HomeMy WebLinkAbout0016 CODDINGTON ROAD - Health (2) i(o ��ro-� Clei�11
low
:.t
r
x S
nn..,.
. t
- ;Flo 408 Y!
IAA 1 y
� t
� w n
r:..€k..�.Sr.ry'v`z+•s..# W' �..-r�. rT" MYw-a,.c>• 's.. �.a�,.`st.r"4s.,�..� ri ,4 x,.b } .
,, ` .
r /
Town of Barnstable P# P 3 9 0ri-
Department of Health,Safety,and Environmental Services
Public Health Division Date 3 - 107
367 Main Street,Hyannis MA 02601
% eARNareerE,
MAea q
0r •� Date Scheduled_ Z —'j- S — / 7 Time Fee Pd. t D o
Soil Suitability Assessment for Sewage Disposal
Performed By: c4 ✓' /g �. Witnessed By: JD v.-r•79 0 o W
LOCATION &>GENERALINFORMATION
Location Address 6 Owner's Name .w
Address
s,.•. , Yc.�Je� c� y3o�3
Assessor's Map/Parcel: -A a (9 09 S Engineer's Name �'�rcR.:y (•Fo
U
NEW CONSTRUCTION REPAIR Telephone# g oS S2 G 4 9 9/
Land Use /Z e S r Slopes(%) / Surface Stones N e
Distances from: Open Water Body 74 " ft Possible Wet Area 7S ft Drinking Water Well ft
Drainage Way �U 14 11 Property Line _> ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
T-n CAS Jd179r'&7
c @\
Q�\r
S 7`•--t c4
Parent material(geologic) Ca fe r epth to Bedrock N�!t
C ol .t3 1 a.
Depth to Groundwater: Standing Water in Hole: Z/ Weeping from Pit Face /U//�
Estimated Seasonal High Groundwater Z K r
..EA H H WATER TAB EDETERNHNATIONYOR S
Method Used. mSsrr:�Q L`io., re
Depth Observed standing in obs.hole: 2 in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level
PERCOLATION TEST Date J 9 ;Tie // ac
yL7m
�,q ,S .Sane( �.1C0 �rC� 4t be/ovr �4.raL@r'
Observation
Hole# I Time at 9"
Depth of Perc Time at 6"
Start Pre-soak Time cr Time(9"-6")
End Pre-soak
Rate Min./Inch I
Site Suitability Assessment: Site Passed L--"- Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back—�
Copy: Applicant
DEEP OBSERVATION HOLE LOG Hole# /
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.° Gravel)
7.1'Y12 �c
/2. L eoaw, 9 2
Coae,se l o YR
Sa1.k /Va
Q7r94"f( Cadr ��
. ..
DEEP OBSERVATIO.N HOLE LOG ;Hole# Z
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface`on.) (USDA) (Munsell) ( Mottling I(Structure.Stones,Boulderes.
-Consisten ° Gravel)
c4 r 7�s 32
z o,, c oars a n/o
vr9an� .
G7F,0—a t
7
DEEP OBSERVATION HOLE LOG Hgle_#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.° ravel
A
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 Gravel)
t
Flood Insurance Rate Map:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No Yes
Within 100 year flood boundary No_ Yes X,
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? A<s
If not,what is the depth of naturally occurring pervious material?
Certification
i certify that on n/AV 9'¢ IAMB'I_have passed the Isoil evaluator examination approved by the
V,,
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required training,expertise and experience described in 310 CMR 15.017.
Signature Date �3 T s^g 7