HomeMy WebLinkAbout0111 OCEAN DRIVE - Health � i C�G�,rl �r►�2, 1-l�,�c�n�'s
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SOIL EVALUATOR&PERCOLATION TEST FORMS
DIME tb, Page 1 of 4
Town of Barnstable
eAMASS. ' Department of Health, Safety, and Environmental Services
prEo; t•�`� Public Health Division
367 Main Street,Hyannis MA 02601
Office: 508-190-6265
FAX: 508-775-3344
Soil Suitabili Assessment for Sewage Dis osal
NO. Date:
Performed By: ''09
/ "A 6 Date:
Witnessed
Location Address Ow er's Name
Lot#: Address,and
3zo9Z.
Assessor's Map/Parcel: Z Ge L/o OS Telephone#
NEW CONSTRUCTION REPAIR
Office Review
Published Soil Survey Available: No Yes
Year Published Publication Scale /: 241<7ci0 Soil map unit
Drainage Class _V l/z Soil Limitations e n
Surficial Geological Report Available: No Yes
Year Published 3/9— Publication Scale /t 3 190
Geologic Material(Map Unit) 6 -_ C 01-
Land form G7(G 0--., -4 t7<-rC
Flood Insurance Rate Map:
Above 500 year flood boundary No Yes
Within 500 year boundary No Yes ,X
Within 100 year flood boundary No Yes X_ S�4®
,S VS q F 1r,,.—,= /1 e-S 7-0 ®G /"L C70 d .7O V•a'• 03
Wetland Area:
National Wetland Inventory Map(map unit) N
Wetlands Conservancy Program Map(map unit) n/n
Current Water Resource Conditions(USGS): Month 4Sl7 4,
Range: Above Normal /-3 Normal Below Normal
Other References Reviewed: Z 2~
r.
DEP APPROVED FORM-12/07/95
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 4
Location Address or Lot IJo.
On-site RwiM
Deep Hole Number
/ Date:. . :��/z 3/ 9 Time: �.� Weather
Location (identify on site plan)
Land Use 2 6 Slope M e7,,. Surface'Stones
Vegetation . .. L ca, r7
. .. .:.,. ..... .:...::
Landform ...... <F./ o� c_ i,G i.L':. .`�.� r=c►
Position on landscape (sketch on the back)
Distances from:
Open Water Body /o® -I-feet Drainage way �f�7- feet
Possible Wet Area / c3#344-feet Property Line .I5. feet
Drinking Water Well A-�11 feet Other
DEEP OBSERVATION HOLE LOGS
• other
Depth from Soil Horizon Soil TexturePOMA'un
Soil Soil Gravel)
Surface Ilnchesl (USDA) Mottling (Structure,Stones,Boulders, Consistency. 96cc y
7.
2 7 -- lr c,
r. ter, �, o, DepthtoBedrock:
Parent Material(geologic)
Weeping from Pit Face:
Death to Groundwater: Standing Water in the Hole: 9 f 9 ' — ` . r Q-d� 4-
Eptimated Seasonal High Ground Water: 7.
'f
DEP APPROVED FORM-12/07/95
k
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 4
Location Address or Lot No. P a 2 J�.-' - `^✓ ' ✓''y��
Determination for Seasonal HiE Water Table
Method Used:
Depth observed standing in observation hole.....4 inches
Depth weeping from side of observation hole...p $,i inches
'Depth to soil mottles . Alle inches
B'Ground water adjustment .... feet
Index Well Number Reading Date ..4,-11.4 Index well level .7- 3
Adjustment factor ....../.../ Adjusted ground water level 4. !
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? �V
If not, what is the depth of naturally occurring pervious material?
Certification
i
I certify that on N/v v S" (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 &/i o/9�
DEP APPROVED FORM-12/07/95
t
FORM 12 - PERCOLATION TEST
Page 4 of 4
Location Address or Lot No. / / d r �_,, � . f ✓ ''
I
COMMONWEALTH OF MASSACHUSETTS
r—^ t3 X , Massachusetts
Percolation Test*
Date: Z/ C Time:. :...i ' ........:.. .
Observation Hole #
Depth of Perc ,, "
Start Pre-soak
End Pre-soak
CW C4�/s 0 , /a .• 1S
Time at)2
Time at 9"
Time at 6"
Time (9"-6") 3 '
Rate Min./inch ,
Minimum of 1 percolation test must be performed in both the prirriery area AND
reserve area.
Site Passed Site Failed ❑
....................................................................................................................-.-...._..._..r....__......._
Performed By: C4 r
Witnessed By: JL= /3
Comments. _.............................
...:a..�..�.;..... :a..K ..,..�.....� . ...��.�. ... ..�r,2..
DEP APPROVED PORM-12/01/95