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HomeMy WebLinkAboutLot 16A DWCP No. DISPOSAL WORKS.CONSTRUCTION SUMMARY TOWN OF MANSFIELD BOARD OF HEALTH DWC LOCA' /6 SUBDIVISION LOT NO. . APPLICANT TELEPHONE STREET TOWN STATE ZIP, FEES: 50.00 Perc for'New Construction _$150.00 Construction, Upgrade _$ . 75.00 Septic System Plan Revision _$ 25.00 Septic System"Repair _$ 25.00 Disposal System Reinspect _$ 25.00 2nd Reinspection SDS Certification Inspection Date Received 3 1 Date Received Date Received Date Received Date Received Date Received Date .Received INSPECTIONS:. 1.st Inspection Date Approved Disapproved 2nd Inspection Date Approved Disapproved Comments: Reinspection Date - Approved Disapproved f� Comments: word_d, c - ommomvealth of Massachusetts Town of Mansfield Soil Suitability Assessment for On -Site Sewage Disposal Fee $150.00 R f147ew ❑ Upgrade Site Number - Location address: 1E_:L.V4 S i RE T Applicant: —FA-AoMA S P, V,3A .-SI4 Subdivision/Lot: L.o- T 1 Co Pd -U t lCa Fi EZ1b5 VI (LAddress: GO 9,0'�E> Owner: Telephone: 50 O , 1 j A ' oZ� 03 Performed by: RI M ErIG 11,4EE N tJ[a Co,) 1 NC Witness: Scott Leite, Health Agent (Site Evaluator) Address: ISO moi TM 1 MAI t l sVrK Address: Six Park Row, Mansfield Telephone: 5Dg 9 - 3-731 Telephone: 508 261-7366 Office Review Soil Survey published 1978 Soil limitations Publication scale 1:20,000 Soil Map Unit H t A Drainage Class Surficiat Geologic Report not, available. Geologic Material � A I &L OlU l WAS R Landform PL_,�.l Flood Insurance Rate Map: L'� Above 500 year ❑ Within 500 year ❑ Within 100 year flood boundary Wetland Area: National Wetland Inventory Map (unit) Wetlands Conservancy Program Map (unit) Current Water Resource Conditions (USGS) Month 12-(1 Range: ❑ Above Normal PN- ormal ❑ Below Normal Summary TH 1 TH 'Z Locus Soil class Percolation Rate Z 2-- Adjusted ground water Certification I certify that on April 30, 1993, I have passed the 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. Scott Leite Date Deep Test I Parent Depth Test I Parent Depth ite Review Locations ( 1(o G(Lt=-3 Pi b W(k i Date Z '-( 12 Pagc t u5 tDElsi"f7�� L.andform CAI t� ation Sr d� Surface stones . .. i-EVJ _ Slope _ 6 "3 i ice fromi Open water body Possible wetlands _ Drainage way Drinking well _ - - Ptopu ty I iec bservation Hole Log N q �t7�,A 1 Depth to bedrock occurring previous material 9Z't -. Hrzn I Texture AE IAt �L i r �9SLA_ Depth to bedrock occurring previous material , __ t J 2-2' Depth to GW -3-Z.l _ ❑Plow ❑ weep ❑ seep 1_I Poi, I ❑ high ❑ Low ❑ Ihip ❑ Steady ❑ ine`casu,g I i ces,�ip Vloy� Consistence GW Nloelilit' I 32-,�A Depth to GW 09 ❑ Fh,w ❑ Weep ❑ Seep I _ I Pe„ ned 1 1 _ ❑ High ❑ Low ❑ Dail) ❑ Steady ❑ Increasing ❑ I wac,i,,,q Deptlisur I I Hrzn Texture Color Mottling Consistence GW — 1 C i Al L_ l0 2.3 1 C 'SL ZS -7 2. i 'erwl tion Test Determination for Seasonal High Water Noics Test le j TLL Ti H,Z Method used rH TH 2 De th bfPere j 3(�-Sa(" 't--G>U' Depth observed standing Depth weeping Be in kresoak _ I Dethofsolmottles (n 11 End Prisoak /O; to 1 �, 3G Index Well Time 12" _ 9 1 BettySchool 9" O: k 2 Gilbert Street — 6" j O 0; t # 3 Fioit Street -- 'rime - 6" j 3 M I � , I N t # USGS Well Rate IV INAN NOTES - _ Index Well Level j _ _ _ Less: index well high Ad' ustraeut factor Site Level Less: Adjustment Factor Adjusted ruundivater N E z C c 0 C� L Y® CO) vI 0 0 N i N A w ILI 0 1* m -t- El } 0 N U O m C Iry E z ro 1; r m a ƒ / � c O 0 2 @ E $ m ■ ■ $ � } � \/2 7/� E E k 0 LL WE / H. 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