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HomeMy WebLinkAbout0116 SHEAFFER ROAD - Health (3) « Anna ef�o +463 STlIVfiS,; ,pqi� } 4 a e x 3 , s a `� �,�fi _�lW '_�k.` V°."a-W '�'"+4ei".'�5..«•�r• 'l", W+a,v, -:_':�`-•a... ay r«r„rs�`-�s.,.. yYti.�k`'�� �t �•�.� x rx s,a Y.�„��7 x'�-�,n. y��a , ML Town of Barnstable P# Department of Health,Safety,and Environmental Services tss�n>ul �1W Public Health Division Date 17 367 Main Street,Hyannis MA 02601 9AaNSTAUX nags. lFl)MA't�`� Date Scheduled ty Time ��.,� Fee Pd. ©'(� b C-1 -Z —gZ 4 Soil Suitability Assessment for Sewage Disposal Performed By: G� CTJ Witnessed By: /0"'' n m (n LOCATION & GENERAL INFORMATION' o Location Address I I '' Owner's Name/ i �C LO G `� " "`°° "`, ►'�` '„"' Address vt 3 C.Q-rx- xAui.LU— Assessor's Map/Parcel: t 7 Z 01 Lo4 1-52- Engineer's Namq INEW CONSTRUCTION 4V REPAIR Telephone# c�p.e'_'jT--,]W'Z']�'?_ Land Use Res.,of e U4«wf Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well R Drainage Way ft Property Line ft Other R SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) . Shea-�.�e�- vacs a o Lp 0 I moo" Parent material(geologic) Gu f 4. .rs 4 Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOI2 SEASONAL HIGH WATER'TABLE ,v;ewou used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment R. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level hERCOLATION TEST Date. 'rz—Q7Ttme Observation Hole# Time at 9" Depth of Perc Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak 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 DEEP OBSERVATION HOLE LOG Hole# / Depth from Soil I lorizon Soil Texture Soil Color - Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistencv.° Gravel) Lva � toy2 Z N Loa. y a l u y,� y8-/z d' C, Mid sq w� yA s�f z 0�„ 5 Mid J-4 ,4 14 YX �& 0 DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) I I (USDA) I (Munsell) Mottling (Structure,Stones,Boulderes. e-` `r /4 Loa ., y-S/ K 6, 8 Ste -iLo�� C r /t'I¢cl 5.,�( l o y 4 Z o 7. .S--o-i e I'W ,GL /1e--I S4Kd 1 G yR d� DEEP OBSERVATION HOLE:LOG Hole:# , Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,° ravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Ilorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,° ravel i I Flood Insurance Rate Map: Above 500 year flood bcunda:y 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? y q— S If not,what is the depth of naturally occurring pervious material? Certification 1 certify that on F (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 training,expertise and experience described in 310 CMR 15.017. Signature Date '— -z