HomeMy WebLinkAbout0714 OLD STRAWBERRY HILL ROAD - Health (2) �JVIOAL)bct PRL
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Town of Blarnstable P#
Department of Health,Safety,and Environmental Services
oFVE Public Health Division Date Z / P
367 Main Street,Iiyannis MA 02601
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eARNaTABI$ � s
Date Scheduled /�J/ Time �,��I'~ Fee Pd. ��Q
Soil Suitability Assessment for Sewage Disposal
Performed By: V"/M/ , YLe-5 Witnessed By:
OC 't'IQN & NEILAL LIVFpRMATIQN
Location Address v/* � /�(/ n� Owner s Name r / V/C K V<y
/ !S Address o0elX r4O 7 6-t/' (?O►
Assessor's Map/Parcel: ��/ �� Z7.3121 w Engineer's Name J 7` t
NEW CONSTRUCTION REPAIR Telephone N S� Q f
Land Use ����� �is✓1r Slopes(%) a Surface Stones/UO/✓2�_
Distances from: Open Water Body SaO R Possible WetArea_.-4W R Drinking Water Well l�
Drainage Way��D R Property Line 3� R Other R
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes)
7124
4
Lo7- /V 6
\ 369 /82 sue,
�i
'
:3�
v 18,
lip
Parent material(geologic) J��7/V U Depth to Bedrock
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater �V' 33 06S,5ek-,_r—A Cu. f20� G,:5-lz#
EGEvi S/ZC 75 G l/D 72
I'AZ. —
Method Used:
Depth Observed standing in obs.hole: in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment R.
.,index Well N 'Reading Dale:_ Index Well level..,--- Adl.factor Adj.Groundwater Level
PER .0 ::::I( I�1 TEST paie: . TIMg l�r� I ;.
Observation
Hole# ? #T Z Time at 9"
Depth of Perc�TOP> °, Time at 6'.
Start Pre-soak Time® IV.` Z,2 ��'3Z' Time(9"-6")
End Pre-soak
Rate Min./inch Z 2—
Site Suitability Assessment: Site Passed y. Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back j
Copy: Applicant _
blCCz' 0.13S1IZ'�,A:C10N xZOL�LOB Mule # �-
Dcpih from Soil Horizon Soil Texture Soil Color Soil OIr
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes.
o Gravel)352,SY 6A 0 1-
DEEP f BS -OATION 1IOL> LOG Hole
Depth from Soil Horizon Soil Texlure Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Molding, (Structure,Stones,Doulderes.
e
16YP 4IvIe-
2
DEEP liSERVA'I'i0 LE I;0G
Depth fro Soil m Ilorizon Soil'Iextore Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%
n�EP QI�SI;RVATIOI`V>�IOLE LOO
Depth from Soil Ilorizon Soil Texlure Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Molding (Structure,Stones,Doulderes.
Flood I:Surance Rate Elan:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No_ Yes
Within 100 year flood boundary No_ Yes
Dentll of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed (itroughout tile
area proposed for the soil absorption system? Y&S
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on (date)I have passed the soil evaluator examination approved
pp by the
Department of Environmental Protection
p o coon and that the above p r was analysis e f y ormed by me consistent with
the required training,expertise and experience described i n 310 CMR 15.017
.
Signature �� Date