HomeMy WebLinkAbout0085 OCEAN AVENUE - Health (4) - i
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Deportment o(Iicnith,Safely,and Ertvironrncntal Services
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Public Heald Div>ision`.`
367 Main Street,Hyannis MA 02601
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Witnessed By:
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rerrorrned By:
. LOCATION sec GI,NI�1tALXotOsN119AT�lUN_
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Location Address___85
Address, Ktna of
d0- Engineer's Name.13 AKtSV' .
Assessor's Map/Parcel: -.`1 t'-S 1 ..!.-..:... -
- T TelephotteNr <, ;
NG REPAIR W CONSTRUCTION — — Surface Stones
—_ Slopes(%) It
Land Use `�`A _-
Drinking Water Well
i `�" Zoo R Possible Wet Area I15 R t
Distances from: Open Water Body Other R
R t Property Line
Drainage Way
- dimensions of lot,exnclelocations of test holes&Pere tests,locate.wetlands in proximity to holes) 7n, F I _
Street name,dimensio
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_- .- r'.'•�Yx-��`�+.3"�Sa ''s;J +r.�'�r ��,�s � y QA.�F fi' r�' I "_
t f
1
1 _
3 \ i u
x
r :i• j
_ Depth to Bedrock
eolo s{+'
Parent material(g gis) Wcepitig from Pit face
Dcpih to Groundwater: Standing Water In I lole:
GstimalcJ Seasonal lligh Groundwater t -
1I)I�.1'GIZI1'11Nt1`I`IUN 1'(7>lt SL��S�.)IVA��.XIC�I•'4'VA�I'�It'l AI3L'C'''., in.,
in. Depth to soil mettles:
Method Used: -
Depth observed stnn:iir.g in obs.hole: ,.C, In„iw to Adjustment
Depth to we, from side of obs.holclttdex WI!l I've)
Adj.factor _ Adj.Groundwater t:eeci
Indcz Well N .Reading 11tt1
observation V s�� 2,} ro_ �+_ a=o r�s o N PR(--so#*K Time at 9"
Time at 6"
�a Q
I)cpth of rcrc Time t9 -t; > -
End rre-souk
Site Suitability Assessment: Site Passed --
Si1c I r..i!r.!: Additionni Testing Needed(YIN)
Original: Public Health Division
Obsel-VB00n Mole Data To Be Completed on Original:
Copy: Applicant
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1101c# 4_
DEEP 01) ri RVATION ROLE LOG snit other
Soil Texture Soil Color Structure,Stones,Doulderes.
Depth from Soil Ilorizon (USDA) (Munsell) Mottling ( a
GraxdL—
Surrhce(in.)
iALoy.-. -- -- 3�Z
f,
s,�ZZ„ � San✓y Lvtwr '7 5 ]/2 S�� = p'$ �oeu Q.36..
Mcawn sawo 2.5 Y-e 614
2l"- /32 . C /Vo 6ror,�c.Kf�r
DEEP.OBSERVATION HOLE LOG sou oth«
Soil Texture Sol]Color
Depth from Soil I Iorizon,• _ ::S(USDA) (Munsell) Mottling (Structure,Stones,
ry
Douldercs.
Surface(in.) ,
t
i
ERV oil #
ATION 1-IOLE L.OG snit Other--
vCEr OBS Soil Color
Depth from Soil l lorizon Soil Texture (Munsell) Mottling (Structure,Stones,
Doulderes.
Surface(in.)
—i— '. HOW
DEEP OBSERVATION HOLE LOG sou other
Soil Texture Soil Color Slnicture,Stones,Doulderes.
Depth from Soil Ilorizon (USDA) (Munsell) Mottling
Surface(in.)
--------
Flood Insurance Rate Mal?:
Above 500 year(food boundary No
Yes
Within 500 year boundary No— Yes�--
Within 100 year flood boundary No„�.
Yes
Depth ' to Il Occurrin Pervious Material
turally occurring pervious material exist in all areas observed throughout the
Does at least four feet of na
area proposed for the soil absorption system? �—
If not,what is the depth of naturally occurring pervious material?
C'erti catiori r
[certify that on 45 (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection ande that
above
n 310aCMR 15.017.
lysis formed by me consistent with
the required training,/expertise an'/experien
/`T� /
Date