HomeMy WebLinkAbout0121 OLD POST ROAD (CENT.) - Health (3) C�+er��u�
Town of Barnstable
Department of Health,Safety,and Environmental Services
t„ Public Health Division Date & -3 0- 51 7
o+ bra,
Sl. . 367 Main Street,Hyannis MA 02601
MAM
� u�rrat�eeus, r '
1. Date Scheduled l/ - f+ Y- n 7 Time�n" M Fee Pd.—ILL—
Soil Suitability Assessment for Sewage,Disposal
Performed By: t e l4 Witnessed By: � ''t"f 1)V�I�J 1
LOCATION—:GENERAL INFORMATION
Location Address Owner's Name EQIZt_ WI L-t-I A-W
T612A11 t-.CZ-- Address
��a�,�(s1b6 13vt/-�11JG
Assessor's Map/Parcel: Ix)7-O '00-3 Engineer's Name T(- 0 4I LT- fkt—
NEW CONSTRUCTION V REPAIR Telephone# ¢�" 113
Land Use Qmi1t:,eq'(A-L— Slopes(%) 6-6 Surface Stones O
Distances from: Open Water Body ft Possible Wet Area S ft Drinking Water Well — ft
Drainage Way ^ ft Property Line 7o ft Other It
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands In proximity to holes)
per- 20 kC)
qN
140 1 q)
by 47-
M
o� Z
Parent material(geologic) IWA-5N Yt AO 'N l Depth to Bedrock
(fit
Depth to Groundwater: Standing Water in Hole: Otf s Weeping from Pit Face
Estimated Seasonal High Groundwater
DETERMINATION FOIL>SEASONAL HYGH WATER TA16LE
Method Used: in.
Depth Observed standing in obs.hole: in. Depth to soil mottles:
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
� ime :In +t-w
Observation Time at 9"
Hole# I
44 1t
Depth of Perc Time at 6"
Start Pre-soak Time® V OBL Ia.. 4ATLW4M Time(9„-6„)
End Pre-soak 1 JL Aar
Rate Min Anch J 1 I IId GM L l/J /Llf�lj
Site Suitability Assessment: Site Passed V. Site Failed: Additional Testing Needed(Y/1)
Original: Public Health Division Observation Hole Data To Be Completed on Back—�
Copy: Applicant
UI:E1, 0I3SERVATION HOLE LOG 1I0le# ►
Soil Tenure Soil Color Soil other
Depth from Soil I lorizon (USDA) (Munsell) Mottling (Structure,Stones,lioulderes.
Surface(in.) °
Ya
7— gat Sam �C) � 9 a/a 6
HOLE ��
DEEP Of3SEItVATION E LOG Holtz# ':
soil Color Soil other d
Depth from Soil I lorizon Soil
(U DA)Texture (Munsell) Mottling (Structure,Stones,Doulderes.
Surface(in.) °
. . .. . . : ....:.:....:..:. ....
DEED OBSERVATION HULL LOG ". hole#
Soil other
Dcpth from Soil I lorizon Soil Texture Soil Color
Mottling (Structure,Stones,Doulderes.
Surface(in.) (USDA) (Munsell) ° �Il
DEE11 OBSERVATION HOLE LOG Mole# _�
Soil other
Depth from Sail Florizon Soil'texture Soil Color
Mottling (Structure,Stones,tioulderes.
Surface(in.) (USDA) (Munsell) Conslslency °
Flood Insurance Pate Map:
Above 500 year flood boundary No_ Yes—Z
Within 500 year boundary No Yes
Within 100 year flood boundary No Yes
Depth of Naturally occurring rring Pervious Materla
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 MN 199 (date) I have passed the soil evaluator examination approved by the
Department of Envirntal Protection and that the above analysis was performed by me consistent with
(lie required training,expertise and experience described in 310 CMR 15,017.