23 Septic Perc Tests On-Site Review
LocationAddress or Lot# a2 Owner �' - Address \
Date — - -" - — - - _
3 A (,I' ±._ Time Weather - —Engineering Firm T L. o f„'J^_�,,.+ Engineer or Sanitarian - -
Id@naty onSitePlan :1 ----- — — -_
Land Use _ - -
Slope% 1 Surface Stones
Vegetation '2y. ,t w1 -
Lantlform _
Poskion on Landscape _
..._. .- Distances from:
Open Water Body feet Drinking Water Well feet Property Line 1 feet
Possible Wet Area feet Drainage Way feet Other —1 feet J
DEEP OBSERVATION HOLE LOG*
Deep Hole#: f 'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Depth from I Soil Horizon Soil Texture Soil Color Soil Mottling Other
Surface(Inches) (USDA) (Munsell) (Structure.Stones Boulders, Consistency,%Gravel)
f j
�
” `
r 1 .A IT I 1 1(
C..
I lit, -2 yH ��/ F, . J � V ,I �
('
1 ji �
ft
are I /,- , �,/
. Ca
H '-' '5 j )f Li la h
4; — C LI 5L I) yl( 1
•.rent Mater (geologic) 34y ixiS/h"/�� . V. I Depth to Bedrock rr
Depth to groundwater. Standing Water In the Hole —)❑ y Weeping from Pit F r i Cy 1, - -
Estimated Seasonal High Ground Water -' t r Z -
DEEP OBSERVATION HOLE LOG*
Deep Hole It: 1 I 'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Depth from Soil Horizon { Soil Texture ' Soil Color Soil Mottling Other
S
urtace(Inches) (USDA
_ ) (Munson) , (Structure Stones Boulders.Cp nsistency,%Gravel)
-- l
I ( i i/ — s /Y • a ! fryr, :t
�L (�� ) 5 /G ' � Ik L_ , - - .
/ r � � .� c ( If As��- - - IG /OL f-r- -�
',t„� - Lf X77 , '6'11 � b y � ��t
e two ( ' .)'�-<k- .
Pare tilkeAal(OP,199t', .. ^ 4yQePthtR Bddfotl{:, _1
De PIagidl Mi er4Stanli ; W WeelMg from f*Fe:t
melled Seasonal in B91�VS,,ct v 0
� 3 I .H__ 0-1-1
____tea y 1 4__
PERCOLATION TEST(S)
Time:
Time:
Observation Hole
#1
Observation Hole
#2
Depth of Perc
1/ 61
0
Depth of Pew
Start Pre-soak
`
Start Pm-soak
End Pre-soak
C
End Pre-soak
Time at 12'
� j
Time at 12'
Time at9'
(1i
-7)
Time at 9"
Time at 6'
4 ' /I1
Time at 6'
Time(9'-6')
7 I I
I
Time(9'-6')
Rate Min./Inch
_�,,v, 1
Rate MinJlnch
'minimum of 1 percolation test must be performed in both the primary area AND reserve area.
■ ;' ■ ■ ■
Performed by
Performed by
Witnessed by
I Witnessed by
Comments: