HomeMy WebLinkAbout0051 BILTMORE PLACE - Health (2) CtCe Cn �rv,l)
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Department of Health,Safety,and Environmental Services
Public Health Division Date Zz - g
'"t•� 367 Main Street,llyannis MA 02601
SAAMAISM
A, Date Scheduled G Time.�F1�$—�, Fee Pd. 100
Soil Suitability Assessment for Sewage Disposal
witnessed By: � -`� �y!`�NAt-A C7
Pesfonned By:
LOCATION GENERAL INI±ORMATION
Location Address LET `+ AT J HT-• M\�N 1-N Owner's Name 3 Shot. "tome 11.tom'
Address
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.3 P � /�1.M�.�1, GEN 'f� ti�-t-� /w�
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' Engineer':Name jbw►•► CA4"i, G'iJ(A N
Assessor's Map/Pucel: 1-1Y—7.x V I tl�L 100-1 I x I I—� Telephone A 50�
NEW CONSTRUCTION '� REPAIR I
Lend Use
Slopes(0/0) 0^ 10 Surface Stones
Distances from: Open Water Body tl Possible Wet Area
ft Drinking Water Well fl
Drainage Way
n Property Line R Other R
SKETCH Street name,dimensions of lot,exact locations of test holes do perc tests,locale wetlands In proximity to holes)
M N T-0 r,j l._•A N C—
a�\ �IH-oe1
%90
LC—NTt`TZ%J 1'-LA.
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(�5 G,�AN� Mottft• 05t fS Depth to Bedrock^ z oD • —
Parent material(geologic) �"�
Depth to Groundwater: Standing Water In Hole:
Weeping from Pit Face
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE"':-"'
McQiod Used: in. Depth to soil mottles: In.
Depth Observed standing in obs.hole: In. Groundwater Adjustment ♦t.
Depth to weeping from side of obs.hole:
Index Well level ,__._ Adj.factor Adj.Groundwater Level
Index Well a__ .grading Date: •-
.. .... .. . . . .... ..
PERCOLATION TEST tide . 26 Tithe
Observation "'r'F} \ Time at 9"
Hole M
Depth of Perc �� &t7 ,` Time at 6"
Start Pre-soak Time Q
Time(9"..6")
End Presoak
Rate Min./lnch /
Site Suitability Assessment: Site Passed y Site Failed: Additional Testing Needed(Y/I� N
Original: Public Health Division Observation Hole Data To Be Completed on Back-�
Copy: Applicant
I)h,�l� OIISI;IZV11�1'ION IIOLC LOC Soil other
.Sall'I'cxture Soil Color
Ikpllr 6om .Soil Ilorizun (USDA) (Munsell) Mottling (Structure,Slants.moulderes.
Surface(in.)
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2- C b�3 o1oo.c r,r.a
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gLoAM "7/1 taw•vv�- LI cF
y lo0/c, �bb45 bo�� S
-71n� f• •la.
11010#,�12-
DE,EP OBSE"ATION 11 Soil Lou ., Soil other
Soil Texture Color
soil I lorizon (Munsell) Mauling (Structure,Stones,Doul ercs.
1)cpth from (USDA) (M
Surface(in.)
O'
2 Or `
C
L 5 Z �y c/2
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2`-1'4g SA ��I too C. LL b \d S
MIF C AND
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UfI:1' 01)SERVA'I'ION 110LC LUG Soil -;ner
Soil'rexture Soil Color Mollling (Structure,Stones,Doulderes.
Depth from Sol)(lorizon (USDA) (Munsell) •
Surface(In.)
---------------
hole#
DELI' OBS1✓IWATION 11OLt LOG Sail other
Soll'rexture Soil Color
Ucpth from Soil I lorizon (USDA) (Munsell) Mottling (Structure,Sto�es,Doulderes.
Surfncc(in.)
r
Above 500 year flood boundary No— Yes
Within Soo year boundary No Yes —
Within too year flood boundary No Yes
( [ ' 1 mall Q rain Pervious Matgtl>!1
Does at least four feet of naturally occurring pervious material
5 rial exist In all areas observed throughout the
area proposed for the soil absorption system? ___�__._—
If not,what Is lire depth of naturally occurring pervious material? `1
b the
1 certify that on V (date)I have passed the soil evaluator examination approvedY
I))cpartntent of Environmental Protection and that the above analysis was performed by me consistent with
the rr(Mired Ir:': expertise anti rynrrience described in 310 CMR 15.017.