HomeMy WebLinkAbout0019 LILLIAN DRIVE - Health (2) L4► L��"c�vr �eve
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Town of Barnstable P# �r
Department of Health,Safety,and Environmental Services
Public Health Division Date �' l
q^ 367 Main Street,Iiyannis MA 02601
eAnate ASM
MAW
Date Scheduled Z.L_ i�; `7 7 Time Fee Pd. i de3
Soil Suitability Assessment for Sewage Disposal
Performed By: w/yam OOY���• �� Witnessed By: 1-N/ �O��iiq'
LOCATION & GENERAL INFORMATION
Location Address ly' L,i L C i i7 N Owner's Name 7.�,%0�♦h,� �G�,���
1,�✓�/!2�-ate Address 4-Z
Assessor's Map/Parcel: Engineer's Name G110 T l�hy
NEW CONSTRUCTION REPAIR Telephone#
Land Use I'ye'de"I Slopes(%)_ 3 Surface Stones
Distances from: Open Water Body All,* ft Possible Wet Area .y1,,f' ft Drinking Water Well
Drainage Way ft Property Line ft Other R
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes)
0 3�.
_f.P
hr 4Z
4
4� -41
Parent material(geologic) Ovl74 mVll Is Depth to Bedrock •r/��
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater Z 30
DETERMINATION FOR SEASONAL HIGH'WATER TABLE
Method Used: GryyNe/wcrft'i— Cey�ovr-�s4/�
Depth Observed standing in obs.hole: -in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: A// in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_
PERCOLATION:TEST DateYi�/% Time
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 Necdcd(YIN)
Original%-Public Health Division Observation Hole Data To Be Completed on Back
Copy: Applicant
DEEP OBSERVATION HOLE LOG Hole# 88�
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%
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!o�eZ D �+r •saw ��Y�C f�// --" Loos
Imo—/S i� 5i-f �Y.Q
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Jd—�o� G� c✓ /L' b/ — bas e o
DEEP OBSERVATION HOLE LOG Hole
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.°
"DEEP OBSERVATION;HOLE LOG Hole#
Depth from Soil Horizon .Soil Texture Soil*Color -S.oi1 Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
-,Con,rsiste.ncy," Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency-%Gravel)
Flood Insurance Rate Map: /
Above 500 year flood boundary No_ Yes t/
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? yes
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on /O/ '' (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