HomeMy WebLinkAbout0063 BILTMORE PLACE - Health (2) to , I rnor� �1ace` I vrI
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Department of Health,Safety,and Environmental Services
Public Health Division Date �"-
d
� 361 Main Street,llyannis MA 02601
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Fee Pd. 1 �
toys I, Date Scheduled_ — l /,� - Time
Soil Suitability Assessment for Sewage Disposal -
Performed By:
Witnessed By:
LOCATION & GENERAL INVORMATION
cati4Arcss q N4Y, L,JmbS Sw$) Owner's Name 8Tt15�i-$jio5.l�—V. eCJ(t�
V -b1 LT J�OSti"� 1�I.HGF Address 50 1�1 ri ei 1
Assessor's Map/Parcel: et• L- Engineer's Neme 'j p�r0 p�1 Cfj GN(TW.
NEW CONSTRUCTION REPAIR --r— `�(}v,I�Z Telephone p 5076 36'Z L}5"
O"1 O Surface Stones
Land Use \Y/'�� _ Slope!(/o)_ ,
Distances from: Open Water Body R Possible Wet Area tl Thinking Water Well a
Drainage Way It Property Line fl Other 8
SKETCH:(Street name,dimensions of lot,exact locations of test holes dt perc tests,locate wetlands in proximity to holes)
0
A
�011"
L.oT
r
�JC r8s&0
�.M .�s �st
Parent materiel(geologic) Depth to Bedrock QS�''�5�
Depth fo Groundwater: Blending Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater f�i/A ^10
DETERMINATION FOR SEASONAL;MGH WATMR FABLE
Method Used: In.
Depth Observed standing in obs.hole: in Depth to soil mottle!:
.
Depth to weeping from side of obs.hole: In. Groundwater Adjustment tl•
Index Well N_ Reading Date:_ Index Well level Adj.factor Adj.Groundwater Level
PERCOLATION TEST "'1)r1e , 5. 'T6`77tttro
Observation
Hole M Time at 9"
Depth of Pere 7ye `p ~0 Time at 6"
Start Pre-soak Time a c5 ►^ 13'.(D Time(9"-6")
End Pre-soak J
Itate Min./inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)_/
Original: Public Health Division Observation Hole Data To Be Completed on Back--�
Copy: Applicant
11ole 0 "M
0II0(:1C A'I'ION 11OLC LOG Soil other
Soil Texture Soil Color Structure.Slopes,noulderts.
Depth from Soil l lorizon (USDA) (Munsell) Mottling (
Surface(in.)
r
-.%;y6/q
L1-3v �
M/F tih�� Z_5. AIL
30 .?2 t'i 1 1,00/0 fm
L� M/f SAID 2-`'� 1�
1101e# ` Z
lll;Cl' OUSE WATIO IIOLC sou other
Soil Texluro Soil Color
Mottling (Structurc,Stones,Doul arcs.
Depth from Soil I lorizon (USDA) (Munsell)
Surface(in.)
O r .C- —
� t,5
z-� L 2-� / bwl
H-" cv 3 5
�� Mlr- SANS z •�� �l2
3o-�Z °
CANS
$H— 174
L17 /`At 5A
------------
Lole"
. .Ull;l' C113SCItLOSoil'Texture Soll Color glroclurc Slone$,Doulderes.i)cpllr from Soil Ilorizon (USDA) ( •
Surface(In.)
F.
1101C#„_`______
llGCI' OIISLItVA'1'10N 110LC.LOG Soil Other
Soil'rexture soil Color
Ucpllt from Soil I lorizon (USDA) (Munsell) Mottling (Stnrclurc,Slo�es,potrlderes.
Surfnce(in.)
r
�� s Inaurence Rste Mom:
Above Soo year flood boundary No_ Yes —
Within S00 year boundary No Yes —
Within 100 year flood boundary No_ /
Yes
rrrin Pervious M>l�llgi
Does at
least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material? (.._�-
.,
`�`� have passed lire soil evaluator examination approved by the
1 certify that on
1/ (date)I
1)epartnient of Environmental Protection and that the above
nalysiS CMR I s pe formed by me consistent wit t
rhr rr(mired Ir-: expertise anal eynericnce described n 3I