1236 Soil Suitability Assessment 1997 06/01,1998 09124 FROM THE BTOWN COPY CNTR.
AMHERST CIVIL ENGINEERING
TO 14135871264 P.01
PO Box 3312,Amherst, MA 01004-3312 (413)256-3400
June 1 , 1998
Peter McErlain
Dept. of Public Health
City of Northampton
210 Main Street
Northampton, MA 01060
Re: 1236 Florence Rd.
Northampton, MA
Property now/formerly of Frank Fournier.
Dear Peter:
On May 29, 1998 I inspected the as-built septic system repair
at the property referenced above with David Kochan of your
ofice. With one exception the installation appeared to have
been done according to the approved plan and the requirements
of Title 5. The one exception was the decision of the owner
to replace the existing septic tank with a 1000 gallon septic
tank. This was done without advance notice to or approval
from Amherst Civil Engineering. At the time of the inspection
the new tank was in use and the liquid level was at the outlet
invert. As per our telephone conversation this morning on
this subject this deviation from the approved plan is accept-
able. We strongly recommend that the garbage grinder in
this house be removed and that the leaking plumbing fixture
in the house be repaired.
Thank you very much.
Very truly yours,
Robert Stover
I
No.
FORM 11 - SOU. EVALUATOR FORM
Page 1 of 3
Date:
Commonwealth of Massachusetts
, Massachusetts
Soil Suitability Assessment for On-site Sewage Disposal
Performed By: Po t-✓. s+ovet Date: 1 0131J?7
Witnessed By- /Yet Pc Er Liar
Lama Mane s
Le,
New Construction ❑ Repair
0.m'.Nun
nom .
71:r raft•I onit ec
1236 F1or-caner-
NDY-ft, "6-1-v1,1 p) 4-0)060
(41/.3) y 87- O 179
Once Review
Published Soil Survey Available: No ❑ Yes
Year Published
Drainage Class
Publication Scale
Soil Limitations
Surficial Geologic Report Available: No ❑ Yes ❑
Year Published
Geologic Material (Map Unit)
Iandform
Publication Scale
Soil Map Unit
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑Yes ❑
Within 500 year flood boundary No ❑Yes ❑
Within 100 year flood boundary No Oyes ❑
Wetland Anea
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map(map writ)
Current Water Resource Conditions(USGS): Month
Range :Above Normal ❑Normal ❑Below Normal ❑
Other References Reviewed:
S
nar.tenovm POIM-WT/15
Location Address or Lot No. 123L. FIorcvs Lc
FORM 11 • SOIL EVALUATOR FORM
Page 2 of 3
On-site Review
Deep Hole Number _1 Date: )(4311q") Time: 61\40 4i Weather Plc,
Location (identify on site plan) _ ... it'-. . PIAN! -.._ ._.. ...
Land Use _..._j.A V 7 _...... .. Slope (%) 1'_ Surface Stones /20117-t
Vegetation _._ _tjrq<S.
Landform Q.u.Jash IAi
Position on landscape (sketch on the back)
Distances from:
Open Water Body ( D p feet r Drainage wayet i
Possible Wet Area I b 6 feet'- Property Line feet -7 5 ■ 5r_ 51i1 .
;mot o• Cro>M
Drinking Water Well feet Other
DEEP OBSERVATION HOLE LOG"
Depth from
Surface(Inches!
Soil Horizon
Soil Tenure
(USDA/
Soil Color
IMunselll
Soil
Mottling
Other
(Structure. Stones,Boulders.Consistency. %
Gravel,
0-941
ot_ loir
n
611" - lace
Pr
Bw
C 1
c2
rsL
ELS
6P4111'
F5 U
IDY43I?
0YQ4It0
loss/i
nowt..
none-
7W C
2,s ;Iq..
L--)1-1.
F r, bl <
5 t pl.t 4 LI F,.;et 6 L,
5% . {ricita sou-.-?s
J
'AN. cobbles f- Slr:
It I Fsv".,.
w -Pin/- J ruvt l
Pram Material(yaobeiei 0 CA-- ,in p IT -41 Deparotaadloelt
Death to Groundwater: Standing Water in the Mole: n 011 C Weeping frprn Pit Fen:
I (0ii
Faunaba Sword High GrouN Water:
S
ry
De APPROVED BOIM-MOMS
Location Address or Lot No.
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
123(0 E./orevle.t Ace
Nay- yar..A1,1-0,., •
On-site Review
Deep Hole Number 2 . Date: 10/311117 Time: /b ! Y5 Weather c.1e a✓ 55u
Location Odentifx on site plan) 5c P1a'^ .. . _ .. _-
Land Use _ 4u,11. ._ Slope (%) Z Surface Stones no/w. _.. _.....
