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HomeMy WebLinkAbout0017 LAUREL AVENUE - Health (2) Ir1 �UY� AJevtue ,Ceni-e�uill� aat� Jo�c, 7/ � / ��� SOIL EVALUATOR& PERCOLATION TEST FFORMS ��tNE 'Town of Barnstable AAIRMAN 9. 1 Department of Health, Safety, and Environmental Services MAW 1639* 6 Public Health Division 367 Main Street, Hyannis MA 02601 OMcc: 508-790-6265 r-AX: 509-775-3344 ulla,��llll f�.SSCSSll1 ell t for SC f ra e' .DIS osall soil S v ASSESSORS MAP Na` 2 PARCEL No- 7 Date: 9-2 7' � NO. 4 !I- 7 - 9& �t Date: ' Performed By: Witnessed By: �- PE 4.. Owner's Neme I.acnlion Addres. / r r • Address,and JJ Loth: /? Zr2/ 053 36X 67 �f A16� 5�/ 0:5461 Assessor's Map/Parcel: Telephone P ��,� O D ,, i1 O � �.rgoz - 5z4-i803 NEW CONSTRUCTION REPAIR P ffice Review Published Soil Survey Available: No Yes Vol Year Published 3 Publication Scale /,ZS pDy Soil map unitCA��r'��Rr+ -f • Drainage Class �xcc�SS„i� Soil Limitations Surficial Geological Report Available: No Yes ✓ Year Published . I �d 6— Publication Scale Geologic Material(Map Unit) &Fh^ltJCr/�fS[ c F'GAaic� l�N�osifs Landform Gr S Flood Insurance Rate Map: Above 500 year flood boundary No ✓ Yes Within 500 year boundary No Yes ✓ T/� f 16AGH Alz4Ed Within 100 year flood boundary No Yes i,- Mo(,-J6 Wetland Area: National Wetland Inventory Map(map unit) /7U Wetlands Conservancy Program Map(map unit) Gyt' Current Water Resource Co�}ditions(USGS): Month !0 136f Range: Above Normal V Normal Below Normal Other References Reviewed: U� QV" AgeT DEP APPROVED FORM-12/07/95 Arc Dc-CV 72T,!r—1 Z,0 c4-To a/v M 0.2. 6 page On-site Re Deep Hole Number .......I Date: 1�71W Time: Weather .... . . Location ;identify on site plan) .. .. ............. .. .. ... ........... ................. ... Land Use Slope Surface Stones . ....................................................................... ... Vegetstion.....-/ 1.4 it .............................. .. . ...... .. ..... .......I................. .................................... Landform ......... . ...................................... .......... ....... ....... Position on landscape (sketch on the back) ' .. ........ ..................................................... ..................... Distances from: it �S&1-7tW&-A Open Water Body -300. feet Drainage way feet Possible Wet Area feet Property Line ....... feet i131 Drinking Water Well -Mll)- feet Other D EP OBSERVATI HOLE LOCY Depth from Surface' Sail Horizon Sail Texture Soil Color Soil Mottling Other !Inches) IUSDA) (Mumall) 18tructurs,Storm,Boulders, Consistency, %Growl) 0 312- Yr. 7 0 C 2 011W �r- �16 32 Parent Material (geologic) . ..... ........................................ Depth to Bedrock: .......... 1202th to Groundwater: Standing Water in the Hole: Weeping from Pit Face. Estimated Seasonal High Ground Water: 116 (Y6190" FORM 11 - SOIL LVALUATOR FORM Page 3 of 3 Location Address or Lot No. Determination for Seasonal Nigh Water Table Method Used: W►T1f uJ 3©o ot=SA-c-r yr ArS� - Sic W AiE2. L G-uGt. ❑ Depth observed standing ii p gin observation hole....1/�.. inches ❑ Depth weeping from side of observation hole.... inches ❑ Depth to soil mottles ....&J1 inches ❑ Ground water adjustment ...Nfl .. feet / Index Well Number, .< Z y Reading--Date ................... Index well level...... (. Adjustment facto Adjusted ground water level ..........�.4../..A/6..UD.Z� 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? W-5 If not, what is the depth of naturally occurring pervious material? Certification I certify that on MOO. /993 (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(322IJIuumcl)ate 7 q� DEP APPROVED FORM-12/07/9S COMMONWEALTH OF MASSACHUSETTS �1 Massachusetts Percolation Test Date: 7 cl b Time: .................. ..... Observation Hole # Depth of Perc Start Pre-soak End Pre-soak �J Time at 12" Time at 9" Time at 6" Time (9"-6") Rate MinAnch Site Passed LJ Site Failed ❑ Performed By: RONALD J.CADILLAC, PLS, RS Witnessed By: '�� ' e h' Comments: ... ....._. . ..... .. . ..................... ... .... . ............... .