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HomeMy WebLinkAbout0015 SYDNEY DRIVE - Health (2) I�' � �n ����e �r�n�'S � , �i �' --__---�___ �� t b b � I Town ol'Barnstable P# >S5F3 /� Department of Health,Safety,and Environmental Services �Im Public Health Division Date 367 Main Street,Ilyannis MA 02601 BARNUABLE. d HAM (r' Date Scheduled �`S Time; Al" Fee Pd. �0 -r rSoil Suitability Assessment for Sewage Disposal Performed By. 'pAN1EL A. OJALA Pl-S,5C Witnessed By: �NNA M�(LgND I E� ' ' ( 1iEIIsi� t�t�+`U0�AxX�N Location Address Owner's Name a LA s NE Y� y R ' li*(A Q N\5, M A Address -� sName '�O�N C� CNG�u Assessor's Map/Parcel: --z-3� I 4' Engineer's y/,A AAA00;)'W0Y,T , ivy NEW CONSTRUCTION V REPAIR Telephone# SO $ 36 Z y 5`4 I Land Use l/PI�L3! Slopes(%) Surface Stones Distances from: Open Water Body R Possible Wet Area R Drinking Water Well R Drainage Way R Property Line l� t�'�` R Other R SKETCH:(street name, exact locations of test holes&perc tests,locate wetlands in proximity to holes) dimensions of lot, ,tip�'�,�►.� • , l 0 8.-}�- �I �! n � I_ LocrvS 0 � Q W � r qp o ( �2 Parent material(geologic)"' �''' LdAk-`N Depth to Bedrock Depth to Groundwater: Standing Water in Hole: / Weeping from Pit Face �— Estimated Seasonal High Groundwater /'(� N New fin- .. ry�j Syr >:< VH1�TA' 'Itlri. OYt.SASUA . GD'4?VA 'EI .:;.:;:.:<:.., 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# •Reading Date: Index Well level.. Adj.factor Adj.Groundwater Level_ A//A :>:. ;:.>:: »<::.PEItCHLATl1:TES:..::::::::....... .:::::::. .. , Observation —T-4 Time at 9" Hole# eQ2 rr /: Depth of Perc Cy°��^^� 7V Time at6"•tt•N �' i� e•1� Start Pre-soak Time® 0�yo 0'00 Time(9"-6") 'W a N/tar Gals End Pre-soak 15:3o Rate Min./inch GZ-' 4 Z Site Suitability Assessment: Site Passed V Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back—� Copy: Applicant D1> 1X' UIIYY �"Y+tV IYt •E .:::..:; Hn �.;� ... .. ... . : . Depth from Soil I lorizon Soil Texture Soil Color ' Soil Other Surface(in.) (USDA) (Munsell). Mottling (Structure,Stones,Doulderes. e tJrarea ��(' a.n.c to ���2 2iLi �. L5 10`1(L —5 C L-5 I Oy(L7/1 10.wt 5/f. 2T- 132 G V M/t- 5A N7 No w -pe(L j oVN . DEEP OBSERVATI ?N Ht7iE LOG HQ�$#; ) . .. ....: . . .... ..:... .. . .. ...,...: Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface ll (USDA) (Munsell) Mottling (Structure,Stones,noulderes. % 0 Ar.C- A LS n,�,L 3(z L.5 107tL7/1 -30 3 I--15 ( 0 yrt 5/6 30-13"Z- c-1 Aye- SANS 2-5 7/& Co% r . bEEI lorizon Soil iSRVATIUE .()( Dol be I e h from I Soil Te xt ur e So il o Soil Other Surface(inJ (USDA) (Munsell) Mottling (Structure,Stones,Doulderes. % t . DEEP OIIERVATION HCjXE LO;G Hple# Depth from'' Soil Horizon `' t"Soil Texture Soil Color = Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.%Gravel) Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes Z o N6 L 3AjW -PANEL $ Jv171 Within 500 year boundary No— Yes Within 100 year flood boundary No— Yes �Oepth 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? ' }. f #If not,what is the depth of naturally occurring pervious material? t N f) Certification 1 certify that on /V 0V• t;— (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 CM 15.017. Signature -^'` Date