HomeMy WebLinkAbout0000 INDIAN HILL ROAD - Health Town of arnstable P#
Department of Health,Safety,and Environmental Services
�t►+E,q Public Health Division Date _!S' 30- q 7
367 Main Street,Hyannis MA 02601
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°rFo ► Date Scheduled —5—— - . - Time 0 A Fee Pd. �
Soil Suitability Assessment for Sewage Disposal' `
Performed By: A r t\f e W 0.\� � W itnessed By: L vv fl fl t R�
LOCATION & GENERAL`INFORMATION
Location Address dl/-3 7 a_/t,� Owner's Name �a5 ���-:Zq1 e ��
Address TO �1'- -61-1 (C, wlcO
oZ�37
M Assessor's Map/Parcel: i4 l S 7 Engineer's Name
NEW CONSTRUCTION REPAIR Telephone#
Land Use Slopes(%) U-- Jg61_ Surface Stones gcft bo,uJt02k4
Distances from: Open Water Body— ft Possible Wet Area 1 ft Drinking Water Well �/�- 'ft
Drainage Way_ eft `'Property Line Other ft.
� . .,,. .• + •; �� �..tea.�� ���4�, ..
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ,
1 N o R N i t L R 0
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Parent material(geologic) M.okat,,,� Depth to Bedrock `tom 4
Depth to Groundwater: Standing Water in Hole: Ww _ ,n Weeping from Pit Face N� �—
Estimated Seasonal High Groundwater 'Not I NCOUN1-7 f�
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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 ft.
Index Well#_ Reading Date:_ Index Well level. Adj.factor Adj.Groundwater Level
PERCOLATION TEST! bate ' 12 1:TIme
Observation
Hole# 1' I 1 P —�'�S Time at 9"
Depth of Perc y� �; Time at 6"
Start Pre-soak Time @ ) 2 Time(9"-6"),
End Pre-soak :57
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back—�
Copy: Applicant
DEEP OBSERVATION HOLE LOG Hole
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.° Gravel)
O — C. A, 40,401 ny2��
G-' d Sir ! K^ z.sy sl3
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- 120 rn�pk% 5AMIz$y
DEEP.OBSERVATION HOLE LOG Hole
Depth from Soil Horizon Soil Texture I Soil Color I Soil Other
Surface(in.) (USDA) (i�lunseii) Mot", (Structure,Stones,Bnul'ere:.
nitnc °
Z o O
c�--z ,� sajLom�.�• 1oy�y3
/0y12 Z� �r�^�� ra�,
d6YR 6 co�Or5 a I ,or 6%1
mc�Q cSe
y�_iZp cZ 2.5�`gjy 00 � c
r
DEED OBSERVATION MOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.° Gravel)
DEEP.OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.° ravel
Flood Insurance Rate luau:
Above 500 year flood boundary No— Yes ';O*�
Within 500 year boundary No— 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?
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on (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 —. Datea4/4?.7