HomeMy WebLinkAbout0067 FIRST AVENUE (HYANNIS) - Health (2) (e"1 �irS-I- flVen �e, H�anniS
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APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS
LOCATION L6 Z? �3i7 NO.
VILLAGE '1lLQ � 1 4IIS DATE
APPLICANT T rq-� �i� A►?� FEE /O� ar)
11ADDRESS ' TELEPHONE NO. (Non-refundable
ENGINEER V116 k, TELEPHONE NO.
DATE SCHEDULED
(Applicant' s signature)
0 0 0 0 o eAP6i o • o oLOT n e o NU:• . o o . • o . 0 . o 0 . • • • • • • o • • • o • • • • • • • • o 0 4 0 • . • • • • • o • o • • • o o • o • • • •
r�'ssi ssoR s bi
SOIL LOG
SUB-DIVISION NAME So_�Stp &Z _ DATE��„��.� ,
E.YPANSION AREA: YES ✓NO � .r-� 8 TIME
ZZ_4ee
4 ENGINEER:'N' '
TOWN WATER 'PRIVATE WELL BOARD OF HEAL7
EXCAVATOR
SKETCH: (Street name, etc. ,dimensions of lot, exact location of test holes and
percolation tests, locate wetlands in proximity to test holes )
NOTES :
i
001 1
PERCOLATION RATE:_. 141441� OYL CLW_SS
TEST HOLE NO: ( ELEVATION: TEST HOLE NO: Z
1 ELEVATION:
F-`. 2
Lo+K •t Sue. 1
3 Ntu-D 3
Saws C/�N�� 3
5 5
6L�� 6
9 9
10 10
11 11
12 12
13 . 13
14 1 14
15 15
16
I
SUITABLE FOR SUB-SURFACE SEWAGE: LEACHINGFIELD^ , LEA ING PITS
LEACHING TRENCHES t
UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS:
NOTE: .ENG_INEEIRING PLANS MUST SHOW NUMBER• ASSIGNED .ON PERC TEST APPLICATION
ORIGINAL': COtfPLETED TN ENTIRETX F3X P F AND RETURNED TO BOARD OF HEALTH
. COPY: RETAINED BY APPLICANT