HomeMy WebLinkAbout0027 FALCON ROAD - Health 127 FALCON ROAD
West • -
• • 032
i
Town of 1 :arni.stabl.e P# 15-a7
Department of Reguilatozy Services
g ,a .Public Health Division D
v xcAss. ate
pr n6g9•a�e�.. 200 Main Street,Hyannis MA 02601
ED MAy .
Date:Scheduled / /10 /t'g I01.10 ��,yy
Time Fee Pal o be OC/
Soil Suitabzlz
ty.Assessmentf®r Sewage D�sp®sal
Performed BY:_o/art�(il
Witnessed By:
LOCATION&GENERAI,INFORlY1ATION
L.ocationAddress
G � We'p Lrnic,+4� Owner'sNaine L—:;,0 jC j G� .C2G>OGlJ�
Address
Assessor's Map/Parcel: /j 2- En ineer s Name ��,, / g b�UJM C'tk!G 6dVCiIfVt�i'�!.(�fC•r
NEW CONSTRUCTION I f REPAIR p,�' Telephone# ✓j D Fj— J,�Z
Land Use L° Slopes(%) d�✓�[ Surface Stones r e W
Distances from: Open Water Body L to G tl. Possible.Wet,Area�"G ft Drinking Water Well
Drainage Way 66 ft Property Line y #t. Other
ft
SITCH;(Sireet.name,dimensions of exact locations of test holes&pe c tests,locate wetlands hi proximity to holes)
A/ Na QallorJ
POA
Id-
�.
H3
d •
l
Parent material(gboiogic) Depth to Bedrock L f�Depth to Groundwater: Standing Water in Hole: /V Weeping from Pit Face
Estimated Seasonal High Groundwater /) /N
D, T RA N'A.TION FOR.SEASONAL RIGH.WA.TER-TABLE
Methad Used: ?. W
Depth Observed stand ng•in obs,hole- in. Depth to soil mottles:
Depth to weeping frem.side of obs,hole: n1
Index Well# ReadingDate: Index Weft level I' Groundwater.Adlustment ft•
Adj.factor Adj.Groundwater.Level
]PERCOLATION TEST Date Time
Observation
Hole# + / Time at 9,1
Depth ofPerc !
Time at 6"
Start Pre-soak Time @ Time D 0"1k
(9''-6"j.
End Pre-soak 30
RateMin./Inch �J"1.n/,T.n
Site Suitability Assessment:'Site Passed V Site Failed: Additional Testing Needed(YIN) Al
Original; Public Health.Division Observation Hole Data To Be Completed on Baclt----------
***If percolation test is to be conductedmithin 100' of Wetland,youu must first notify the.
Barnstable Conservation Division at least one(1)Week prior to beginning.
Q:ISEPTIC\PBRCP.ORM•D 0 C
I
DEEP OBSERVATION HOLE LOG Hole# 198 3
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency, °o rave
DEEP OBSERVATION HOLE LOG Hole# 2-
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.o o Gravel
DEEP OBSERVATION HOLE LOG Hole#
Depthfrom Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) . (Munsell) Mottling (Structure,Stones;Boulders.
Consistent %Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(h.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
G-3 LS l�y�3/z
Id-z� 6 L /oY
Flood Insurance][late Man:
Above 500 year flood boundary No Yes
Within 500 year boundary No ; Yes
Within 100 year flood,boundary No 7 Yes
Depth of Naturally Occurring?eryious 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 e S
If not,what is the depth of naturally occurring pervious material?
Certification /
I certify that on �S / I Z (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was perfprmed by me consistent with
the required training,expertise and experience described in 310 CMR 15.017.
Signature
Q:\SEPTIC\PERCBORM.DOC