HomeMy WebLinkAbout0102 LAKESIDE DRIVE EAST - Health (2) 7
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Town of Barnstable P#
f ,^•� Department of Health,Safety,and Environmental Services
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� %—�� 'Public Health Division Date -
p� 367 Main Street,Hyannis MA 02601
Muss.
�Foµ. at Scheduled- Time /0 -Awn Fee Pd.I n 7
Soil Suitability Assessmen for Sewage Disposal
Performed By: �/`f/��G j��/ �� � 'a0�� Witnessed By:
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LQCATION&GENERAL INFQRMA 'ION. .
Location Address p Owner's Name M,Q e Ov>j
C��NT Y/ALE Address 73,76 1-W-f NQ2MA?,v.
4/f G�t�i f/f FL 3341b7
Assessor's Map/Parcel: S _ j a Engineer's Name �NiYETr/����
NEW CONSTRUCTION REPAIR Telephone# fl� �j
0
Land Use �1z)6;1 V q L Slopes(°/a) CS6 Surface Stones �/✓�
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Drainage Way 0641,4 ft Property Line ft t Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes)
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}-tcxzs�# 1 DZ
log
ol 1� vQ -
Parent material(geologic) / � F/uDepth to Bedrock
Depth to Groundwater: Standing Water in Hole:404E N aaveeping from Pit Face
Estimated Seasonal High Groundwater
........ :.....:..::.:::::......; .:............:..._............... :......::.......:....:.... .......::::::::::::::::::::::.
t A ON O S ASUNAt HYO >'V ATEt2'Y'A < >:>> .;::>::.....
............. .. ..:. ........ .:.......................................:..:...............:..................::.::.:::.;::.:::.;:.:;.
Method Used:
Depth O served standing in obs.hole: 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_
.:: . .
.; LAT-10 E Tt ttt c:......: :>.............
PERC
Observation
Hole# Time at 9"
Depth of Perc J c 7S Time at 6"
Start Pre-soak Time Q ��9��,� Time(9"-6")
End Pre-soak W 'p
Rate MinAnch <a mml Pw`Nrw
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
DEE1.P UBSETtATIUN�Il7LE LAG H0Ie# _
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistencv.%Gravel)
(%d 0,05" /g �S�/7 / � ��/ /vo-/Ve- �S.y<►r� WTt/ITS.
ay
-F
...........--..........
............ ...............
.... ...... ..................
................................. ........... ...........
....................................
DEEP UB:SERVATIUN HQ,LE LOG Hole#.
:
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
oGravel)
G��l a� 577/Yli
. DEEP UBSERATION DULL Y,( G Dole
..... .::. .....:::......:... ................:..... .... .::..:..:...:.
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.%G
DEEP OBSERVATION HALE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistcncv.° Gravel)
Flood Insurance Rate Maw y►
Above 500 year flood boundary No— Yes /�'
Within 500 year boundary No yypp Yes
Within 100 year flood boundary No /Y Yes
Depth of Naturals 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
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on /1 H W (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 training,expertise and experience described in 310 CMR 15.017.
Signature �-f Date
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