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HomeMy WebLinkAbout0411 SCUDDER AVENUE - Health (2) y►� Scueidtr Ave-ow-, ' SOIL EVALUATOR&PERCOL N TEST FORMS �1HE r� Page 1 of 4 Town of Barnstable • BA s&�, M Department of health, Safety, and Environmental Services '0rE0.19. Public Health Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6265 FAX: 508-775-3344 SOIL Sulta hlllly Assessment-.for Se wa e Disposal 77H_ ` 1 NO. 716--' Date: of -" Performed By: i�'2� /f !Si'1 t! - _ Date:_61 Witnessed By: mac( 43 a r`' y I.ocalion Address �� Owner's Natnern�`,i I.i (ri ,�'Z�ca• P.o• F3 323 ��� ®�� w. hF y..,•,sPe r� Lot n: Address,and v a WAIW7114'Awl, Assessor's Map/Parcel: ,Z $ Q, J 37 Telephone 0 CSo,�� 7 7-f--. 7 2 Z NEW CONSTRUCTION REPAIR Office Review Published Soil Survey Available: No Yes V' Year Published .j g Publication Scale I s 2,5 aob Soil map unit CJ 3 Drainage Class V// s Soil Limitations e-< 4. -,.5 s /v 'e/�e Surficial Geological Report Available: No Yes Year Published Publication Scale Geologic Material(Map Unit) <<, � r v �'r Landform 4. a c , a / o -r Flood Insurance Rate Map: Above 500 year flood boundary No ✓ Yes Within 500 year boundary No Yes r Within 100 year flood boundary No v Yes Wetland Area: National Wetland Inventory Map(map unit) !/6AI Wetlands Conservancy Program Map:(map unit) Current Water Resource Conditions(USGS): Month /" Range: Above Normal Normal _ Below Normal /. 7 ' b eta W' An /S►h e15 Other References Reviewed: Zone B M/W Q� 7,3 � /• !o �dJ• DEP APPROVED FORM- 12/07/95 r - 9 FORM 11 - SOIL EVALUATOR pagic Location Address or Lot No. d l! .Sc c..i oCj,-r �q W, ,y y , • • Ort-site Review - Deep Hole Number Date:. �'�./ Q�9 Time: /./ : /sr Weather Location (identify on site plan) a..!1..:..::�as' . �.r4 S,�/ Land Use Slope(�/,) 21!� Surface Stones ^�:a Vegetation Lantiform ....`C�l.o <.1a Position on landscape (sketch on the back) . . Dlstandes from: Open Water Body /--a+ feet Drainage way N/? feet Possible Wet Area /oc, feet Property Line . 3 Q r. feet Drinking Water Well MJ-4 . feet Other ,.,......::. ...::.:..:....; I i ! DEEP OBSERVATION HOLE LOGS ` Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munseil) Mottling (Structure,Stones, Boulders, Consistency i Gravel rt p--/a /�- Lca•K y J:S' . 410 ) yA 21- C r vQrse l�yak,' A/7,0 i Sj i 'il 'jli 1. ,j `1 r 1 t Parent Materiel(geologic) CA-Y' N DepthtoBedrock:_ Depth to Groundwater: Standing Water In the Hole: S. [ Weeping from Pit Face: E$timated Seasonal High Ground Water: J'; / -- /, G 3 f DEP APPROVED FORM•12/07/9S ,Yt � 1 , I FORM II - SOIL EVALUATOR FORM Page 3 of 4 LncAtion Address met-Ale- "Y<11_I ��or, (� Deter»tinatiott for Seasonal Hiph Water Table Fe..s 1�- H en,/r Method Used: ❑ Depth observed standing in observation hole........:� !.. inches ❑ Depth weeping from side of observation hole inches ❑ Depth to soil mottles . inches ❑ Ground water adjustment ....�.�.b�. feet Index Well Number .A�lt+ '�.9 Reading Date F�I9. Index well level .7.3. Adjustment factor .... . Adjusted ground water level .........:...3.�;s' 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 Nd v 07::Kidate) 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 /® h DEP APPROVED FORM•12l01/95 IL • v t s FORM 12 PERCOLATION TEST Page 4 of 4 ' Location Address or Lot No. •� l a ea•, fir'. w' Hy�� r COMMONWEALTH OF MASSACHUSETTS G e , Massachusetts 4 Percolation Test Date: .. Zli 819 46 Time:. ./. Observation Hole # Depth of Perc Start Pre-soak End Pre-soak 2 Time at)2" z : •- s" o T11ne at 9" r -Z 19 Time at 6" Time (9"-6") Rate Min./Inch l �— Minimum of 1 percolation test must be perfofined In both the prirriery area AND reserve area. , Site Passed Site Failed ❑ Performed By: r- CL l /C' - A-2. .0 Witnessed By: 'ff Cl l3 a �y Comments: DEP APPROVED FORM-12/01/95 I E' SOIL EVALUATOR& PERCOLATION TEST FORMS OF1HE r, Page 1 of 4 Town of Barnstable (� BARM TABLE, Department of Health, Safety, and Environmental Services S. 039. � Public Health Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6265 FAX: 508-775-3344 tS011 Sultab111ty AS.Se.SSlnent for Sewage Dlsposal NO. �— �� Date: Performed By: ��'" �/ ho ?' 