HomeMy WebLinkAbout0071 WASHINGTON BURSLEY WAY - Health (3) 1 w a.�P�'q f m &, s lei-- ,
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1'own of Barnstable P# -5?2 7—�—
Department of Health,Safety,and Environmental Services
Public Health Division Date JL;'-/ 15,/9Y 7
py �SS 367 Main Street,I lyannis MA 02601
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°i059.
0. Date Scheduled ] - �O Time , Fee Pd. ®�
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'1� S W Soil Suitability Assessment fog Sewage Disposal
Performed By: I
Witnessed By:
LOCATION & GENERAL INFORMATION
Location Address Lor ot Owner's Name -��S 1pe '8010394 Co I�
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C.b'7'JrW2_JI LCZ7 Address CL—`9JT-L-f I L,LfF
Assessor's Map/Parcel: 1-1-L l .Z Engineer's Name'$k 2. }-t4ytT (�,�
INCW CONSTRUCTION �C / REPAIR Telephone# q I� I
Land Use �Ci1�C'1J`i")A L Slopes(%) 0"-.3 Surface Stones
0
Distances from: Open Water Body 2000, it Possible Wet Area 2000 ft Drinking Water Well �ft
R Property Line 2.6 ft Other ft
Drainage Way ' P y
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
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Parent material(geologic) 6%rrWa,SW RCAdt/ Depth to Bedrock
Depth to Groundwater: Standing Water in dole: Weeping from Pit Face
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASON A1L aiii GiH WATIER aA,: LE
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 ft.
Index Well# Reading Date:_ Index Well level. Adj.factor Adj.Groundwater Level_
PERCOLATION TEST ': ::: Time io—A---
Observation
2 Time at 9" /0'7 9
Itole M
Depth of Perc VO Time at 6" 1191,3 Z
Start Pre-soak Time
Time(9"-6") 13
End Pre-soak
Rate Min./inch / )'AJ
Site Suitability Assessment: Site Passed y Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back—�
Copy: Applicant I
DEEP OBSERVATION HOLE LOG Hole#_
Depth from Soil I lorizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes.
%
Qlavell
0' Z O -
IV1�-p,
2 8" S
pNo
2 !3 L S'An Io e- S/r
" c SANm
GG e�u� 44
DEEP OBSERVATION HOLE LOG Hole# 2-
Depth from I Soil horizon I Soil Texture , Soil Colo; Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structu:e,Stones,Boulderes.
ve1)
Z S„ SA/in m y2 ZO
SA-IJO y /0 /1 S �.
7/Ug j
e oAlgr �a 4/j/d
DEEP OBSERVATION HOLE LOG Hole#
Dcp1h from Soil I lorizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Bouldcres.
%
DEEP OBSERVATION HOLE LOG Hole#
Depth I}om Soil I lorizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%
Flood Insurance Rate Map: y
Above 500 year flood boundary No_ Yes
Within 500 year boundary No ✓/ Yes
' Within 100 year flood boundary No Yes
Depth of Naturals 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
1 certify that on ,(dU 199r (date)I have passed the soil evaluator examination approved by the
Department of Environmental rotection and that the above analysis was performed by me consistent with
the required traini g,expertise and experience described in 310 CMR 15.017.
Signature C✓� Date ? _q7
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