HomeMy WebLinkAbout0002 IRVING AVENUE - Health (3) a � �UIYI� ftUeSt�1Pi � �GY�NIS
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Town of Barnstable
Department of Health,Safety,and Environmental Services
Public Health Division Date I2,►ga�
367 Main Street,llyannis MA 02601
BARNBTAB[E,
�C I q� Fee Pd. �l
rEe►Axt►�' Date Scheduled t-�s� Time 10 ta-�
C� � r Sewage Disposal
Soil Suitability Assessment fo g
Witnessed By:
Performed By: �t AAA �A x l-e, —
LOCATION & GENERAL INFORMATION Owner's Name 1115 pd�'1T CW13
Location Address 6FF A4A1z61 414-r MlL-(- VOAD 'I
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4xl,4 w a i5,po� Address IIZ�/1W to d✓G t4,P'I-
Assessor's Map/Parcel: Z(0& J'3 Engineer's Name
NEW CONSTRUCTION ,I/ REPAIR Telephone# h" i3
CougAr, P (o ) ?� - j Surface Stones U
Land Use �ot�l` Slopes /o
Distances from: Open Water Body 15_ft Possible Wet Area /8Q fit Drinking Water Well _ n
Drainage Way n Property Line
ft Other n
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SKETCH:(Street name,dimensions of lot,exact locations of test holes&Perc tests,locate wetlands in proximity to holes)
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tip:
G�,�,
P,o , — 7,01LE)- V GeYSTR+JGTiOM WITH FGASToUE
AS 4SEDE-D To T'LEVEVf E2CSIOIJ
77-
_ �: Top OF Sao-
RAM OF 111E LL
&PACE
c sue_ - x -ram -_ff rv5nk). P._au
- W02' L—"M — -
i R4til MUW
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Parent material(geologic) �X U �1(l7WQS� ' L,/4"IAI Depth to Bedrock
Depth to Groundwater: Standing Water in Hole:
--- Weeping from Pit Face
Estimated Seasonal High Groundwater
DETERMINATION FOR St!ASONAL'I-IMGH 'WATER TABLE
Method Used: in. Depth to soil mottles: m.
Depth Observed standing in obs.hole: in. Groundwater Adjustment R•
Depth to weeping from side of obs.hole:
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level—
PERCOLATION TEST Date 2-1Zo Time ' oA,"
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t
Observation Z Time at 9"
Hole#
Depth of Pere
24/" 3-/ Time at 6"
1 �
Start Pre-soak Time Q Time(9"-6")
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End Pre-soak
uvA6eg- � -*rwa 7z-
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--j
Copy: Applicant
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DEEP OBSERVATION HOLE LOG Hole # /
Soil other
(Munsell
Depth from Soil I lorizo❑ Soil Texture r Mottling (Structure,Stones,Boulderes.
Surface(in.) (USDA) ( ) ConsislencY.°
j e
6-4
7/4
O
DEEP OBSERVATION HOLE LOG Hole# . z
Soil Other
Depth from Soil Horizon Soil Texture (Munsellr) I Mottling I(Structure,Stones,Boulderes.
Surface(in.) (USDA) I ( sistenc
°
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from DEEFOBSERVATIOSoilTcxt'N'IIOLE Soil
LOG Soil # other
Depth rc
(USDA) (Munsell) Mottling (Structure,Stones,Bouldcres.
Surface(in.) n ' ° v I
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DEEP'OBSERVATION HOLE LOG : Hole
ofl,er
UA) Soil Color Soil
Depth from Soil Horizon S( D re (ht,nsell) Mottling (Structure,Stones,Bouldcres.
Surface(in.) °
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Flood Insurance Rate Man:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No Yes
Within 100 year flood boundary No Yes
Depth of Naturally Occurrini?Pervious Material
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Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
jarea proposed for the soil absorption system?
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j If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on x4lq �I, 995�(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 C, ►1�� bate Z'20 9