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30 Septic Inspection Form 2012 Kuehner 's Inspection Services 168 County Road Southampton, MA 01073 Phone (413) 533-3031 TITLE 5 INSPECTION At the request of Ms. Tricia Walker, an inspection of the septic system located at 30 Brisson Drive, Northampton MA. was performed on March 23 2012. The septic system was in normal operation at the time of the inspection. The inlet and outlet baffles were in place and functional. The septic tank was pumped to allow for inspection. The distribution box was located and inspected. It is my opinion based on information available that this septic system meets the passing requirements of Title 5 (310 CMR 15.00) at this time. Problem Areas: 1. None: Recommendations: I. None This report is based on conditions existing at the time of the inspection, and is not intended to project, guarantee, or warranty the future operation of the septic system. For further information please refer to the attached inspection report. Inspector: Karl M. Kuehner Inspector Owner information required every page Important. When filling out forms on the computer,use only the tab key to move your cursor-do not use the return Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 30 Brisson Drive Property Address Tricia Walker&Arielle Pern Owner's Name Northampton City/Town MA 01060 3/23/12 State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. A. General Information 1. Inspector: Karl M. Kuehuer _ Name of Inspector Kuclmefs Inspection Services Company Name 16R County Road Company Address Southampton City/Town 413 533-3031 Telephone Number MA State SI 124 License Number 01073 Zip Code B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system'. ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority a ,G 3/28/12 Inspector ature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. '""This report only describes conditions at the time of inspection and under the conditions of use at that time This inspection does not address how the system will perform in the future under the same or different conditions of use. Tide 5 Official Inspection Form Subsurface Sewage Deposal System-Page 1 el required for page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 30 Brisson Drive Address Tricia Walker& Addle Pem_ Name Northampton MA 01060 3/23/12 State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary. Check A,B,C,D or E/always complete all of Section D A)System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 - 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes" , "no" , or"not determined" (Y, N, ND<) for the following statements. If "not determined." please explain. The septic tank is metal and over 20 years old" or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ N ND(Explain below). title 5 Mani Inspection Form Subsurface Sewage of Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 30 Brisson Drive Property Address Tricia Walker& Arielle Pen Owner Name information Northampton MA 01060 3/23/12 CltylTown Slate Zip cede Dale of Inspection B. Certification (cant.) B) System Conditionally Passes (cont.y ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection (with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below). ❑ obstruction removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below) ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health) ❑ broken pipe(s) are replaced ❑ Y n N _ ND (Explain below). [_ obstruction is removed ❑ Y ❑ N ❑ NO(Explain below). C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(I)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool - privy is within 50 feet of a bordering vegetated wetland or a salt marsh Tale 5 ORUal Inspection Form Subsurface sewage Disposal system-Paa Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 30 Brisson Drive Property Address Tricia Walker&Ariellc Perry Owner Owners Name information is Northampton MA 01060 3/23/12 for City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS) and the SAS is within 1 00 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance.