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140 Septic Soil & Perc Tests October 2010 Massachusetts Department of Environmental Protection 140 Coles Meadow Road, Northampton Bureau of Resource Protection —Wastewater Permitting Program Site Address or Map/Lot Number j Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal A. Facility Information Littletree Environmental Consulting Owner Name. Joyce Lak P.O. Box 503 Chesterfield, MA 01012 Street Address. 140 Coles Meadow Road Lot. (413) 537-0344 City: Northamptonate: MA Zip Code: 01060 B. Site Information 1. (Check one) New Construction ❑ Upgrade Z Repair ❑ 2. Published Soil Survey available? Yes ❑ No ❑ If yes: 1981 1:15 840 Cn Charlton Year Published Publication Scale Soil Map Unit Soil Name Soil limitations slight 3. Surficial Geological Report available? Yes ❑ No ❑ If yes'. Year Published Publication Scale Map Unit Geologic Materiel Landform • 4. Flood Rate Insurance Map: Above the 500 year flood boundary? Yes Z No ❑ Within the 100 year flood boundary? Yes ❑ No Z Within the 500 year flood boundary? Yes ❑ No Z Within a Velocity Zone? Yes El No Z 5. Wetland Area: National Wetland Inventory Map Map Unit Name Wetlands Conservancy Program Map Map Unit Name 6 Current Water Resource Conditions(USGS) September 2010 Range: Above Normal ❑ Normal Z Below Normal ❑ Month/Year 7 Other references reviewed: DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 1 of 4 I Massachusetts Department of Environmental Protection 140 Coles Meadow Road, Northampton \h— Bureau of Resource Protection —Wastewater Permitting Program sfeAddress orMap/lat Number Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Littletree Environmental Consulting C. On-Site Review (minimum of two holes required at every proposed disposal area) P.O. Box 503 Chesterfield, MA 01012 Deep Observation Hole: Date: October 12,2010 Time: 10111_30 Weather: clear (413) 537-0344 1. Deep Hole Number 1-A Location (Identify on Plan): 2. Land Use: driveway Surface Stones: no Slope(%): <1 Vegetation spruce,oak Landform: Kame Position on landscape: /X-Z_ 3. Distances from: Open Water Body NA ft. Drainage Way NA ft. Possible Wet Area NA ft. Property Line 10' ft. Drinking Water Well NA ft. Other NA ft 4. Parent Material: Outwash Unsuitable Materials Present: Yes ❑ No If Yes: Disturbed Soil!: Fill Material❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock ❑ 5. Groundwater Observed: Yes ❑ No If Yes: Depth Weeping from Pit _ Standing Water in Hole Estimated Depth to High Groundwater: >80" Redoximorphic Features Coarse Fragments Soil Soil Matrix: (mottles) %by Volume Depth Horizon/ Soil Texture Color-Moist Depth Color Percent Gravel Cobbles Soil Structure Soil Consistence (In.) Layer (USDA) (Munselp 8 Stones (Moist) Other 0-6 A Is 10 YR 4/4 0 single grain loose 6-20 Bw cs 10 YR 518 0 single grain loose 20-80 C1 gess 10 YR 5/4 0 single grain loose 80+ C2 s 10YR 7/2 0 single grain loose Additional Notes DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal• Page 2 of 4 • Massachusetts Department of Environmental Protection 140 Coles Meadow Road, Northampton L Site- I Bureau of Resource Protection -Wastewater Permitting Program Address or Map/Lot Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Littletree Environmental Consulting C. On-Site Review (minimum of two holes required at every proposed disposal area) P.O. Box 503 Chesterfield, MA 01012 Deep Observation Hole: Date: October 12:2010 Time: 10:45 Weather: clear (413) 537-0344 1. Deep Hole Number 1-B Location (Identify on Plan). 2 Land Use: driveway Surface Stones: no Slope (%): <1 Vegetation: spruce,oak Landform: Kame Position on landscape. /X—L 3 Distances from: Open Water Body NA ft. Drainage Way NA ft. Possible Wet Area NA ft. Property Line 10' ft. Drinking Water Well NA ft. Other NA ft. 4. Parent Material: Outwash Unsuitable Materials Present: Yes ❑ No If Yes'. Disturbed Sail❑ Fill Material❑ Impervious Layer(s)❑ Weathered/Fractured Rock ❑ Bedrock ❑ 5. Groundwater Observed: Yes❑ No If Yes. Depth Weeping from Pit _ Standing Water in Hole Estimated Depth to High Groundwater: >88" Redoximorphic Features Coarse Fragments Soil Soil Matrix: (mottles) %by Volume Depth Horizon! Soil Texture Color-Moist Depth Color Percent Gravel Cobbles Soil Structure Soil Consistence (In.) Layer (USDA) (Munsell) &Stones (Moist) Other 0-6 A Is 10 YR 4/4 0 single grain loose 6-22 Bw cs 10 YR 5/8 0 single grain loose 22-80 C1 gcss 10 YR 514 0 single grain loose 90-88+ C2 s 10YR 7/2 0 single grain loose Additional Notes DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 3 of 4 Massachusetts Department of Environmental Protection 140 Coles Meadow Road, Northampton Bureau of Resource Protection —Wastewater Permitting Program site Address or Map/Lot Number ; Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method used. ❑ Depth observed standing water in observation hole A. B. C. D. ❑ Depth weeping from side of observation hole A. B. C. D. ® Depth to soil redoximorphic features (mottles) A. B0" B 88" C. D. ❑ Groundwater adjustment(USGS methodology) A. B. C. D. 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. 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 34 No❑ b. If yes, at what depth was it observed? Upper boundary. 22" Lower boundary: 80" F. Certification I certifyihat I have gassed the soil evaluator examination` approved by the Department of Environmental Protection and that the above analysis was perforrged bjMe consistent with the required training, expertise and experience described in 310 CMR 15.017. �(l l I I ✓{II 't Y `c t (A October 12, 2010 Littletree Environmental Consulting Signature of Soil E aluator Date P.O. Box 503 Chesterfield, MA 01012 Lesley A"Mickey"Spokes 5E2310 April 27, 1997 1413) 537-0344 Typed or Printed Name of Soil Evaluator Date of Soil Evaluator Exam Aimee Petrosky Northampton Board of Health Inspector Name of Board of Health Witness Board of Health Note: This form must be submitted to the approving authority with Percolation Test Form 12 • OEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal • Page 4 of 4