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HomeMy WebLinkAbout0043 IRIS LANE - Health 51 Iris • 34 Barnstable ne 1 1 1 Town of Barnstable P s Department of Health,Safety,and Environmental Services �t ]Public Health Division Date 1/00 Q, 367 Main Street,Hyannis MA 02601 3 sartrtsraat.e, + Mass i639`°rEn Me't" Date Scheduled b �Time A Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: cR Witnessed By: 0,,Pj,4 r' i cIPMJ Q 0 .... .. l�l?CA ( Nc GETIiAL INt+ORMA'I SON Location Address ;/)/ al l �� Owner's Name Df Address Assessor's Map/Parcel: � f Engineer's Name CAT IL NEW CONSTRUCTION REPAIR Telephone# 3/pZj'- r(�-t a�(�. --d�e Slopes("/o)_ / Land Use 4 "'ro 7d Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Wellft Drainage Way VIA— ft Property Line 1Zft Other SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) N L 1 1 44 IT f-2 G�f�•r L" 0-0 Parent material(geologic) CIL N' IA(, G Depth to Bedrock y Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face /V O/V f Estimated Seasonal High Groundwater Method Used: JVli� 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 PEttCOLTO%V`TEST tate�� T,me ;E' 1 Observation Hole# Time at 9" _ Depth of Perc 5� Time at 6" L�� Start Pre-soak Time @ �J���N ��%d ��' Time(9"-6") End Pre-soak �� 3 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 j Copy: Applicant DEEP MR.* �ATIU�1 Hl7LE I,O� lIol�## Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.%Gravel) (9—Z d1-4— 0 4 6V( CU ItAplrC 'i—� iay� 13 a 1O&AY544 Z•SY Se� yle DEEP o�sER�A�rroN xoE xoct,r Depth from Soil Horizon. Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. °o Gravel) D Z � �- 01 -32 G.•fw' /b Y(25� f w-e.S&,A AIVZ.617 y w J �yy 41N c-�, s y /y DEEP OBS�RUATT�N HOLE LOG Isle Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(i (USDA) (Mansell) Mottling (Structure,Stones,Boulderes. --CQp2istency.°o Gravel) DEEP ERVA"i'IC�NJfOLE LQG H[o�e Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. ronsi5loicy.%Gravel) Flood Insurance Bate Map: Above 500 year flood boundary No_ Yes 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 9 (date).1 have passed the soil evaluator examination approved by the Department i of Envir onmental onmental Protection and that tlle above ana lysis was performed by me consistent with the required training,expertise and xperi ice described in 310 CMR 15.017. Sienature