HomeMy WebLinkAbout0015 MINTON LANE - Health (3) S boom Lane,C"W u ilie
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Department of Health,Safety,and Environmental Services
Public Health Division Date
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� 367 Main Street,Ifyannis MA 02601
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►e>� Date Scheduled !F -a b Sj Time--�—
Soil Suitability Assessment for Sewage Disposal
Pett'otnled By:
r.J\E t- A- OJ/-%s LA Witnessed By: J C—fZ-IZ`f -L,,J N N te,
LOCATION & GENERAL:INFORMATION
Owner's Name 'P6v. LWO
Location AJdres's LC;IT '\ M I N-M N L-A\"1 E
3 N 5'�rh3tC W m0IAS Address 5c9 'P 1NC- ST- S_WC-YM•
LLK NTFf1-\J\\-"
Assessor'sMap/Pucel: 1- LA x 1 �-�, j '00-7/01(pEngineer'sNano -Vpwa �- CN6-W
NEW CONSTRUCTION ✓ REPAIR Telephone# 5000 25"- Ht5u I
o Zp Surface Stones `^'
• • Lend Use V�"C-A•N'r� t�To o�S Slopes(/o)
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Drainage.Way ft Property Line ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes et pere tests,locate wetlands In proximity to holes)
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2S
,23
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+2 ZOO _..i i
ON
0 0 �, 27'
- J l
Parent material(geologic) QS/^ SAND. MORR•�R$o`�`'�S Depth to Bedrock GOO
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater '1v11 . /V O
DETERMINATION FOR SEASONAI:HIGH WATER TABLE `
Mcthod Uscd: �_ in. De th to soil mottles: In.
Depth Observed standing in obs.hole: P
Depth to weeping from side of obs.hole:
In. Groundwater Adjustment ft.
Index Well#_ •Reading Date:_ Index Well level„•___ Adj.factor Adj.Groundwater Level
PERCOLATION TEST tide': 481Ime )o
Observation 'Lj
Hole 0 Time at 9"
Depth of Pere �- O Time at 6"
Start Pre-soak Time Q �y�� �" 3•�Z Time(9"-6")
End Pre-soak
Rate Min./Inch
Site Suitability Assessment: Site Passed ✓. Site Failed: Additional Testing Needed(Y/N) //
Original: Public Ileallh Division Observation Hole Data To Be Completed on Back---�
Copy: Applicant
110le#,..J
tVA'I M 110 Ci LOG Soil other
I)I�,�l' OIISI;1
Soft 1'cxlare Soil Color Mottling (Slruclure,Stones,nouldetes.
I)cptir from Soil Ilorlxun (USDA) (Munsell) •
Surfaee(In.)
p-2 v
15
"3 i°`((`-70
G( 5,4N Dy LOAM
°\i IM1- 7 I-..
1101e#, 1.'1
1101J� 1.,C3(►~` other
UCCr C10S " t'VAT10N Soil Color Soil
Soil Texwro Mottling (Structure,Slone'.
Douldercs.
Soilllorizon S (Munsell)
Depth fr om (USDA)
Surface(If.) �fit'=n.C—r�C'�
14
V,Nyv�Ta�tiE
C L�
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rcal5A1V'f UW In t^.�/ti vrti��')ab� l��gh c\ay GQti+ 7
3_____. Lti MILT (0` 7(I 11'D 1
60AV
It' a#_ �?
Dr, 1.1' oils , RVAT1ON 110LCi,00 Soil stones,Douldercs.
Soil TcOlte Mottling (structure, •
pcplh from
SoilIlorizon (USDA) (Munsell)
Surface(in.)
E
1,5 ri.-�Y b�ti I ce�v o��P�•l�cobb44
MlF 5AHD 2-t�" 6�y
AtJD
lam_
1101c# `
CLI' 01BJ ri tVAT10N 110L1; 1 OG Sou other
ll Soil Texture m Soil Color Mottling (Structure,Slonts,Doulderes.
Ucpth from Soil Ilorixon (USDA) (Munsell) •
Sulface(in.)
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,. roo�p �ond45 Vv�tN�jaV:.t
`Il�b LOAM 2-�iy7/`i
s `iNA -7I loop o rwYa-�
.7Z. G C12. Very �\va C
��F SAt✓D 2-sy$/I r
Above 500 year nood boundary Yes No�/
✓
Within 300 year boundary No Yes,
Within 100 year flood boundary No
✓ Yes
ry
ail occurring pervious material exist in all areas observed throughout the
Does at least four feet of naturally z, fi l�1
area proposed for the soil absorption system? G4 L
depth of naturally occurring pervious material?„_�--
If not,what is the C 41` q 5
by
i date I have passed fire s
certify tllat on oil evaluator examination approved consi the
� 1 I
'nv ironmenla{ Protection and that the above analysis was o'�
Ow r�nnirctl It:': fonned by me stent with
Department of L
' � ise and evnrricnce describcll in 310 CMR .