HomeMy WebLinkAbout0040 WINDLASS LANE - Health (3) Wi►)&ILa,a,a L—e,.Cep�e�v I1�
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Department of Health,Safety,and Environmental Services L Z
Date
Public Health Division
dF �rr� 361 Main Street,Hyannis MA 01601
Si.
I aurtat�tas I Fee Pd. OV`
n tee Z Time , �4�
01 Date Scheduled aecA (2t��
e Disposal.-
suitability Assessment for Sewag
soil S �
Witnessed By:
Performed By:
I,i�CA'I'ION & OENFRAL IN1+i�sl2MAT 9 Fe2�n�c�'as
Ow Name
Location Address //OivD4/9SS �a.�e i`s o s
Address �,yle i•�•►o c, �1 rr.p ,:
I?ngineet'a Name .!�!�✓� ''��f/7 77
Assessor's Map/Parcel: I f Z 0717 Z
REPAIR
NEW C Telephone N
ONSTRUCTION REPA
Slopes(%) Surface Stones r
Land Use t,' It Drinking Water Well a
R Possible Wet Area
Distances from: Open Water Body B
• It Property Line' f_J.J(J --R. Oar
Drainage Way
• t name,dimensions of lot,exact locations of test holes dl pare tests,locate wetlands in proximity to holes)
SKETCH.(Street
it.
i
tRn
�-�
Depth to Bedrock
Parent material(geologic) I ,n
�6 Weeping from Pit Face
Depth to Groundwater: Standing Water in Hole:
Estimated Seasonal High Groundwater
DETERMIN nN 1; R SEASONAL MG-+H'i�ATER TABLE:...
7 �°-� Depth to Boll mottles:
Method Used: in. Dep tl.
Depth Observed standing in obs.hole: in. Groundwater Adjustment
Depth to weeping from side of obs.hole: _Adj.Gtoundwatet Level
Index Wcll N___._._ Reading Date:
Index Well level...___ Adj.factor
PERCOLATION TEST
Observation Time a 90
Hole N l�
Time at 6-
Depth of Pere '
`/!a Time(9"-6")
Start Pre-soak Time Q
End Pre-soak rp��' `
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN)
Observation Hole Data To Be Completed on Back—
Original: Public Health Division —�
Copy: Applicant
t �dG ' ltolla#_,_,�
c t[ULC soil nd,er
I)I��LI' ()IjJIiIZV�ITN Soil(blot Mottling (Structure,Stones,Doiddercs.
Sofl'I"exlure (Munsell)
Ikplh frnm soft Ilorizon (USUA)
Surface(In.)
it
_ D 5
�^ 2 t6
x G
--r
. :•:Nolte# '.
i ATION 11OLt LGC Soil er Idercs.
llCEI' OI3SCIiV Soli Color Structute,Stones,Dou
Soil Texture (Munsell)
Soil Ilorizon (USDA)
Mottling
I)epih from
�•
Surface 00',
u_
: 11�1��p her �•;
Ul;,rl' CiI1SERVA't'10N IIOL'I O ( Son Slones,00uldercs.
Soil Texlore Mottling (Slruelurc,
Ucplhm fro
SoilIforizon (USUA) (Munsell)
Surface(in.)
I
t•
�'tON tIOLC LOG
llCLp 013SCItVA soil Other
Soil Color Molding (Sinrclute,Stories.
Soil I loriron ouldercs.
Soil'Cexture (Munsell)
Ucpth from (USUA) t
Surfnce(in.)
r
• n••P� ta,1� '
JZ
Above 500 year flood boundary No— Yes
• Within S00 year boundary No— Yes i
Within 100 year flood boundary No
Yes
' to [i u rin Pervlo �
feet of naturally occurring p7WF7
l exist in a aras observed throughout the
Does at least four tion system?
area proposed for rite soil absorption
.. IC not,what is the depknaallurrO,lly occurring pervious material?
rlf
certify, tltnt on
b (date)i have passed the soil evaluator exam fnetion ePP a yme si tent it i
lysis
Department of[:nvirod CXtoef ncen and ilat(lie describedin 310ve aCMR 15s017.
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