HomeMy WebLinkAbout0083 POND VIEW DRIVE - Health (3) 1
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Department of Health,Safely,and Environmental Services
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Public Health Division Date a - a V �
� 367 Main Street,Hyannis MA 01601
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16 Date Scheduled :;l: - ` Time_ D A.Aj,+ Fee Pd. 100
Soil Suitability Assessment for Sewage Disposal
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Performed By: C r a Z ' '5 a t'' Witnessed By: -D a2 rl 1 ^ / `3(o H
LOCATION &'GENERAL INFORINATION
33 �d•v D V/c vi. e Owner's Name 1L t 141
Location Address 9 3 Pam cy V/ a,A
Address C e•, L e: V i</G, �''
40 z
Assessor's Map/Parcel: '� �, "� - 0 -).3 Engineer's Name r+�, + Sri a�
p 8� ' 9 $ — g 3� �
NF,W CONSTRUCTION REPAIR Telephone_� C� � 3
Land Use l2 "5 Y/C�. ) Slopes(%) Surface Stones No
Distances from: Open Water Body / 4-OI t it Possible Wet Area ft Drinking Water Well ft
Drainage Way ft Property Line 40' 8 Other ft
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SKETCH:(Street name,dimensions of lot,exact locations of test holes do pert tests,locate wetlands In proximity to holes)
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71
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37
�owG. POND °!
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Parent materiel(geologic)
Car„er- tea( Depth to Bedrock
Depth to Groundwater: Standing Water In Hole: 't' Wee ping from PIt Face
Estimated Seasonal High Groundwater
Y)EI1LItIiTiivATI�;iti' `Or.S,.AUWNA _.. �u WATER TABLE'
Method Used: Nd^ r r a".,
Depth Observed standing In obs.hole: In. Depth to soil mottles: (n•
d ustment ft.
In. Groundwater A
Depth to weeping from side of obs.hole: �
Index Well N_ -Reading Date:__ Index Well level _ Adj.factor Adj.Groundwater Level
PERCOLATION TEST ''` brae rtnie
Observation / 0 4,3 /a
Hole q t Time at 9
Depth of Perc 8 L I r Time at 6"
Start Pre-soak Time @ / OD ;'Time(9"-6). z '
n
End Pr
e-soak so ak
Rate Min./inch
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
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UI;I;fl' Oh5It,RVATION IIOLC LOG Ilolc# J
I)cp111 from Soil I lorizon Snll Texture Soil Color Soil Other
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mottling (Structure,Stones,bouldercs.
Surfnce(In.) (USDA) (Munsell)
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j)V EP OBSERVATION IIOLE LOG:! hole#._.____:
Soil Other
Soil colorwrath from Soil I lorizon Soil
(USDATexture
(Munsell) Mottling (Structure,stones,boulderes.
Surfnce(in.)
Drl:l' OBSERVATION HOLC LOU Voltz#
Snil'rex Color
Soil other
Ucp1h from Soil horizon
(USDA)) (Munsell) Mottling (Structure,Stones,bouldercs.
Surfnce(In.)
UCI�1' 013SC1tVA'I'ION IIOU, LOG liolc#
Depth from Soil I lorizon Soil Texture Soil Color .
Son other
Mottling (Structure.Stones.bouldercs.
Surfnce(in.) (USDA) (Munsell)
r
Flood insurance RateAat>
Above 5oo year flood boundary No Yes ✓ �'too
Within 500 year boundary No Yes °
Within 100 year flood boundary No— Yes
Depill of Nat_ur 1 Occurring['ervlou�Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption systemT
If not,what Is the depth:of naturally occurring pervious material?
f'ertlflcatlon � M .,,t
I certify that on AJ(n 9/ (date)I have passed the soil evaluator examinatlon approved by the
DeparUnent of Environmental Protection and that the above analysis was performed by me consistent wish
the required training, expertise and experience described in 310 CMR 15.017.