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HomeMy WebLinkAbout0556 YARMOUTH ROAD - Health (2) i t I 10:41 TOIAIpd OF BARMST � 3 V HBLE 1+,,t'„+775+,,3c)4 P.©2%02 ayrrna V1 @Ad[a >ta�lA0.ldG Y!# l� L4 Department of Health,Safety,and Environmental Services 9 f 3 ' Public Health DliVision Date��' 367 Alain Street,Hyannis MA 02601 RARNa1`AB[$ v NAM t67q. ion + Date Scheduled - "7 Time Fee Pd. pc� Foil Aitability Assessmrent fog• Sewage Disposal Performed By: C r a-J q l2 . S A o r L, i-'E Witnessed By: Se= r r` -DV n e7 r h 9 LOCATION& GENERAL INFORMATION Ldcation Address 6-6- � �A Owner's Name Win. w1(6�r irk 72S Ceo/Qt- Tre-eN« PC/, f l�hn15 Address M .5 tic q M,//s �'t C 1G48 Assessor's Map/Parcel: .3 4 T/ 7 G - / Engineer's Name C►^w,#5 lz . Stior�C- NEW CONSTRUCTION REPAIR ✓ Telephone (5-06) 3 98 1/ Land Use C o-�-,r�-s cr /CA Slopes(0/0) /. Surface Stones A/m Distances from: Open Water Body Possible Wet Area — ft Drinking Water 1VcII R Drainage Way ti �9 e S Yft Property Line _7S ft other tt SKETCH:(street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) y'} 2/'N C Gj 00 r* 8a Parent materiel(geologic) C a Depth to Bedrock Depth to Groundwater: Standing Water in Hole, Af o n C, Weeping from Pit Face ALJ Estimated Seasonal Nigh Groundwater .t l)FTERIVIIN:4'I" Method Used; .c-/,q ION FOR SEASONAL.WGHI WATER TABLIE _ Dept of bselcd standing in obs.hole: Depth to weeping from side ofobs,hole. to Depth to soil mottles; in Index Well k in. Groundwater Adjustmcgt Readin ft g Date:,- Index Well level Adj.factor J Adj.Groundwater Level PERCOLATION TEST Date rimy Observation Hole q �, Time at 9" 140 4 3:O o Depth of Pere (�O f r Time at 6" / 43 .3 0 Start Prc soak Time(� / :.,3(o: 40 d Time 9"-6" 3 .SEC r c4 q Q/s ( ) End Prc-sock /,n : 4 1 : 4a 6 Ratc Min./inch Site Suitability,Assessment: Site Passed &-11' Site Failed; Additional Testing Needed(Y/N) Originate Public Health Division Observation We Data To Be Completed On Back Coov: Aoolicant ---�' TOTAL P.02 1 DEEP OBSERVATION IIOLE LOG Ilole N / Depth front Soil I lorizon Soil Texture Soil Color Soil other Su face(in.) (USDA) (Munscll) Molding (Strucluic,Slone%,Houldues. 5 ych i 1 2 PQ V-e.+'fe.!t s�•,dy ioY� <o am 3 / L o or# •%y 3 „ Q SG v►d - --- Go,. C 1o�r��. y) ` ci�a�e / _ --- DEEP OBSERVATION MOLL LOG I101c N _ Depth lions Soil Ilorizon ,. Soil'I'cxlurc Soil Color Soil Other Surface(in) (USDA) (Munscll) Moll fir rg (SUucturc,Slnncs;llouldctes. ' C:4lisislctrSY.1.�(ar;tt�cl� DEEP OBSERVATION HOLE LOG IWe 11 Dcpllt from Soil I lorizon Soil Texturc Soil Color Soil Other Surface(in.) (USDA) (Munscll) Molding (Structure,Stuncs.Iroulderes. DEEP OBSERVATION HOLE LOG hole N Depth from Soil I lorizon Soil Texture Soil Color Soil other Surlitce(in.) (USDA) (Munscll) molding (Sinrciurc,Shares,nouldcre%. . r I�ysl In�►r;tncc Itatc Man: Above 501)year flood boundary No_ Yes Y Wilhin 500 year boundary No ✓ Yes Within 101)year flood boundary No Yes P--Rltluj-[Vtttltr lly Qccurring Pervious Maternal Does at least tour feet of naturally occurring pervious material exist in all areas observed I1111-ough6ill Ilie area proposed for file soil absorption system? yt x If nol,what is the depth of naturally occurring pervious material? i Qtdi-rwali.lz1 1 certify that on N/e✓ ,941" ((late) I have passed the soil evaluator examination approval Iry the Department of Environmcn(al Protection and that the above analysis was performed by ale consi.:lcirl tvidl (lie required fraining,expertise and experience described in 310 CMR'15.011. Signaltirc - —`-� — -�--- Date ��� ;! Town oil B.