HomeMy WebLinkAbout0028 LAUREL AVENUE - Health (3) a� lol%
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]'own of Barnstable P N 8' Z!5E�
Department of Health,Safety,and Environmental Services
�Im Public Health Division Date 8 97
367 Main Street,Hyannis MA 02601
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Date Scheduled l q-/7 Time W 'JD A01 Fee Pd. c9C�
Soil Suitability Assessment for Sewage Disposal
Performed By: J ' CA 1�> I LkA4e_ Witnessed By:�]t_� V NA-)I/U6j
LOCATION & GENERAL INFORMATION''
Location Address Owner's Name 61 fz,"[H q J , I OM N61
4- 5 L 4L)Riv L A UG � Address 'F,>d, QO;K •Z. B 1
C(2A,1 G 111 LL. C-41- 'Noa:[IiBo"L)ej�l YhA
Assessor's Map/Parcel: 2 ZG 76 Engineer's Name 01 5.3Z
NEW CONSTRUCTION REPAIR Telephone# 5c8--775-q'100
Land Use Stir `C bWd1jp/�t Slopes(%) O Surface Stones No
f.t I )
Distances from: Open Water Body 95 R Possible Wet Area 4D R Drinking Water Well N! (t
DITLt{ I 141 lliZ
Drainage Way d It Property Line SI _i 1 n Other n
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
SCJcwu
l7� •_
xej
`Tli 2
Tttf 1
/ Parent material(geologic) (ui"J mk t' Depth to Bedrock Nil A.
�1 Tit i Depth to Groundwater: Standing Water in Ilole: 1"rt4 1_ Weeping from Pit Face N)A
�^ a i
Estimated Seasonal High Groundwater ,Y I
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Mcthod Used: O bSeirVC D DAI A 40-+ 3 T6S lS
Depth Observed standing in obs.hole: &C4't 1. $2-1� in. Depth to soil mottles: N,PF in.
Depth to weeping from side of obs.hole: N 1A in. Groundwater Adjustment I ' UWJ> R.
Index Well#_NJA Reading Date:_ Index Well level_ Adj.factor_!4� Adj.Groundwater Level_
PERCOLATION TESTWte18 ii cl1 Ttme`,t D
Observation Z j
I tole# Time at 9" AJl A
)I �l
Depth of Pere (bog vm) I 5 S Time at 6"
Start Pre-soak Time ZC, 12'.(m'.DU Time(9"6")
End Pre-soak `A p Env& 1 l°.3�;,1 O 12',,,�,�;,_45
Rate Min./Inch < Z' Yh IM <2'""�'�/tfJ
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
IDEEP.OBSERVATION HOLE LOG Hole# 1
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
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rt i� 1 kj ee l y r 5 j C, n O
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At
66iH H2O
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DEEP"OBSERVATION HOLE LOG Hole# 2
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.° Gravel)
Pe-tom C I ey- c,) .GW 1 D r 6/ n o 107,0 rcusP
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J�7 8Zlt Nzc)
� ZD t t �o�►-►-t
DEEP OBSERVATION HOLE LOG We#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.° Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil 11(uizon Soil Texturc 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? _
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on 000• C(3- (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 trai expertise and experience described in 310 CMR 15.017.
Signature _ Date 121