- "This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow Title s ar¢lal inspection Form Subsurface Sewage D ,osal Sysrem-Page 4 o17 req ulred every Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 30 Brisson Drive Property Address Tricia Walker&Arielle Pern owner's Name Northampton MA 01060 3/23/12 C ltyli own State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s) Number of times pumped_ ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® portion of a cesspool or privy is within a Zone 1 of a public well ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® - portion of a cesspool or privy is less than 1 00 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. n The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. O El E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either yes or no to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection ❑ ❑ Area- IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes" to any question in Section E the system is considered a significant threat, or answered Vied In Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Tses Onioal Inspection Fomr Dimosal mem-Pages <CN Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 30 Brisson Drive Property Address Tricia Walker&Arielle Perry owners Name Northampton MA 01060 3/23/12 City/Town State Zip Code Date of Igspeclon C. Checklist Check if the following have been done. You must indicatd 11/45 dr Was to each of the following'. Yes No M ❑ ❑ M Z ❑ ❑ M ® ❑ ® ❑ M ❑ M ❑ M ❑ M ❑ M ❑ Z ❑ Pumping information was provided by the owner, occupant, or Board of Health Were any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined? (If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were all system components, excluding the SAS, located on site? Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? Was the facility owner and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS) on the site has been determined based on. Existing information. For example, a plan at the Board of Health. Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) 1310 CMR 15.302(5)] D. System Information Residential Flow Conditions: 3 hilrooms 3 bedrooms Number of bedrooms (design). Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203(for example'. 1 10 gpd x#of bedrooms): 330 gal/day Title 5 Officlal inspection Form Subsudece Sewagt OISPOS siern-Page 6 of 17 Owner information is required for every page ftlns-09/05 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 30 Brisson Drive Properly Address Tricia Walker&Ariellc Perry Owner's Name Northampton City/Town MA 01060 3/23/12 Stale Zip Code Dale of Inspection D. SYSTEM INFORMATION 2residenls Number of current residents. Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes / No Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes /1 No n/a Water meter readings, if available(last 2 years usage (gpd)y Detail: Sump pump? Last date of occupancy: Commercial/industrial Flow Conditions: Type of Establishment. Design flow(based on 31 0 C MR 15.203)'. Basis of design flow(seats/persons/sq.ft., etc.)'. Grease trap present? Industrial waste holding tank present? Non-sanitary waste discharged to the Title 5 system? Water meter readings, if available. ❑ Yes Or No present Date Gallons per day(gpd) ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Mlle 5 DPooal Inspect Form Subsurface Sewage Disposal Systnn-Page 7 of Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Bnsson Drive Properly Address Tricia Walker& Anelle Perry' Owner's Name Northampton MA 01060 3/23/12 City/Town Slate Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Other(describe below). Dale General Information Pumping Records: owner)pumped every 2 years Source of information: system pumped as part of the inspection? ® Yes ❑ No 1500 gallons If yes, volume pumped'. gallons Determined at time of pumping How was quantity pumped determined? to inspect tank Reason for pumping. Type of System: Septic tank, distribution box, soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes, attach previous inspection records, if any) Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Title 5 Official Inspection Form Subsurface age Olsposad System•Sag"of 5C.' ft cr Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 30 Brisson Drive Properly Address Tricia Walker&Ariellc Perry Owners Name Northampton MA 01060 3/23/12 City/Town Stale Zip Code Dale of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information_ 1997 file at BOH Were sewage odors detected when arriving at the site? Building Sewer(locate on site plan): Depth below grade: Material of construction- El cast iron ®40 PVC ❑other(explain) Distance from private water supply well or suction line. 24" feel ❑ Yes ® No cttc water feet Comments (on condition of Joints, venting, evidence of leakage, etc.)- Septic Tank(locate on site plan). Depth below grade: Material of construction. [g]concrete ❑ metal If tank is metal, list age'. 