-arlista lll I'N 1 t V ; Moo rintr n(of Hen lilt,Safely,and Environatenlal Services i Public IIeallh Division vale 1 •_ } 367 Main Street,I lyminis MA 02601 t. MARMAltl ra7P ` rto " Dale Scheduled .5` `- y 'Time /a-caG Fee I'd. / y U Soil Suitability Assessment fog• Sewage Disposal. ...Performed By; q 2 �?mob Witnessed By: J Jw -7-1 e9_ -- ` LOCATION & GENERAL INFORMATION Location Address S3�, %a�-�-�o u T� �����/�o�Uwncr's Name VVe,v �� v.-�n/� /h 1.2J��cfa.-- Ti-r r i✓�. �. I i _ Address i Assessor's Mnp/Pnrcel: .: 3 Q 0 7 G ©,® � Engineer's Nnme O Z 4 �' NEW CONSTRUCTION REPAIR ` 'feiepiwne /: Land Use 4e 'O, Slopes("/o) 5urfnce Slones Distances from: open Water Body N/ R Possible Wet Area ^K/' 11 Dtiokiog Water Well A/.;% II tDrainage Way �V is¢ R Properly Line f It Other — R # SKETCH:(Street name,dimensions of lot,exact locations of lest holes&picric tests,locale wellnods In,pmxhnily to holes) 9 V r S 3. 7S ti 1 Parent material(geologic) CQ V- ✓t'r. e Depth to Bedrock /✓/� I)eplh to Groundwater: Standing Water in I tole: Weeping from I'it Face li 1honted Seasonal I ligh Otoundwalcr S VS �S ritar� DE I'I'RMINATION VOR SEASONAL 111G11 AVATER TAM A,' ntcmnd I ISM: v G s --7� Depth t)bst-n•C(I standing in ohs.hole: in. Depth In soil rn1,111Cs i„ I)Cplh Ina-ecpinp frotll side of obS.hide_ --- —_ in. (irtnmdw:licl Adjuslnu'm it Index 1V1:1111 -- I(crlding Date: Index WCII lCVCI _ Adj.factor -__- _-Adi.1;mmot.:,jt I rt,l - PF,RCOL,ATION TEST call — Iiml• - __._ t,bservation I lulc 0 Tinlc al 9" Depth of Pere ZL ca— 'I ime a1 6" %`Y ` ¢3.'•� `' Sinrt Prc-soak'fink tjt) / 3��-'c'C . 1 trod Prc-sunk 1 i Italic Min./Inch C 2.' / Site SIIIIaI111it`y A ssCssillcol.,Site Pas ✓ SIIC I:IIIC(I: •�'A(Illtllltll;ll ICSIIIII!NccdullYr!I —_--� Oligilull: Pllblic IICa1111 Division OIlse 1.va l ioll I Iule D10 To Ile 01 Ill I 1 Ic 11'1 I o11 1t:11,N---•—•---1 O)py: A111ii and I Uli;l%1' U13Sl 1tVA'I'ION IIOLh; I..U(v hole H / I)cplh I'iuin Soil I lorizon Soil Texlure Soil Color Soil ^(Abet Surface(in.) (USDA) (Monscll) Molding (Suuclow,Slonr�.Ilouldues. • _�.._ _l�(!rlsislc'rr�Y.,i�.lhn1'SI) +Vl e d .Sct,%.- / L A4 L.6Ca �r Lac,BSc' Z.S UL11' 013SLltVA'1'IUN IIULI�, I,UG — Depth from Soil I lorizon soil'I'cxlutc Soil Color Soil 1 nhcr Slit We(in.) (USDA) (Monscll) Molding (Shuchuc,Sloncs.nouldeles. _S kills i'mcpcy.-;e(;r yo. j) 1)I,I�,I' U13Sl:1tVA'1'IUN IIU1,1; I,OG Ilolc i'= Depth floor Soil Ilorizon Soil'I'cxlorc Soil Color Soil (Ilhcr Surface(in.) (USDA) (Munscll) Willing (Slnrc4nc,Sloncs.Ilnuldcres. — —. �,QIrCIglltnSY.1^.(il�rYll) . DEEP OBSERVATION HOLE LUG Ilole /I Dcplh from Soil I lorizon Soil Twurc Soil Color Soil (nher Surface(in.) (USDA) (Monscll) Molding (Slnrclure,Sloncs,Ilooldcres. � (�S!R�.islcPcy,10(.ira!'SI) L19tlll I.)rs nl(Sg_Ittllc Alai): Above 5011 year flood boundary No` Yes Wilhio 500 year boundary No Ycs Wilhio 100 year flood boundary No Yes — ))clr�J!ujfV;(1)n's►Ily Oct(( n 'ervi lug 11tg(cl-iil,l Does al Iensl liver lint of naturally occurring pervious material exist in all aiew; olscl r e,I Ihrnul,hrnd the area propnce(1 tin'(Ile soil absorption sysfcnl? If not,what is the depth of naturally occurring pervious nlalerial? r 1 cerlil'y that Im iJt)y I have passed the soil evaluator exan(inalinn appr(rvcd I,v lhr DeparUnent ul'I?nvirnnmenlal ('rolecliun and that tle almvc analysis was pel101lite([ I,y Ile con»;i:Icnl (eill, Ills required training,expertise and ex )cricnce described in 3 10 CM It 15.017. Signature ,c >% Date