HomeMy WebLinkAbout0055 LAKE AVENUE - Health (2) a �
Town ol' Barnstable
Department of Health Safely
,y, and Ell virounlenlal Services
°fItE Public Health Division Dale
f 367 M11n Silecl,I lyuonis MA 02601
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U MASS [//
p�toµ�Ay� Dale scheduled
1'inle rrill� fie 1'tl.
Soil.Suitabilitj) Assessment for Sewage Disposal
Pclfonncd lly: N2 Wilrlcssal BY: �oNNro /"<' aR,"o-V0
�OCA'Il0 & GIN 1IZ L INI�OiW...fI'ION
I.ocalion Address f j rj �fi due 0%yacr's Name yV lle� D r1V&ILL-
�l Y l J:';,PbAt
-/ address
Assessor's ML1p/I'lrccl: �0 � `�'�O I Engineer's Name
NIM CONSTRUCTION ,kL` ItGPAIR J 'Telephone/I
1.1nd lJse `�LiiO� Slopes surface Stones A
I)islances from: Open Waler llody /O U It. Possible Wd Area g C] R Drinking\Va(er Well
Drainage Way /yA It Properly Line 7/C) 11 Other p
SKI TCI I: (sucel ntuue,dimensions of lot,exact locations of test holes&perc tests,locale\VC111111IS III proximity to holes)
Z 9Z
k
��r2 �- 4.v r 1�.✓ 131 //SST t?ti nee v Gd
Zof L
IS Vo
f_ A
�z v
-age-- -�N
GsT "o
fir, v w
Palcml olatelial(geologic) �p!/NL� / wr/Tr Depth to IICdrock
Depth to(iround\valef. Standing\Vtaef in 1 to
le:--,«-- \Vecpimg from Pit Pace /✓y
Ialiwaled Seasonal I ligh Groundwaler
T�
DETERMINATION FOR SEASONAL, IIIGII;}'VATI,PR 1'A13LIs
Method Used: G'w'c��r/✓o
Depth Observed standing in ohs.hole: in. Depth to soil mottles: 111
Depth to weeping from side of obs.hole: in. Groundwater Adjustment Il.
_ Index Well ll .. Rvading Date: _ Index Well level_ _ Ad.i. factor..__ Ad,i.Gro ndwalcr Level
PrRCOL.ATfON TES`r°
Observalion /
1 lute 11 'I'inle ul 9" ;
36 �yo` 3�
Depth of I'm Time at 6"
Still I Pfc-soak'l ime n o:oU O: Ou Time
God Pic-sulk ZS
Rt11C Mill./Inch G Z L Z., 3/0 G,,41e
Site Suilabilily Assessment: Site Passed Site Failed: Additional Tesliug Needed(YIN)
Original: Public Ilcallh Division nhservaliou I Iple Dahl To Be Contpleled on INClc j
Copy: Applicant
l)IGL;P 01181dWA'I'1ON ILoLL LOG llole li�—
Ucplh from Soil I lorizrm Soil•I-cxlurc Soil Color Soil Oflier
Surface(in.) (tISIM) (A•lunscll) Nlotlliog (Structure,Sloncs,Ilouldcres.
— — S..Stll�lslgJgY.14_Si1�Yf1)
3 S r t_oAw.l'rj,,GO
i"-JI�N'1y F"Id
I)l', I) OIISLRVA'11ON IIOLE LOG IIole 11
Depth I'iunt Soil Horizon Soil Texlurc Soil Color Soil Oflier
Surface(io.) 0ISDA) (Munsell) Mutlliog • (StrucUuc,Stones,Boulderes.
°o(lr;l)'cl)
L/ F — - /'ylossi✓�J „or3v
/1�iISS/c�3 �2ilot��
J V2 614,
U1,EP OBSERVATION IIOLIIJ LO(: Ilnlc {�
I)eplh From Soil I lurizon Soil•I•cxlurc Soil Color Soil Olhcr
Surface(in.) (1151)A) (Munscll) Mo111h1g (Slnrclurc,Sloncs,Iluuldcres.
DE,RT 01 81.tAVATION IIOLIP, LOG Hole #
Depth Ilont Soil I lorizon Soil•I-exlure Soil Color Soil Other
Surface(in.) (USDA) (Monscll) Molding
(Slntcltire.Sill ties,I►ouldcres.
-- ��J-115l51�114Y.°[4_S11tlY�I)
I I
1 1md Iilsill_i)tce 12 a L')_3I),
Above 500 year flood boundary No Ycs--
Within 500 year boundary No Yes__--
Wilhio 100 year flood boundary No Yes—_
12cl> u—if Nahmffly Occinjilig_ 'cr Ltt� 111;11crllil
Does ill lead four feet of naturally occurring pervious material exist in all areas observed (hrollghonl file
area proposed for the soil absorption sys(em7 yGS
If nol, whtit is file dep(h of naturally occurring pervious material? �—
C:gt--i Tin:_i11imll
I certify Ihal on G =/5 —9J ((tale) I have passe(I the soil evaI or examination approved by II►e
I)eparlloent of Elivironnlcnlal Prolcclion an(I that the above analysis was perforn►cd by n1e consislenl with
file required training, expertise and experience(I ribcd in 310 CM 15.017. +++
Signature-- -- —_- -- Dale