18"below grade feel ❑fiberglass ❑ polyethylene ❑ other(explain) years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) 126"x 68" x 64" Dimensions'. Sludge depth ® Yes ❑ No 6" Title 5 ONfcal Inspection Form Submdace Sewage nspoel System Page 9 of v information is required for every page. .. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 30 Brisson Drive Property Address Tricia Walker& Arielle Pem Owner's Name Northampton MA 01060 3/23/12 City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont-) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, eta)'. 21" 6" 19" measured at time of pumping Grease Trap (locate on site plan) Depth below grade: Material of construction feet ❑concrete ❑ metal ❑fiberglass U polyethylene ❑other(explain)- Dimensions. Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping. Lee 5 Official Inspecton Coen Subsurfam Sewage Disposal System-Page 10 o717 Commonwealth of Massachusetts Title 5 Official Inspection Form FT li Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 30 Brisson Drive Properly Address Tncia Walker&Aricllc Perry Owner Owner's Name information is Northampton MA Ol(1(>0 3/23/12 required for State N r„ae naio of m�oa every page- City/Town D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan)'. Depth below grade: Material of construction ❑concrete ❑metal ❑fiberglass ❑ polyethylene ❑ other(explain)- Dimensions. Capacity'. gallons Design Flow: gallons per day Alarm present ❑ Yes ❑ No Alarm level. -- --_ Alarm in working order: ❑ Yes ❑ No Date of last pumping: pate --- Comments(condition of alarm and float switches, etc.)- •Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Titles Official Inspection Form Subsurface Sewage Disposal SYstef-Page I l or 1- el Commonwealth of Massachusetts Title 5 Official Inspection Form Owner information is required for every page. 15ias-93108 y Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Brisson Drive Property Address Tricia Walker&Aricllc Pem Owner's Name Northampton MA 01060 323/12 City/Town State Zip Code Date of Inspectron D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Equal flow to all legs Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.) Chamber(locate on site plan). Pumps in working order: ❑ Yes ❑ Na Alarms in working order ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.) Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Title 5 Ofiiinal Inspeclion Form Subsurface Sewage Disposal System-Page 12 of17 Owner information is required for every page. owns Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 30 Brisson Drive Properly Address Tricia Walker& Ariclle Pen} Owner's Name Northampton MA 0106(1 3/23/12 City/Town State Zip Code Date of nspection D. System Information (cont.) Type: ❑ leaching pits ❑ leaching chambers ❑ leaching galleries leaching trenches ❑ leaching fields ❑ overflow cesspool ❑ innovative/alternative system number number: number: number, length'. number, dimensions: number 2- trenches Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth -top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Tile s ODAml Inspection Form Subsurface savage Deposal System-Page 13 of ir C� alsansr into required For es s page. .. a Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 30 Brisson Drive Prepon>Address Tricia Walker& Arielle Perry O.ners Name Northampton Cd.r)Wf MA 01060 3/23/I 2 State zit rode Dale of nspecuo D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, eta)_ Privy (locate on site plan)_ Materials of construction- Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.). rme 5 Official Inspection Form Suesrface Sewage Disposal 14 of s II Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 30 Brisson Drive Property Address Tnciu Walker&Ariellc Pen Owner owners Name information is Northampton MA 01060 3/23/12 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 1 00 feet. Locate where public water supply enters the building. Check one of the boxes below: 'Eris 09108 iihand-sketch in the area below drawing attached separately see attached drawing Title 5 Official Inspeclion Form subsurface Sewage Disposal System-Page 1501 I Ownei information is required for every page. a a Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 30 Brisson Dose Property Address Tricia Walker&Adelle Perron' Owner's Name Northampton City flown D. System Information (cont.) Site Exam: ® Check Slope flat MA 01060 3/23/12 Slate Zip Code Date of Inspection ® Surface water None ® Check cellar dry ® Shallow wells None