HomeMy WebLinkAbout0055 BILTMORE PLACE - Health (2) oo-I
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Department of Health,Safety,and Environmental Services .
Public Health Division Date ��
367 Main Street,I lyannis MA 02601
lUNWANA }
1° Date Scheduled 5'- ,`r Time 14 Fee Pd.--�.o-r�
Soil Suitability Assessment for Sewage Disposal,
C is LA Witnessed By: S�)ty bQ/NN1 N U
. Performed By: 'L�hl i�I— �- -
OCATION & GENERAL INFORMATION :: ..
ass Owner's Name _Cl- rim- '$I1013 -V..
Address 'Erb •Pl NC EyT
M-M 1��SC�1zV, Ml'\ 1p. WC-.`<^^0.�1
Assessor's Map/Parcel: i 1� �—1,,c p e-T c'•l Engineer's Name'�jt�JN �J� Ci�(r\N
NEW CONSTRUCTION REPAIR 1�`7 V O1 O Z� Telephone t1 j06. 3b'L-�I�N
Land Use • �'/t-e A ri') Slopes(%) Surface Stones
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Drainage Way ft Property Line ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes dt:pere tests,locate wetlands In proximity to holes)
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t�I t-0C-�
VA
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/w 4A/1h. 4Ar�. G�-�S Depth to Bedrock �O
Parent material(geologic) ,r���i
Depth to Groundwater: Standing Water In Hole: Weeping from Pit Pace
Estimated Seasonal High Groundwater r--- /J/A
DETERMINATION FOR SEASONAE'HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: In. Depth to soil mottles: in.
ft.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment
Index Well N__.. -Reading Date:_ Index Well level Adj.factor Adj.Groundwater Level
PERCOLATION TEST
Observation TIA—L Time st 9"
Hole a
Depth of Pere TD P 5� �r Time U 6"
Start Pre-soak Time Q Time(9"-6")
End Pre-soak ..
Role Mln./Inch
Site Suitability Assessment: Site Passed_V Site Failed: Additional Testing Needed(Y/N)_V
Original: Public Ileallh Division Observation Hole Data To Be Completed on Back--�
Copy: Applicant
1101e# �
U135l:ItVA'1,10 ROLE LOG Sail other
I)I�,LI'
Soil(USDA)
Soil Color Atollling (Structure,Stones,tlouldcrts.
Ikplh from Soli I lorizon (USDA) (Munselq •
Surface(In.)
t.� 2•ti� b/-t-
2�`1
3 0 i % rq V. s
1
N r�� /w/�SANS 2•'S -7/3 Ar
cby- I Og G"t-- MI� gAN 2 Y
Z G'� MIr SAND �.-yy'713
A101e#��-
other
pki rm 0 sr"ItVATION 110 soi��� 4011 mottling
(Structure,Stones,Boulderes.
SoilIlorizon S (Munscll) M
Depth from (USDA)
Surface(in.)
r
M�3� to /o S
CIO C�l M/F 4hNn Z-sy7j logo
l H
1''J
1[ole# -
sou other
U J r s 013S1:IZVA'I'lON I IOLC i���' Mottling (slruClore,Stones,Doulderes.
lorizon L(U
xture unsell •
m Soill A (M )
Ucpth from )
Surfnce(In.)
.�
1101C#
ULLI' 013SL1tVA`1'ION 11ULC LOG Sou utlrer
soil'fexlure Soil Color
soil I lorizon (Munseli) Mottling (Structure,Slog es,Doulderes.
Depth from (USDA)
Surfnce(In.)
r
Yes ✓
Above 500 year flood boundary NO—
Within 500 year boundary No
•� Yes
Within 100 year flood boundary No, Yes —
II Q rrrin Pervioul�
our feet of naturally occurring pervious material exist in all areas observed throughout the
Does at least f G
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material?�--
• p �q� (date)(have--passed the soil evaluator examination approved
by pme consistent wills
certify that on N V at
Department of[environmental Protection nceldeslcr described 310aCMR 15S017fo
expertise and e:t .rl.
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