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HomeMy WebLinkAbout0049 RUE MICHELE - Health 1 �49.RUE MICHELE t Barn"stable r 066 4 1 r I r v!{j 33.; 0 LAt 3 Town of Barnstable r# Department of Regulatory Services � e�nrrareet$ ' Public Health Division Date 5 �� D t\ 6s9-��� 200 Main Street,Hyannis MA 02601 , Date Scheduled Time Fee Pd. Soil Suitability Assessment for Sewage Disivosal Performed By: � ��, '� Witnessed By: ti LOCATION GENERAL INFORMATION (� Loc ion Address Owner's Name ,E'c e-T6T G3 Fr. 77 2v� wl rL i is ' :L. ddress /0z /I U& Assessor's Map/Parcel: ^q,0 3 35 ptlk(C4.S 6 T �r 16 Engineer's Name G/2�dF' NEW CONSTRUCTION REPAIR Telephone# 5�' T 7 7 e, v Land Use �fi�t/�- Slopes(%) 4,!>""5_,+a Surface Stones Distances from: Open Water Body ft Possible Wet Area IFS ft Drinking Water Well ft Drainage Way IV4 ft Property lane t� ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ti 'IV f63 -ow Parent . Parent material(geologic) f' '���"p'�• Depth t0 Bedrock N� Depth to Groundwater. Standing Water in Hole: 7 Weeping from Pit Face N� Estimated Seasonal High Groundwater e lw DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: b�5 n Depth Observed standing in obs.hole: fell C� Z in. Depth to soil mettles: In. Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level�...m..a Adj.factor Adj.Groundwater Level, PERCOLATION TEST � Dgtp��. Time/�� Observation '— Hole# `fi"to atry° i'0 IV Depth of Perc � � P� C a�� �o'^I S Time at 6" a 3 Start Pre-soak Time @ ly` � L.. +� t/tCr�'r61 Time(9"-6") '£N End Pre-soak {c'?:e(tt . Rate Min./Inch cam? Site Suitability Assessment: Site Passed_ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:XSEPTICIPERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole# / Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. ravel Yam. V3 /✓''Ne. s,,s g, 73 /V0A1,5 C 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. av I). /0Y2 T/3 lvowf' f2" Zy,/ (j L. 5ttrv0 /D A S 6 Gt/dMI C'► s,C'c%Iqc.o /vY2 6/5 'Uw I S 26 wl.SAIVO /0 y6L NONE Soy+^ S orv�4 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) 14 C 5'w o 6�'' - � 32" C�z, ""t�j. b`���1� �®�'i�"- +�r�� -•- Sav��� S�'�r*s�'�; DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsi ten Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes Within 500 year boundary No= Yes We►hin ion 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? . A-19 (,S If not,what is the depth of naturally occurring pervious material? a... Certification I certify that on l/ D 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 `�� Date S / Q:%$EP71C%PERCFORM.DOC