HomeMy WebLinkAbout0055 GOLDENROD LANE - Health SS 601dewod LUC,Cafeid)lle
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Town of Barnstable P# V- 3,C-7
Department of Health,Safety,and Environmental Services
Public Health Division Date
367 Main Street,Hyannis MA 02601
MAM
Date Scheduled - / (, W %� Time 4,41 Fee Pd.
Soil Suitability Assessment for Sewage Disposal
Performed By: ea to Dvy/e-_�C Witnessed By:�So 4�rJl�rli.�!1 i
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LOCA,V0.* Adkxx
Location Address Ey y- a. Owner's Name
C,,®c.wd=� � (ems• ��'{')� Address _<,,o,rz: 44✓E.
Assessor's Map/Parcel: ,��I'- l �e Engineer's Name C�I-v Aj i tT 0'py1P
NEW CONISTRUCTION �_ REPAIR Telephone# jj��y�/'7Z✓r
Land Use /n/(7 Slopes(%) Surface Stones ,170,1 e-
Distances from: Open Water Body uT_ft Possible Wet Area ft Drinking Water Well 1119 ft
Drainage Way 'UIW ft Property Line ft Other ft
exact locations of test holes& erc tests locate wetlands in proximity to holes)
of lot exa ,
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Parent material(geologic) Depth to Bedrock y�
Depth to Groundwater: Standing Water in Hole: AIN Weeping from Pit Face
Estimated Seasonal High Groundwater 50_ �et— Qja.` r—
DTLlYA�YCIIO) SASUA ,An_ GUM— TBL
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Method Used
Depth Observed standing in obs.hole: in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: N/ in. Groundwater Adjustment ft.
Index Well# Reading Date: index Well level Adj.facto: Adj.Groundwater Level_
PER+COLAmIO1� TEST Date 1,me
Observation
Hole# Time at 9"
Depth of Perc �y ��U Time at 6"
Start Pre-soak Time @ Time(9"-6")
End Pre-soak
Rate Min./Inch Got �SU4;&1e YZ7 GOeet3sre
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Al
Original: Public Health Division Observation Hole Data To Be Completed on Back--
Copy: Applicant
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BEEP O$SER`�ATtOiIOYL+ �.OG <HnYe# '
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulderes.
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DEEP OBSER'�ATION HOLE L! G Hole# „
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(m.) (USDA) (Munsell) Mottling Structure,Stones,Boulderes.
%
1EEP OBS;ERVATION HOLE�dG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulderes.o
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DEEP OBSERVATION HOLE L0 Hale#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(m.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%
DEEP bSSERVATIC)N IIOLE I,0G
Depth from Soil Horizon Soil Texture Soil Color f Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure Stones,Boulderes.
Consistency,°
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