HomeMy WebLinkAbout0053 CLIFTON LANE - Health (2) CI;fiisii LcAe- C 4c D u i Ile-
4-7 ��
Town of Barnstable P#
Department of Health,Safety,and Environmental Services
DIME Public Health Division Date ZZ/T
367 Main Street,Hyannis MA 02601
BAMSTABM
MAS& I
'prEo 39. Date Scheduled 5 Time . Fee Pd. 00
- Soil Suitability Assessment for Sewage Disposal
Performed By: I\6UA I J J CAA �� S Witnessed By: POIVtUA ' "`l on4 j
......... ..........._...__. _......... ........_.,....... ...__......,....... .,....................... ...................,. . .__... .......... ...........
LOCATION & GENERAL INFORMATION
Location Address $ a,Z�4'1
Owner's Name : 7 4 ST5" 1�E/} 4
Address �j C�� /lJ
Assessor's Map/Parcel: 247/ 15 � Engineer's Name R . , `;4d1JA
NEW CONSTRUCTION REPAIR Telephone# 62o6 — 775-q 76
Land Use Ya.iZ_p Slopes 474Surface Stones Wo
r
Distances from: Open Water Body F ft Possible Wet Area 110 ft Drinking Water Well ft
Drainage Way 4 13 _ft Property Line 10/ ft Other ft
I
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
✓TME
17
i
i
V o�
Parent material(geologic) BArv(/Abe? gQt/t?S Depth to Bedrockp
Depth to Groundwater: Standing Water in Hole: 6b k Weeping from Pit Face Ill Ifl
Estimated Seasonal High Groundwater 3zrl P 6 6 6r
_..... .......... ........................ .......... .......... . .......... ....... ................. .............. ...... ........
DETERMINATIOl t FOR'SEASON'AL G�T't?VATEYt TADLE
/:. _ .
Method Used 8 0�'� ey i O .yC,p,.r. h r7 /�G l..(.P Av'/14P r
Depth Observed standing in obs.hole m. Depth to soil mottles: u
al
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well# _ZCA Reading Date: 1_ tr Index Well level =fJZ Adj.factor_ Adj.Groundwater Level '2
PERCOLATION TEST: Date I tmebv
Observation J a
Hole# / Z Time at 9"
Depth of Perc Time at 6"
Start Pre-soak Time @ i/v Time(9"-6")
End Pre-soak q.,3 J:4 0 24 6AIy d A)
Rate Min./Inch Z 22nSZ-�, jw(
Site Suitability Assessment: Site Passed Vol' Site Failed: Additional Testing Needed(Y/N) Al
Original: Public Health Division Observation Hole Data To Be Completed on Back j
Copy: Applicant
r
DEEP OBSERVATION HOLE LOG Hole# /
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency,°o ravel
D/3 '' Iq /oyr3 z d'20
/vyrs /70
/O p^S
0
DEEP;OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Tv Consistency,°o ravel
S ff 0
.
.DEEP<OBSERVATION I U LOG
Hole#....:'.
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.°o ravel
..DEEP OB.SERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.%Gravel
Flood Insurance Rate Map /
Above 500 year flood boundary No_ Yes
Within 500 year boundary No— 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? 1/FS
. y
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on 4)0d, (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 ln' ,expert'se and perience described in 310 CMR 15.017.
Signature cr,` Date �'/
RONALD J. CADILLAC, PLS, RS
Professional Land Surveyor
Registered Sanitarian
P.O., Box 258, West Yarmouth, MA 02673
(508) 775-9700
HIGH GROUND-WATER CALCULATION SHEET
Locus 53 C i-rt.1 N L Date of observed water S/7 99
Depth water observed below ground q 2 "
Well Zone C Index well mAsh zq Reading B.Oz Month of Reading
U.S.G.S.(Frimpter) djustmert"for,maximum-mundwater�
Well used below(usually same r4 PcS k Vl Date of Observation 2b c19
8 of. 10 year high reading ��71 (from data below), Zone well is ink.
Years highest reading & month (cross out two high readings in 10 yr span)
(record next-highest reading above)
1 119 �1�1 -7, 8 G f' l L,4 (data represent distance below ground)
3 1616_ �4 7
r
4�,ci 7, i6Z 18 7 '�6T' i
5 61/-13 9-}cq
Current reading ,D� _minus 8/10 yr. high 6 F = ad'ustment l.. for_Zone
Well Zone Adjustment: (Frimpter Adj. Zone x ,3=(8/10 yr. Adj. Zone x)-L 45
(For locus if needed) (Frimpter Adj. Zone ),I I = (8/10 yr. Ad'. Zone y) C
. � a 1 b yr1-45��3,�1 Z,
Hipth' round-Water Elevation definition fr m 310CMR 15.002 a and - The
elevation above which in eight out of ten consecutive years the ground water table
does not rise."