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1280 Septic Soil & Perc Test FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. ( A8D +S*li-4 1 1oc4 Determination r Seasonal Hi r ii Water Table Method Used: ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of observation hole inches Depth to soil mottles—?004, Winches I I Ground water adjustment feet Index Well Number .. . Reading Date _... Index well level _. ... Adjustment factor Adjusted ground water level Depth of Naturall Occurrin• 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? If not, what is the depth of naturally occurring pervious material? Certification I certify that on 4/2„).,9 (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 �y;�?G �9 Date _71721722_,_ • ore APFRO VEO FORM•,12/07/95 FAA)i icivfn ei3jrai Otoicin). ioi otd Ferrti 47, d. � cr1tQ npfl\, m %Cie,^. Lj13- s-- Sao No. FORM 11 - SOIL EVALUATOR FORM Page 1 of 3 Date: 9- 9-0 Commonwealth of Massachusetts porthornp-iii, Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed By PI t c hq-e.J ax) I soci- Date: O-S-a a Witnessed By R tL& (n- \c Ca 3 lAcimn^,,,' iaSO 3b1-1S P;t+Kcnd New Construction C Repair iN WQSIICK Add"," la so r3ut-+5 , F+ IZc�d .., , ko r'}tl ayn pion rnR 0/cco tooLIO Office Review Published Soil Survey Available: No ❑ Yes ❑ Year Published Publication Scale Drainage Class Soil Limitations Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Geologic Material (Map Unit) Landform Flood Insurance Rate Map: Above 500 year flood boundary No Eves ❑ Within 500 year flood boundary No ❑Yes n Within 100 year flood boundary No ❑Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Publication Scale Soil Map Unit Current Water Resource Conditions(USGS): Month Range :Above Normal ❑Normal ❑Below Normal ❑ Other References Reviewed: DEP APPROVED FORM• 1/07/95 A)oirOPrneWit+ ' Ow"11` ICI ord Ferry 42, d_ SSoi'F-!' mp Ten, mr Li 13- S -- `�% C DH -DO) FORM I1 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. J O al A hi-.5 Y If Acad. On-site Review Deep Hole Number I,a Date:. 7/5.16,2 Time rn01-1"'"1. Weather Location (identify on site plan) S' as 7,(A°` Land Use f ti Slope 1%)0 -S Surface Stones ht&_ Vegetation c r-S" Landform Position on landscape (sketch on the back) f' - - J'Q°-n1'- Distances from: Open Water Body >LCD feet Drainage way >Sb Possible Wet Area -flat) feet Property Line >as Drinking Water Well!/en) feet Other c r r-- -v' 'D)-)t feet feet /n / DEEP OBSERVATION HOLE LOG. Depth from Surface(Inches) Soil Horizon Son Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure,Stones, Boulders, Consistency, % Gravel) p_grr 8"-,jo" ado"- lap" A 8 C St SL 5 lo-1f314 ioigLIN /oVR-TA3 toom- ^'oA2 iunted tnp:x)11 Sc-tbscil Ecru -ynedlt..m p-8- 6--ac" q 100" ice.- 1 3" /7 © 0-, Ca St SL S S ioit?3H iNk9/y /OVem rbVRSla ti;oitt OCAS2- )0&& >5% .3YR,j/6 topSoll SG(bsc. l ft u -me CLitw-M F''''''-- . ' rnaiuunnnc lr nlcLntAl DrA Parent Material (geologic) Ow /e-t. Depth to Groundwa er: Standing Water in the Hole: DC y /cX%rr Estimated Seasonal High Ground Water: , _ OEP APPROVED FORM- 11107195 DepthtoBedrock:= 00 i&a Weeping from Pit Face:Iptj J In" A.)u oA)meic cj lc97. tot ord Ferro Rd. (3c rI-op,mp-onr hn i3 v/arC 73- S za FORM 12 - PERCOLATION TEST A / Location Address or Lot No. J Bart * cliC)Q d COMMONWEALTH OF MASSACHUSETTS CO i +'ICY , Massachusetts Percolation Test" Date: 9-5- Ckg Time:.v POttVr)OOA) v Observation Hole ft P ' Depth of Pere I,I Lf;r Start Pre-soak 10-. DB .End Pre-soak 10■ 13 Time at 12" i6, 1/3 Time at 9" to yi Time at 6" /0. y(0 Time (9"-6") a Rate Min./Inch 2 Mifimum of 1 pe colation test must be performed in both the primary area AND reserve area. Site Passed op Site Failed ❑ Performed By: m/Chad La,L)l,j�t� Witnessed By: ry)C \ t,'s_.) Comments: Orr APPROVED FORM•rirbns CNVicolom eiSto-C Ot0i99n rot Cid Fern{ id. � oF`tW mPivti,, mA Clue u( L3- 5 S mac Location Address,or Lot# Date ., PERCOLATION TEST(S) Time: Time: Observation Hole #1 Observation Hole #2 Depth of Rem Depth of Perc Start Pre-soak ( Start Pre-soak End Pre-soak i End Pre-soak /' Time at 12" )tI Time at 12" Time at 9" 4 i Time at 9" Time at 6" `1 Time at 6" Time(9"-6") Z/' f Time (9"-6") Rate Min./Inch Rate Min./Inch 'minimum of 1 percolation test must be performed in both the primary area AND reserve area SITE SITE I SITE SITE PASSED _ FAILED PASSED — FAILED Performed by I Performed by Witnessed by Witnessed by Comments: NORTHAMPTON BOARD of HEALTH— Title 5— Site Review Deep Hole#: DEEP OBSERVATION HOLE LOG* 'M1IINIP1UM OF TVJO HOLES REQUIRED: T EVERY PROPOSED DISPOSALAREA Depth from Surface(Inches) Soil Horizon Soil Texture (USDA) Sal Color (Mensal! Soil Mottling Other (Structure,Stones,Boulders,Consistency,%Gravel) (, Hr cf., Hil- 1 . _.- -_ - - - - -. - _. Parent Material(geologic) I Parent Material(geologic) I Depth to Bedrock I Depth to grou ndwater. SfaMirg Waterin the Mae ^(eepirg from:Pit Face Estimated Seasonal Mgh Ground'Water DEEP OBSERVATION HOLE LOG* 'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Depth from Surface(Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure,Stones,Boulders,Consistency,%Gravel) (, Hr Parent Material(geologic) I H. DepBim'Bedra�k 1 Depth togroundwater:; rehdim9 WateT lathe HNe; GYV$009 from Pit face. I Estimated Seasonal l t,Graz Water '. PERCOLATION TEST(S) Time: I Time: Observation Hole #1 Observation Hole #2 Depth of Perc qtr- Depth of Perc Start Pre-soak lU �j i, b7 Start Pre -soak End Pre I() I} l 7/ End Pre-soak -soak Time at 12" / /0 ' c2 Time at 12" Time at 9" ,/Ly( Time at 9" Time at 6" /0 ,/ j� /T 7U/ Time at 6" Time(9"-6") Time(9"-6") Rate Min./Inch ` . vv /Ll.,-' Rate Min./Inch 'minimum of 1 percolation test must be performed in both the primary area AND reserve area. 1 ASSE' :'SITE '• FAILED-, �..'',.. - $13Ei+ '_ .P7x5SED. SITE FAILED J —. Performed by Performed by Witnessed by ' Witnessed by Comments: