HomeMy WebLinkAbout0081 PIRATES COVE - Health (2) �s 1 ��,�Q,�e,c� Gj Je, Osamu i Ile
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SOIL EVALUATOR& P VZCOLATION TES',FORMge I of S
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YP�OFTHETp Town of Barnstable
I7 Qi•
I BARNSTABIE. � Dcparhncnt of I-Icalth, Safety, and Environmental Services
7 MASS.
i639. Public Health Division
jOrE0�Mt� 367 Main Strect, Hyannis MA 02601
OI'l icc: 509-790-6265
VA 509-775-3344
Lor
Sa e Disposal
SLI w
soil 'ability l
ANc.ESSORS MAP N
PARCEL Na 5 /
Date: ! ��6/1
NO g f G
-t
Date•
I'crformed 13y:
Witnessed By:
I.(jCillllln Address D.4j11,D .eal.4`/
gI 1'/ f God PO)W-AX 5238
o�L /�A�►'.go2s , fS�G/t/I Ifs �i�7'�vJG.s/ P.4
Address.and
Lot a: / A
'I'cicplionc N 41¢_ 404�Z ' BZOD
Assessor's.Map/Parcel: SI✓5
NEW CONSTRUCTION REPAIR
Office RevieW Yes �t
Published Soil Survey Available: No Soil ma unit C_
Year Published Publication Scale _1-S� jW p
Drainage Class EX Soil Limitations
Yes
Surficial Geological Report Available: No
Year Published /97S Publication Scale WV
Geologic Material(Map Unit) ✓✓t
Landform
Flood Insurance Rate Map: Yes
Above 500 year flood boundary No �c Yes ✓
Within 500 year boundary N0 Yes ✓
Within 100 year flood boundary No
Wetland Area:
National Wetland Inventory Map(map unit)
Wetlands Conservancy Program Map(map unit)
Current Water Resource Cond' ions(USGS): Month t7CY
Range: Above Normal
✓Normal Below Normal
Other References Reviewed:
DL•P APPROVED FORM- 12/07/95
i
p- A8J 7
FORM 11 - SOIL ENAWATOR FORM
page 2 of 4
Location Address or Lot No. l #4 /�i/2,4-f13 Ire
Opt-site Review
Deep Hole Number 7- Date: 12_5 -9r, Time: /0 /1-- Weather r,t.5)/L
Location (identity on site plan) i1/DRI# S/P4�r 'Of 6�f,6r.06 Dw4r "- U6
Land Use Slope M 0'3 Surface Stones p
Vegetation L4,u 9ey0D &c)n A90000 &VIS,*W Y260D61I ems'
Landform 60M'✓1m P2 .4-Av
Position on landscape (sketch on the back)
Distances from:
Open Water Body t00 feet Drainage way — feet
Possible Wet Area feet Property Line feet
Drinking Water Well feet Other
DEEP OBSERVATION HOLE LOGO
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(Inches) (USDA) (Munseill Mottling (Structure,Stones, Boulders, Consistency. %
Gravel)
D
/dy'2�/�
a�v,
_'C —
s�uo
ptvpta-
I MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Parent Material(geologic) ���G��- OdT�U/jS DepthtoBedrock:
•Deoth to Groundwater: Standing Water in the Hole: Weeping from Pit Face:
Estimated Seasonal High Ground Water: AGUD _
1
VEP APPROVED FORM-12/07/9S
/ / 60877 DORM 11 - SOIL L;VALUATOR F0101
Page 3 of
Location Address or Lot No.
D
etenninatioiz or Seasotzal Hi li W ter Ta le
Method Used:
inches
❑ Depth observed standing in observation hole iinches
❑ Depth weeping from side of observation hole
es
❑ Depth to soil mottles inches
El Ground water adjustment
Index Well Number ...
Reading Date ..... Index well level
Adjusted ground water level .. .
Adjustment factor
D Cdn�t r-iv�J — 51rz• A�1Ac�u?- 7`D
De th f N t rall Occurring Pervious Material
Does at least four feet of naturally for the soi abso ptionervious risystemal ?in all areas
observed throughout the area proposed
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on iU� /9g�(date) I have passed the soil evaluator examinatior
approved by the Department of Environmental Prrotection training,and
that
expertise and above
an.ence
wes performed n 310 me CMR 15 01 consistent with the required
described i
Signature
ate ec.. S, 1�q6
DF.P APPROWD FORM-12/07195
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/ PI7 FORM 12 . PERCOLATION TEST
Page 4 of 4
t
Location Address or Lot No. l �' D�i/ZA� C°✓g
COMMONWEALTH OF MASSACHUSETTS
13Aa146rA61,6 , Massachusetts
Percolation Test*
.Date: Time:, io A+v,
Observation Hole #
Depth of Perc
5
Start Pre-soak
End Pre-soak
f Time at 12"
i
Time at 9"
Time at 6"
Time (9"-6")
Rate Min./Inch
minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed Site Failed ❑
Performed By:
Witnessed By: cV rj
Comments:
DEY A"ROVPD FORM•1210119f