HomeMy WebLinkAboutSoil Evaluator Form 00 J U
FORM 11 - SOIL EVALUATOR FORM
Page 1 of 3
Q [EC C DMLED
NOV 1 2 2002
No. 02124 HEALTH DEPT. + Date: 10/10/02
Commonwealth of Massachusetts
YARMOUTH , Massachusetts
Soil Suitability Assessment for On-site Sewage Disposal
Performed By: DAVID B. LAJOIE, FELCO, INC. Date: 10/10/02
Witnessed By: YARMOUTH HEALTH AGENT — c.6 tvtufappiy
mob^Address a #1020 ROUTE 6A(DENNIS) air'Nam. BENJAMIN MONAC
`'O1' YARMOUTH,MA Ads'.aid 138 OLD MAYFAIR ROAD
.1:4 S MAP#224 PARCEL# / Tdeytnrs'
y � is' S. DENNIS, MA 02660
78
New Construction ❑ Repair id
Office Review
Published Soil Survey Available: No ❑ Yes 0
Year Published 1614:13 Publication Scale 1:25,000 Soil Map Unit 2vL-
Drainage Class Soil Limitations Pia— t
Surficial Geologic Report Available: No ❑ Yes 0
Year Published .17:74 Publication Scale 1.;24,000
Geologic Material (Map Unit) Q 4
Landform14M2tots-14 4-rr JA )6"pdSrr
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑Yes
Within 500 year flood boundary No Yes ❑
Within 100 year flood boundary No Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit) N/A
Wetlands Conservancy Program Map (map unit) N/A
Current Water Resource Conditions (USGS): Month .. OGT/ZOO Z
Range :Above Normal ❑Normal ❑Below Normal El
Other References Reviewed:
DEC DEP APPROVED FORM-12/07/95
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. #1020 ROUTE 6A(DENNIS),YARMOUTH
On-site Review
Deep Hole Number 1 & 2 Date:: /0-1°- OL Time::: _Z.F314 Weather
Location (identify on site plan) M.....: .:
Land Use ..................... ............. ............. Slope (%) : .;44. Surface Stones .
Vegetation Lku��
Landform
Position on landscape (sketch on the back) .. ..„....:..: SEE FELCO PLAN#02124
Distances from:
t 4-
Open Water Body _ IPQ... feet Drainage way..'2' . . feet
Possible Wet Area : I0. feet Property Line i.w. feet
Drinking Water Well 1w feet Other
DEEP OBSERVATION HOLE LOG'
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, %
Gravel)
#1 ZSF- '' A �or►�,y 5. InyQ3/3 PegC-. @ 675 '
2*..- 465 " a LofiMy s. S/. No P o4, = 2 S- G.�..
YE3N.. 72-" a MB>DIt1,u►S. GA` /2 al__ 1I G •Ni/v
7z,,.. f3 B.. C M
u-cre- 3 Ms.1I it)
#2 0"_. Z4f-I• A toMrAY S . /o yx 5/3
Z`f4 •`fe)" '3 Cosy S. S/b
f /o$„ Gi µJE 5. 7� ND
to6`=/S79" CZ i4QDium gl3
S.
` MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Parent Material (geologic) Dept toB.edrock: N/A
Depth to Groundwater: Standing Water in the Hole: A/OA/6- Weeping from Pit Face: e-
Estimated Seasonal High Ground Water: sg.z. 5 ' POE/tp�,4���.7got,11,b(,A/AI
- L6& iJ ., /98G
DEv
DEP APPROVED FORM-12/07/95
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No. #1020 ROUTE 6A(DENNIS),YARMOUTH
Determination for Seasonal High Water Table
Method Used: GROUNDWATER ENCOUNTERED: YES NO X.
❑ Depth observed standing in observation hole inches
❑ Depth weeping from side of observation hole inches
El Depth to soil mottles inches
El Ground water adjustment feet
Index Well Number Reading Date Index well level
Adjustment factor Adjusted ground water level
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? YES
If not, what is the depth of naturally occurring pervious material? -
Certification
I certify that on 11/94 (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 fo/o/�
D E t DEp APPROVED FORM-12/07/95
FORM 12-PERCOLATION TEST
PAGE 4
COMMONWEALTH OF MASSACHUSETTS
Yarmouth ,Massachusetts
Percolation Test
#1020 Route 6A (Dennis), Yarmouth FELCO Job #02124
Date: 10/10/02 Time:
Observation Hole# /
Depth of Perc l� 4S"
Start Pre-soak
End Pre-soak l — /4f — /S
Timeat12"
Time at 9" /— Z O " /S
Time at 6" / — Zg —/S
Time(9"-6") / w1l�
Rate Min./Inch 3 M t N I
Site Passed Site Failed 0
Performed By: ‘2).4vi D
Witnessed By: T ee a f 1 c.27 - ,
Comments: