HomeMy WebLinkAbout0032 CLIFTON LANE - Health (2) �� C Li`-gym s (cA
Town of Barnstable P# 9e S 2
Department of Health,Safety,and Environmental Services
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Public Health Division
t , 367 Main Streel,'liyannis MA 02601RNSTABM
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�rEetrtat'' �^�Date�Sclieduled ;5 --•��/O6, OD
Soil Suitability Assessment for Sewage Disposal
Performed By:SJ II►van r nq ncerl'nti -7�• Witnessed By:
V10
Location Address 3 02 n �, n / ,�, � er's Name TQrne -uSfQS
9 Frost Area/. °
edes<t /�t�Qnni's�oor�, mA ' Address W. V-fMVud ; M+Q. atti73
Assessor's Map/Parcel:y~/)')Qp a-.rat 00/ Y Engineer's Name Pef e f' S+�l/iYQm Pt
NEW CONSTRUCTION A, REPAIR Telephone H 50Y' y"'3.3 41
Land Use Qr=5 t 0 C-L Cl A L Slopes(%) 106 Surface Stones aw-L E.
Distances from: Open Water Body ft Possible Wet Area 1�� ft . Drinking Water Well '� ft
` � 1 v ,
Drainage Way ft Property Line %d ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of lest holes&pert tests,locale wetlands in proximity to holes)
34 TIC. ;T�, J TACO
• 'T 2 Z .. .
P� 6 JTAC.
C
330 _
Parent material(geologic) C)(��u.gSH `C L.1"N Depth to Bedrock ���yea—,—, �L 0 S
Depth to Groundwater: Standing Water in Hole: pv S Weeping from Pit face
Estimated Seasonal High Groundwater
SEASONAL ....:... ...
SC� .;:' '::::<:. ...:..;•::.:.:::..;.
....:
Method Used: I� `i / (.:.+kPC-iop Cc>�v.w.,k>°`•�vtv ,
Depth Observed standing in obs.hole: ?5 in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: 71T 8D 11 in. Groundwater Adjustment ft.
4ndex Well k _._ •Reeding Dale: �9_ Index Well level:2 Arll.factor Adj.Groundwater Level��',?j FT 4`� )
:.....:.:..::.... N EST:..........>::Dgte::>:.. e... :
::«: X. X
W,
xx ' <:€ : : <:.....PERC( LATLU ...'X' ............................... 14: .:
Observation T)A_i�
Hole H °.•Time at 9"
Depth of Perc I O r Time at 6"
SteitPre-sohk,Time®A;,, r ..V1 �l�^ atiS+.. l a i �:,r' Time(9 6")- 2rr.Y• , _ _
a _ •� w
E A Pre-soak L �. �^1 Z L ESS` a-,ora�(
a Rate Min./Inch
E E.#O OC A L < u L.47r10
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back
Cnnv: Annlicant
DnEP dBSI '�ATTON. CJ►Y� LpGnle# >1
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%
Wye 5/8
-9-66'$ tb�(te-�/b 2
...:...:........D....EEP` OBSERV TH N HOL LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil ur
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
oGravel)
'�---�"C7 C^ l L L,
p` Z C> `Q Np
`Z.- I c, A I S Ceres 6 Icr4 V-'s o ao � ��L A20-
16- It C,, 10y" 9 t4o T O
ge
?S
Dp OSRA'I'ION0 .��.U�;.
�.
: .
....... Vole
Depth from Soil Horizon SoitTexture Soil'Color �:Soil
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
DEEPOBSRVATION HOLE LOB Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%
Flood Insurance Rate Man:
Above 500 year flood boundary No— Yes
Within 506 year boundary"'` No-A- Yes
Within 100 year flood boundary No Yes
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? E S.
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on MIL S�S (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required trai ' ,expertise and ex erience described in 310 CMR 15.017. . A t fE7 F pe
ID) 1 1�9 US6 S w c��oFliD�
Signature Date �,p� e