HomeMy WebLinkAbout0097 RUE MICHELE - Health 17-Rue Michelle
Barnstable
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Town of Barnstable P# `X
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Department of Regulatory Services
Public Health Division Date
•b,¢ �� 200 Main Street,Hyannis MA 02601
Date Scheduled Time .1/— Fee Pd. C
Soil Suitability Assessment for Sewage Disposal
Performed By: Witnessed By:J,s!AQC-A,
LOCATION& GENERAL INFORMATION
Location Address fj Z ' Owner's Name
Address
Assessor's Ma /Parcel: pe 65c G/1 P u P.
P �3 S;(��Rl�.t, I l�- ._ En r.'s.Name
NEW CONSTRUCTION x REPA -� � Ielepp one 5000-778 9I
v Land Use lopes(4b) Surface Stones /✓/ -
Distances from: Open Water Body Zcb — ft Possible Wet Area 2o! -' ft Drinking Water Well ft
/' f Drainage Way 2c� ft Property Line ZS 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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Parent material(geologic) Depth to Bedrock
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Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in.obs.hole: Irl 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 n TEST,factor— Adj.Groundwater Level..,.
• PERCOLATIONPERCOLATIONzaw.,;�..,_,e, Tim_ _
Observation
Hole# / Time at 9"
Depth of Perc 5'Z P(''ele. `.04 Time at 6" p
Start Pre-soak Time @ P/' 3'' 7[me(91,41)
End Pre-soak I L 6 fI _-zN /D TIFV
Rate MinJlnch L 2 ir"PC
~ Site Suitability Assessment: Site Passed _ Site Failed: Additional Testing Needed(YM)
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:%S EPTICIPERCFORM.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,%Gravel
—/3"n ✓� L,S�it/D /D '�/z �� /tIO�I
611.
s'Toe�i�s t`
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
(713
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consi tene %Gravel
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency. ra I
Flood Insurance Rate May:
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? Y 6 �
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on I 02 (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 5 D
Q:\SEPTIC\PERCFORM.DOC