HomeMy WebLinkAbout1105 OLD POST ROAD (CT & MM) - Health (2) b7s loo ►10,3
LOCATION SEWAGE PERM T
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VILLAGE
INSTA L. LER'S NAME & ADDRESS
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U I:L D E R OR OWNER
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DATE PERMIT ISSUED ,
DATE COMPLIANCE ISSUED ��
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007 6'- 001 D )3 Town of Barnstable P# 89 S ✓
Department of Health,Safety,and Enyironmenfal Services„
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�,►+�, , Public Health Division Date
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Soil Suitability Assessment for Sewag 'PDI osal
Performed By: c�t✓�7ir/�i21� �/ /o w�vLr ' Witnessed By: ��2tiy~ wi✓iry '
i )LCCATION &(CNERAIL YNF0121Vt�lTiOl�t
Location Address ,[.07 t/ / j (�poy�+� -_. Owner's Name Nip �,� ;•C -
�,`^"''%cS�`9�(� 6 : ( q Address - J�aGQ 7ia
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Assessor's Maprareel Nib S �i�.o eecs'Z ` jIp.�3 'F�gtreer s Name Si xR' ��Q �i otivj ,�
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NEW CONSTRUCTION REPAIR «-a Telephone#1 y3 Z^85 3 1..._. {
Land Use Y L.et^ Slopes(%) -.Surface Stories..
Distances from: Open Water Body ft Possible Wet Area / 6d ft Drinking Water.Weli` ft
Drainage Way``"> ZS- ft. .Property Line c7 fli 'Other >'}. �¢_ It '
SKETCH:.(streeiname;dimensions,of lot,exact locations of test holes&peratests,locate wetlands n pro mityito,holes)
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Parent material(geologic) 1 wA TN R._46i t ti S Depth to Bedrock � /y.0
k Depth to Groundwater:"Standing Water in Hole =, e ' Weeping from Pit Face.,,,da _ IV
Estimated Seasonal High Groundwater>040b A-!r oG7Q R� `
DE TIJIt1VYtNATYON FOit:SI✓ASOAL HIGH WATER TALE
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Method Used:. r� ,.. a w w
Depth Observed standing in obs.hole: " in. •Depth to'soil mottles:� Y.r# in.
Depth to weeping from side of obs,hole: m. y,Groundwater Adjustment ft.
Index Well# Reading Date i•' de Inx Well level Adj:factor t Ad1j Groundwater Level
I'ER OLATION.TE3T o�Date "�� Time o0
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Observation `
Hole# tit ;Y1(��>jz�}s�3��3L«a"�,9iN,;II5 Z.;!:tytt�°�ts3t:ctf' /� i�a 1 ziS +T�me.at9�� "jr2� Z$+3�+���-a Li
Depth of PereLy•..3 +` x t.t., z f fl f Twx er,Z
Z, S�l 6 `l8`' - ` - Time at 6"
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Start Pre-soak Time Q
End Pre-soak 2%o5 Z r3 3 w 6 t
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Rate Min./Inch;
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Site SuitabtlityAssessment: Siter Pass+ed t ` .,tr;raa Site palled t 1t c{=t}�}t,.z�+.kkAdditional Testing IVeeded.(YM)` r �Y.r,F
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Original: Public Health Division Observation Hole Data ted�To Be Comple on Back.-�
Copy: . Applicant " � . • f 1
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DEEP OBSERION HOLE VAT
Depth from Soil Horizon Soil Texture' Soil Color Soil Other
Surface (USDA), (Munsell Mottling (Structure,Stones,Boulderes.
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DEEP OBSERVATION HOLE LOG Hole# } Zr
Depth from Soil Horizon I Soil Texture Soil Color Soil. Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
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... DEEP OSERATTON HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Other
Soil
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
ConsistenCyr%
y.,
DEEP:OBSERVATION HOLE.LOG Hole
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) . (USDA) (Munsell) Mottling (Structure.;Stones,Boulderes.-
k
Flood Insurance Rate Man: . ;. y,
Above 500 year flood.boundary No'_ Yes
Within 500 year boundary No Yes
Within 100 year flood boundary No Yes•T_ -, Ira
Depth of Naturally Occurring 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? yc;S
If not,whair is the depth of naturally occurring pervious material?
Certification, .
I certify that on L�/6 -Jr'S� (date)I 4avi passed-the,soil evaluator examination approved by the
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Department of.Environmental Protection and that the ,above analysis was performed by me consistent�with,.~ ,
the required training,expertise and experience d �. ribed in 310 CMR 15.017.Y
Signature Date -.Z�-9 I 4, .