HomeMy WebLinkAbout0029 LILLIAN DRIVE - Health (2) ,1 4
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Town of Barnstable P# 7�
Department of Health,Safety,aqd Environmental Services
Public Health Division Date
� 367 Main Street,Hyannis MA 02601
BARNBTABM
rE 19. Date Scheduled Z. - ► 3 — 7 Time_�� .� Fee Pd.
Soil Suitability Assessment for Sewage Disposal
Performed By: Cwro �✓! Witnessed By: .*Ph
LOCATION &GENERAL'INFORIVIATION'
Location Address Z� �,� A2 I _ Owner's Name
Address ;
Assessor's Ma /Parcel: LI�J Engineer's Name C&rr tyw �DyIP�
P Z4r - Zc" c.T dr"-q iwPe!—r17
NEW•CONSTRUCTION _yC REPAIR Telephone# f fd-- S"'7Y"S
Land Use 1AlL1C7Gl Slopes(%) 0=3 Surface Stones
Distances from: Open Water Body y/i4 ft Possible Wet Area 41/4 ft Drinking Water Well ft
Drainage Way ft Property Line ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
d 5 D
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3`T
Parent material(geologic) Depth to Bedrock •'y/"A
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater ._1 30 (Slle elek- fit' 6 4,' le
DETER I SEASONAL HIGH WATER TABLE
Method Used: 1 reu r�G;�u Pr CoNdavr�iCr�
Depth Observed standing in obs.hole: ;09///4 in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: X//10F in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level
PERCOLATION TEST Date �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 _��� ���117
1 Site Suitability Assessment: Site Passed kl�-, Site Failed: t Additional Testing Needed(Y/N)
Original. Public Health Division Observation Hole Data To Be Completed on Back—j
Copy: Applicant
DEEP.OBSERVATION HOLE LOG. Hole
Depth from Soil I lorizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
sistency.°
rill
�/�30 � /Ori.•r aye /o Y�? s2// — Loos L'-
�O—(o0 a� !o Ye y/9 — le
e
land—/3oz Got F7iwe 100,0"eaY
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Co sistency.° GnUell
'DEEP OBSERVATION`HOLI+; LOG Hole;
Depth from . Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.° Gravel)
DEEP OBSERVATION HOLE LOG Hale#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
—Consisten ° r
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Flood Insurance Rate Map:
Above 500 year flood boundary No_ Yes
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?
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on WJ6! (-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.
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Signature 4---� -�_,—_ Date -0//_27/9�z i
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