HomeMy WebLinkAbout0174 COBBLE STONE ROAD - Health 174 COBBLESTONE ROAD
BARNSTABLE -`
A= 316 - 064 - 003
v
I�
M
I.
i
/7- 137 r WI� ,-W
Town of Barnstable P# �S
�FIKE r
dy` c Department of Regulatory Services
EARNSTABLE. : Public Health Division Date
y MASS.
Q� 039. �0 y�—� /�L(00 Main Street,Hyannis MA 02601 hp=�
ArEO Mptl A i O
✓\ N3
Date Scheduled `" ? Time Fee Pd.
Soil Suitability Assessment for S ge Disposal -:1
Performed By: N't, Witnessed By: -�1 `�
LOCATION& GENERAL INFORMATION
Location Address Owner's Name
Address
Assessor's Map/Parcel: 3/�/ T Engineer's Name b ow,N, `�P—
NEW CONSTRUCTION REPAIR �T1elephone# 06 J b cl
Land Use U j,JOJ e d Slopes(%) l/y Surface Stones ✓an e
Distances from: Open Water Bodyft Possible,Will et Area >161G ft Drinking Water Well.T 00 ft s
Drainage Way >1.0 ft Property Line / ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
o � � &4
T, _
Parent material(geologic) h ac,,ct v dkzA Depth to Bedrock > "
Depth to Groundwater: Standing Water in Hole: V Weeping from Pit Face Al A
Estimated Seasonal High Groundwater /V l�
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: �1/ G W F.=
Depth Observed standing in obs.hole: in. Depth to soil mottles: in. -
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_
PERCOLATION TEST Date-Z/lIlk Time 10!GV
Observation
Hole# ` Time at 9"
7 Z ��
Depth of Pere 7�/( Time at 6"
1 r'
Start Pre-soak Time @ Io:UG I U•!3 Time(9"-6")
t End Pre-soak
RateMin./Inch
Site Suitability Assessment: Site Passed#' Site Failed: ~ +'Additional Testing Needed(YIN)
Original: Public Health Division Observation Hole Data To Be Completed on Back---------
1
***If percolation test is to be conducted within 100' of wetland,you must first notify the'
-- tsarnstab'Ie`Conservation Division at least one(i)week prior to b ginning.
QASEPTIC\PERCFORM.DOC
r
- r
f ,
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency %Gravel)
to
^(Q� C I 1,S' r/3 - /00 Gra ve L
00409 Cz AIFS Z tSY PIV
DEEP OBSERVATION HOLE LOG Hole# z-
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
_/0 � 3�Z
IrN
S L 10YR�-lq
q0-�(0 �-r /� 2,Sys�3 oolo bra ue�
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel
040 S (OXKLI/z
S C d yk-/�
3&- 00 C �CS (oYk 0/(0 107a 6ravel
&0- CZ ll`f�- 7 YP
DEEP OBSERVATION HOLE LOG Hole# y
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel
g- 3 S L, [OYk-W'
y-S-y � )4/(S soy"llp �f,�v Grea W
Flood Insurance Rate Man:
Above 500 year flood boundary No Yes
Within 500 year boundary No V Yes
Within 100 year flood 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? y e ,5
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on I> t Z (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"L ' -� Date Z Ar
Q:\SEPTIC\PERCFORM.DOC