HomeMy WebLinkAbout3785 MAIN ST./RTE 6A(BARN.) - Health Ilk
TOWN OF BARNSTABLE �
LOCATION SEWAGE VS
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VII.LAGE r a U44 ASSESSOR'S .MAP & LOT ,L
INSTALLER'S NAME & PHONE NO. �o
Y . SEPTIC 'TANK CAPACITY /00 0 6,4 L
LEACHING FACILITY:(type)-PAg Fl--J j'jEajAsize) 'mow e
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER . ALL
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BUILDER OR OWNER
DATE PERMIT ISSUED:
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DATE COMPLIANCE ISSUEDY/I e�
VARIANCE GRANTED: Yes No
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Town of Barnstable P# 900
Department of Health,Safety,and Envirotimental Services,.
oFt Public Health Division _Date 91 Z9- 4
367 Main Street,Hyannis MA 02601 r •
BMINgreer$ ! a s
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' � ress , '.9 N- 4 Time ; o�Oar Fee Pd. '�00.
OrFn t���•T Date Scheduled — �— _
Soil Suitability'Assessment for Sewage ), -
soil
Performed By: /a;0,VV20 Witnessed By:, .�C/Ls�y,.. �u/✓y�
LO ATIO,N & GEN MAL INFOI M�1Tyt N
Location Address 3�� lZ, &A (MA i,✓ ST, Owner's NameXZ wi r,)a C t w 1J/
134BrJ.971 A 63 t✓u Address'
Assessor's Map/Parcel: 3 3 S /ems/y Engineer's Name SDI vt 9MA In) €
NEW CONSTRUCTION REPAIR 4_,,k_ _Telephone#, y/3 Z
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Land Use A L- Slopes(%) Surface Stones �U
Distances from: Open Water Body J O O ft Possible Wet Area /OU f ft?' Drinking Water Well :(/0 ft
Drainage Way 7 z S ft Property Line 7 ) ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
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'33+5�
Parent material(geologic)G[,1?I/A1- 61 14d A j001^ Depth to Bedrock 300-F r
Depth to Groundwater: Standing..Water in Hole: — Weeping from Pit Face Qi �•l3CL�i J G QiADc?
. � (F'�lOYh SiniGc�d P��l2oviS
Estimated Seasonal High Groundwater /✓aT A Fy4.-rdlZ
DETLI2NYINATIOl T Y. A SEASONAL HIGH WATER TALE
Method Used: 1VTL/oeb'
Depth Observed standing in obs.hole: in, Depth.to soil;mottles: ,-rr7 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
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PERCOiLATION;:TESI' Datjt:
Observation
Hole# / Time at 9' n
Depth of Pere -/F'SG Tune at 6'
Start Pre-soak Time Q Time(9"-6")
End Pre-soak 1�•00 A ^,,
rrr r N
Rate Min./Inch ��✓ /Z '
r zuvc xd .e-,t iAs v {1 f'i3%vsA/�<.d !�?^�t l'r�i A
Site Suitability Assessment Site Passed Site Failed: "' Additional Testing Needed(Y/N)_d
Original: Public Health Division Observation Hole Data To Be Completed,onBack
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Copy: Applicant
1)EP CISEIt'�ATt01 HOLD LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color" ` Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%
Ar
2'/-3 6 3� s�o.,,oy ,�bp 10 ►Z 5/3 °
GoArtif0 -r-99y N
6"d G G' ► c,or w� 10 y!2 S�L1pSlivc3' �i2
6y
t.
.
DEEP OBSERVATION HOLE LOG : Hole#
Depth from I Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes..
%
11El✓P OHSE1tVATION HOLE LUG Hot+e
Depth from Soil Horizon Soil Texture .. Soil Color Soil Other
Surface(in.) (USDA) (Munsell Mottling (Structure,Stones,Boulderes.
%
DEEP OBSERVATION HOLE LOG Hole
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%
4
Flood Insurance Rik*ap: y '
Above 500 year flood'boundary No_ Yes k- r
Within 500 year boundary No k Yes ,
Within 100 year flood boundary Nolte 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? .tro
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on (date).L-tlave 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 Date