Estimated depth to high ground water: 120" feel Please indicate all methods used to determine the high ground water elevation- 111 Obtained from system design plans on record If checked, date of design plan reviewed: Dale ® Observed site (abutting property/observation hole within 150 feet of SAS) • Checked with local Board of Health -explain. information on file ▪ Checked with local excavators, installers- (attach documentation) • Accessed USGS database-explain You must describe how you established the high ground water elevation: Vim ed site, checked past reports on fit with BOB Before filing this Inspection Report, please see Report Completeness Checklist on next page. Tile 5 Official Inspection Form Satan-Face Sewage Dsposal S79em-Page 16 of 17 a .. • Commonwealth of Massachusetts Owner Information is required for every page. thins 09708 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 00 Bnsson Drive Properly Address Tricia Walker&Arielle Perry Owner's Name Northampton MA 01060 3/23/12 Cily/Town Stare Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary'. A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information-Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file Tile 5Ofical in ion Form Srbsjda ge Pryosal SY9en-Page IF of 17 SAS D distribution box 24" below grade c 1500 gallon septic tank 1.5 below grade patio A LEGEND AB-26' AD=44' CB=18.9' CD = 12.5' 30 BRISSON DRIVE garage KUENNER'S INSPECTION SERVICES INSPECTOR: Karl M. Kuehner NO SCALE: I!�:li l' .I , F al d s 5 T It .• t lI��IiIJ ti , • 4- r3 • 4 . . . [ .i 3 , ti 44 • y • � - $ .. Ill I �� `. ) m� 1 � . • 7 � { , , t ter ,• k' l►irolI :IIll11, OLIVER ®liver OLIVER: MassGIS's Online Mapping Tool ;l 0 In y 30 Brisson Drive Noremptor 7 @ `A ar^ Type an address or location into the box and press Enter Page 1 of I Baseinaps http://maps.massgis.state.ma.us/map_ol/oliver.php 3/27/2012 OLIVER )liver OLIVER: MassGIS's Online Mapping Tool 30 Brisson Drive Northamptor .) a Page 1ofl http://maps.massgis.state.ma.us/map_ol/oliver.php 3/27/2012 OLIVER diver OLIVER: MassGIS's Online Mapping Tool i` 0 Page 1 of 1 tt- p R et In rs 30 ensson Drive Norlampmr ) O `� WezNamOm`Boa4 http://maps.massgis.state.ma.us/map_ol/oliver.php 3/27/2012 No. FORM 11 - SOIL EVALUATOR FORM Page 1 of 3 Date: Aug. 14,1997 Commonwealth of Massachusetts Northampton , Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed By: Paul B. Hatch. PE Witnessed By: Peter McErlain Location Add,assor Brisson Drive Lola Date: Aue. 14, 1997 New Construction RepairXXX ors Name Dave Dombrowski Address,and 30 Brisson Dr. ,Northampton 01060 Telephone 413-584-2361 Office Review Published Soil Survey Available:No Year Published 1981 Yes XXX Publication Scale 1:15840 Soil Map Unit Hg Drainage Class A Soil Limitations Surficial Geologic Report Available:No XXX Yes Year Published Publication Scale Geologic Material(Map Unit) Landform Glacial outwash Flood Insurance Rate Map: Above 500 year flood boundary: No YesX Within 500 year flood boundary: No Yes X Within 100 year flood boundary: No Yes X Wetland Area: National Wetland Inventory Map(map unit) Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(USGS):Month Range: Above Normal Other References Reviewed Normal Below Normal r, FORM 1 -SOIL EVALUATOR FORM Page 2 of 3 30 6rt iSbc& V I1 Location Address or Lot No...V:L=ndcherir.Northampton On-site Review Deep Hole Number 1 Date: 8/14/97 Time: 9:00 Weather Clear Location (identify on site plan) Land Use home recreation Slope(%) 1 Surface Stones None observed Vegetation Diciduous and coniferous Landform glacial outwash Position on landscape (sketch on the back) Distances from: Open Water Body > 100 feet Possible Wet Area> 100 feet Drinking Water Well>100 feet Drainage way >100 feet Property Lines feet /0" Other 'MINIMUM OF 2 HOLES REQUIRED AT EVERY PROP Parent Material(geo ogic) Depth to Groundwater Standing Water in the Hole: None Estimated Seasonal High Ground Water: Over 120 inches Depth to Bedrock:not found Weeping from Pit Face: None DEEP OBSERVATION HOLE LOG* Depth from Surface(inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure,Stones,Boulders,Consistency,% Gravel) 0-11" 11"-28" 62"-120"+ Ap B C1 C2 LS LS S 5 10YR3/2 10YR5I6 10YR5/8 10YR6/6 no no no no 10%cobbles&20%gravel 30%gravel 'MINIMUM OF 2 HOLES REQUIRED AT EVERY PROP Parent Material(geo ogic) Depth to Groundwater Standing Water in the Hole: None Estimated Seasonal High Ground Water: Over 120 inches Depth to Bedrock:not found Weeping from Pit Face: None