HomeMy WebLinkAbout0039 LILLIAN DRIVE - Health (2) f,y/
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Town of Barnstable P
Department of Health,Safety,and Environmental Services
Public Health Division Date I '
367 Main Street,Hyannis MA 02601
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Date Scheduled "Z - / 3 7 Time I r Fee Pd.—A),5—G�C�
Soil Suitability Assessment for Sewage Disposal
Performed By: /`0 r?'�'I T• �0���� E' Witnessed By: JP�t y Qdr//1!'?,�—
LOCATION &"GENERALINFORMATION'
Location Address �ty r �,`t q.
Owner's Name
Address
Assessor's Map/Parcel: 'j �' ZL Z Engineer's Name 4°zt/`o /yam
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NEW CONSTRUCTION ✓ REPAIR Telephone# fee- .7
. Land Use ly poc& 1/ Slopes(%) O 3 Surface Stones
Distances from: Open Water Body NlVO ft Possible Wet Area ft Drinking Water Well N//¢ ft
Drainage Way N1,4 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)
PS.oO' #0,9.0
40'
So' �P
a
./03 o: A5%00
37
Parent material(geologic) Depth to Bedrock
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater -X 30 Oihe Blet- SvI—Gw ML, 2o,J
DRTERMINAT101r1 FOI2 SEASONAL MGH'W TER TABLE
Method Used:
Depth Observed standing in obs.hole: /!///ft in. Depth to soil mottles: W1,11i in.
Depth to weeping from side of obs.hole: d// * in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_
t-e�ere.rce` P-88�� PERCOLAT1CjN TEST nAte 2 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 V" Site Failed: Additional Testing Necdcd(Y/N) /y r
Original;-Public Health Division Observation Hole Data To Be Completed on Back
Copy: Applicant
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DEEP.OBSERVATION HOLE LOG Hole# BAG
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.° Gravel)
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DEEP OBSERVATION`HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
n i tenc °
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon: Soil Texture Soil Color Soil, Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.°o 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
Within 500 year boundary No Yes
Within 100 year flood boundary No'--s 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 v''/ y