ail areas observed throughout the
area proposed for the soil absorption system? y�%S
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that'on 6 /G 47 (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and lhat the above analysis was performed by me consistent with
the required training,expertise and experience described in 310 CMR 15:017.
Signature��/� - Date S--Lco- 7
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