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HomeMy WebLinkAbout0103 LONG BEACH ROAD - Health )o� 1,� �C��� I�v� , � -�e„�vi�le �u �. Town of Barnstable P# 932 y Department of Health,Safety,and Environmental Services �VV Public Health'Division Date 367 Main Street,Ilyannis MA 02601 BARNBrABIF : - n+Aas. ' Date Scheduled Time / '!�6 Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: !,, gmg-s �aNGVq� , P�rf� Witnessed By: if-gtl To w tpJ L,tGATIQN& NERA INFORIV�ATION Location Address Owner's Name AUT2AU W� L°K� 66A6H V-p Address o G�IJ-r04VIU,6) M!A JO�, L.oNG BC-Au-F <zp Assessor's Map/Parcel: c9-0 Engineer's Name t2G,G 4 V41)p I NEW CONSTRUCTION REPAIR x UP04A Telephone a 12A. &51• 7q b Land Use UlIlQeO-rIAV Slopes(%) C Surface Stones K)OtJr- 6 legUop Distances from: Open Water Body Z OV R Possible Wet Area R Drinking Water Well R Drainage Way fO R Property Line �~`'Z R Other R SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Gaw4 A!5,4a APP 1Jos� : �in��NOWA��L ApJ�g'�M�ctJ'( II 1�5f� 01569 6►J M IW.Zq . (/03 ► e\j(0J5t J A6C6M0 5EP11� VLAP FOL 112, fowl( OfA1,14 IW0 (PA"1, 41 MAO 20t9) 011 W 1't"bl 104 l� Parent material(geologic) f b(ZaG�I� OVTWASH Depth to Bedrock -7 0 b Depth to Groundwater: Standing Water in Hole: '7b Weeping from Pit Face AOIVO D�w1p; LJA9 Estimated Seasonal High Groundwater Y1T1✓T2NATIglr111: tJlt SASONA�,HYGT't? AT1 TAT3L «:: . .. .... ..::....... .... ...:: .. .. ..:...............> . Method Used: ......: Depth Observed standing in obs.hole: "' in. Depth to soil mottles: _in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment .A R. l 4ndex Well# 'Reading Date:_ Index Well level.-___ Adj.factor Adj.Groundwater Level ,;. PERCULATIUI'Y TEST Hate "' TttiteL� ' :. Observation y��/ V PA IF L! 16 Hole N Time at 9" Depth of Pere Z5 4ALL445 Time at 6" Start Pre-soak Time @ Z ZQ US fio W . Time(9"-6") End Pre-soak 9'ZeeQ �✓ (ul t l�J Uis Rate Min./inch GdM/'1 Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant ll� I' OI3II�IZA 101� HO .E L,G1G I�o1e Depth from Soil I lorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes. o Gravel) /o Y/L Y 3 luau, ` 1,4,11 e A.1s°A4-9�� NEo 5 p`f< s9A1a� �0 vEEP OBSERVATION HOLE Lt7G I�ole Deplh from Soil Horizon Soil Texture Soil Color Soil ,Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes. ° r �ole SCRA�tYbCou Depth from Soil Horizon Soil Texture Soil Color S011 Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Bouldcres. % r .. .: .:. .... DEEP:.OISE1tVATION HOLE LO.G Hale#. ... Depth from Soil llorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % Flood Insurance Rate Map: C�n�n�v�vir+' pA.v04` o?5UQ0/ eookD le"'S'OV Above 500 year flood boundary No_ Yes 2rj,�/F A 4 C61— Within 500 year boundary No Ik' 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 W,4412t-Z (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 mg,expertise/d experience described in 310 CMR 15.017. Signature w Date��- f'