HomeMy WebLinkAbout0045 UNCLE AL'S WAY - Health (2) �S �nG�L �"� 's Ut1a�-, �G►�►1rS
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'l,uwn of Barnst,'Ible 110
Department of health,Safe(y,and F,nvironmental Services , d—
Public Health Division Date
367 Main Street,I lyannis MA 02601
I. ruw+arearr. °
MAW � Time Fee Pd.. I DD
rE019.0.` Date Scheduled
• Suitability Assessment for Sewage Disposal.
Soil Suitability
C1.�(,l SON Witnessed By: I
Performed By: r�Om(J j M '
LOCATION & GENERAL INFORMATIONOwner'sNarne I M>`►IONE.`J
Location Address S wucuju
HV tv"'I Address
,�/3_r, Engineer's Name bEMI rlks(-M �N�
Assessor's Map/Parcel: ZQ
NEW CONSTRUCTION REPAIR
Telephone N 398-71 ID
Slo es(%) 0— is ' Surface Stones NA
Land Use a;6'5 l ve/vl' l_ p R
R Possible Wet Area—
Line R Drinking Water Well /�
Distances from: Open Water Body /_
Drainage Way
SQ' it Property Line Z_5—R Other R
KF,TCII•(street name,dimensions of lot,exact locations of test holes&pert tests,locale wetlands in proximity to holes)
S
Depth to Bedrock
Parent material(geologic)
C,l�4U4( OUYlvOsy
" i 1�
Depth to Groundwater: Standing Water in hole: 108
Weeping from Pit Face
Q—r"
Estimated Seasonal Iligh Groundwater U
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: t ry L1P a aF 1641, Nt�H)la8 in. Depth to soil mottles: NdA't in.
Dcpth Observed standing in ohs.hole: In. Groundwater Adjustment R.
Depth to weeping from side of obs.hole: N4 Ad factor Adj.Groundwater bevel
Index Well H A(�b Reading Date:'"ll-I Index Well level 21.01 �--
PERCOLATION TEST I>ate 'rime
Observation Time at 9"
Ilole N
Time at 6"
Depth of Pcrc
Time(9"-6")
Start Pre-soak Time u
End Pre-soak
Rate Min./Inch M
d
Site Failed: Additional Testing Needed(Y/N)
Site Suitability Assessment: Site Passed�_ •
Observation Hole Data To Be Completed on Back
original: Public nealu,Division -�
Copy: Applicant
i
DEEP OBSERVATION HOLE LOG 1101c # I
Depth from Soil I lorizon Soil Texhue Soil Color Soil 011icr
Surface(in.) (USDA) (Munscll) Mottling (Structure,Stones,Iloulderes.
Consistency,°
IOdM 0A,V
IO$tt flLL 57Um (Spbuowilr-% 148tr
a t, c, Mir) s1&')
DEEP OBSERVATION HOLE LOG 1101e# 2
Depth from i Soil I lorizon. I Soil Texture I Soil Color Soil. Other
Surface(in.) (USDA) (h'iunscll) Mottling (Structure,Siunes,Iloulderes.
Consistency.N��
(, jUn,htffL qL r,
DEEP OBSERVATION 11OLE LOG hole#
Dcpth from Soil I lorizon Soil Tcxturc Soil Color Soil Other
Surface(in.) (USDA) (Munscll) Molding (Structure,Stones,Boulderes.
en ° Grave
DEEP OBSERVATION HOLE LOG Hole#
Depth From Soil I lorizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munscll) Mottling (Structure,Stones,Iloulderes:
cons stency.° Gravel)
rlood Insurance Rate Man:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No— Yes
Within 100 year hood boundary No_ Yes
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?
If not,what is the depth of naturally occurring pervious material?
('ertification,
I certify that oil l—4 (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 trai ing,expertise and experience described in 310 CMR 15.017.
/ , In ) Date