6 Date: Witnessed By: 4Ea �3 4r y <3 Location Address/ / Owner's Name t1 7 • P,(0,F3�x 32 3 Lot N: L m Address,and `� ,,5e- G'GQ�,y Assessor's Map/Parcel: 2 e Q, ! 13 7 Telephone H CS"p 8, 7 T.�-6-7 , NEW CONSTRUCTION REPAIR Office Review Published Soil Survey Available: No Yes F Year Published .3 I `)3 Publication Scale t s� Soil map unit Cad C3 . Drainage Class V/I ,s Soil Limitations ex, r-r,5s e Surficial Geological Report Available: No Yes ✓ Year Published ,V 9 A Publication Scale Geologic Material(Map Unit) 9 C-,= y ►" Landform 4, a / i�D --j C --z e, 1 — Flood Insurance Rate Map: Above 500 year flood boundary No ✓ Yes Within 500 year boundary No Yes �- Within 100 year flood boundary No v Yes Wetland Area: National Wetland Inventory Map(map unit) Wetlands Conservancy Program Map(map unit) �� Current Water Resource Conditions(USGS): Month or_yl- Range: Above Normal Normal _ Below Normal /. T 6 eA0 W !S►y e Other References Reviewed: Z®r1@ A Al/w a? 7.13 r /• 4 DEP APPROVED FORM-12/07/95 r - F0101 II - SOIL EVALUATOR FORM Page 2 of 4 I W10 Loc ation Address or Lot IJo. On-site Review Deep Hole Number 2- Date:.. G,�/.4R,f 9 4 Time:. t/ /� Weather Location (identify on site plan) �'.-:.fr' ^r X.,ar.. ." :. " Land Use .f� ' �� "' Slope M 2-/d Surface Stones - •C. c,,. A . .. Vegetation . .. � ,� ... .... ._.. .., .. ..:.. ....:: .:.:: Landform .... L o c e o f. . Position on landscape (sketch on the back) Distances from: feet Open Water Body /90 r1- feet Drainage way fR Possible Wet Area /q o' feet Property Line e- .. feet /✓ .4. :..::.. Drinking Water Wellfeet Other :.::....... DEEP OBSERVATION HOLE LOGS Other Depth from Soil Horizon S(USDA)re Mil cor Soil unsellol) Mottling (Structure,Stones,G avlel►rs, Consistency, % Surface(inches) sQ.tay Lao y i �3 y2 r /S 2 � sahaf F. E 24�( 30�� ` sa-r,cA Co CA. 2.s-y - 30- /cam 2 SsnC, Ct Y° v , 'J � " ---- DepthtoBedrock: �V Parent Material (geologic) 1 weeping trom Pit Face: Depth to Groundwater: Standing Water in the Hole: 7• Estimated Seasonal High Ground Water: 7 DEP APPROVED FORM•12107195 i FORM 11 - SOIL EVALUATOR FORIM9 Page 3 of 4 Location Address ot=Let--Al$-- %A1 /-tyG-,.,, Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole.......BS inches ❑ Depth weeping from side of observation hole . inches ❑ Depth to soil mottles . ..— inches ❑ Ground water adjustment ....:�.-.fib. feet Index Well Number .�Mr Reading Date . 9... Index well level.?... Adjustment factor ....../.'A Adjusted ground water level ................ -s...... ..... .... 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 Nd v M (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 G— ��--- Date DFP APPROVED FORM.12/07/9S i FORM 12 - PERCOLATION TEST Page 4 of 4 Location Address or Lot No. /® c�a� fir'• w' �yy� COMMONWEALTH OF MASSACHUSETTS t3 .s C.C; e , Massachusetts Percolation Test* Date: .. 4�i8/94 Time:, 1 /.. `. . Observation Hole # Z Depth of Perc 6 ©" Start Pre-soak 4 2 : 4 0 End Pre-soak /; s s : �, d ,; ,e Time at 12" Time at 9" Time at 6" Time (9"-6") Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed a Site Failed ❑ Performed By: Witnessed By: ff d 13 Q y Comments: DEP APPROVED FORM-12/07/05