Vegetation _.._ _..pet,$)r4 .... . ..... . ._
Landform II W4$k flat h ... ..
Position on landscape (sketch on the back)
Distances from:
Open Water Body I a 0 feet 4 Drainage way C1 feet ± 511 r.1tT g Wa
Possible Wet Area f0 0 feed-- Property Line T!• feet t ( � we „ t- brJ3h
Drinking Water Well 1—min feet Other
Wr{ ✓
DEEP OBSERVATION HOLE LOG.
Depth from
Surface(Inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
Montmg
Other
(Structure.Stones,Boulders. Consistency, %
Gravel)
pp
D — p
g Z �
2c, —94e
g140— Im/
ar
BV/
L (
L2
/
YsL
FL5
F5(-1
• t-�
Iott3
IoYl�9ib
Ioyy5i6
Ioe'i/)
n'I'lc
vw^ti
run--k
z.S1s1y
cYI ALIT
Slt'. 244t1 'F:ri ul,L.
•5-va1L'il,rft 5a.«t + 1*04
I.& e)411 fiat 4-0 twArt7I-,
11/e v. I
• Ire,) c.abfa1.5 a ✓,idt^ro
IacY / /^,5i11Ilk qra.•"
• eV'z‘-<X `OOJ1
TIC.
Parent Material(geeagie: DU-kweJ4' over 4J)
pecan to Groundwater: Standing Water in tM Hole: gWant
Esteneted Swooned Koh Ground Water / lo
S
ov A7?ROVm rows-s2atns
102-
Weeping from Pit Face: �"t-
FORM 12 - PERCOLATION TEST
Location Address or Lot No. /23(0 F-I oV(NCL vrat
COMMONWEALTH OF MASSACHUSETTS
Not*amp4n, , Massachusetts
Percolation Test'
Date: 191-311 97 Time: ,. 1 �'.. '...-
Observation Hole #
)
f-
Depth of Perc
(53 "
/r
Start Pre-soak
i0 ', 33
(0 :57
End Pre-soak
I o , S g
cec,Y.Q mil 4;-, ,h
u u,az, /2.4,,e4
Time at 12"
Time at 9"
I D : 4 Q
Time at 6"
I I D i
Time (9"-6")
Rate Min./Inch
u kb,
G
1 3
(J :. o
• Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed ® Site Failed ❑
Performed By: kobcr _,��»�i�✓
Witnessed By: Q,1c,
Comments f Liam - ( s c endLA+;oti
S
nv APPROVED FORM•WOW
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No. /2-3j0 1- I ore. a,„
rlor� ✓1w� p F�.I
VIA 4\
Determination for Seasonal High Water Table
Method Used:
❑ Depth observed standing in observation hole inches
❑ Depth weeping from side of observation holeinches
Depth to soil mottles 4(0 inches
❑ Ground water adjustment feet
Index Well Number Reading Date
Index well level
Adjustment factor Adjusted ground water level
Depth of Naturally Occurring 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 49 Ige") (date) I have passed the soil.evaluator examination
approved by the Dep rtment 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. y�
Signature ' Jyv""- Date
DO APPROVED FORM-l317tF!
FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVAL
PAGE 1 OF 5
Commonwealth of Massachusetts
No1--l/ P .. , Massachusetts
Application for Imo! Upgrade Approval
Title 5, 310 CMR 15.000
DEP Approved form required by 310 CMR 15.403(1)
To be submitted to Local Aonrovine Authoritv/Board of Health: For the upgrade of a failed or
nonconforming system with a design flow of <10,000 gpd, where full compliance, as defined in
310 CMR 15.404(1), is not feasible.
To be submitted to DEP: For the upgrade of a failed or nonconforming system with a design flow
of 10,000 up to 15,000 gpd and/or for upgrade of a state or federal facility, where full
compliance, as defined in 310 CMR 15.404(1), is not feasible.
NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the
addition of new design flow to a cesspool or privy or the addition of new design flow above the
existing approved capacity of a system constructed in accordance with either the 1978 Code or 310
CMR 15.000.
1) Facility/system owner
Name Frank Fournicr
Address 12_3(j newts,cc. /24 Noe antr / hi Pr O10(41
Phone N (4113) 587 - 0! �4
Address of facility SH.."c
2) Applicant (if different from above)
Name Sates
Address
Phone
3) Type of facility
1resideatial commercial_school
institutional
(Specify) +l+✓u,lamt ly heu5c-
S
oat•ttlOV®tow:U2/17/A$
FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVAL
PAGE 2 OF 5
4) Type of existing system
_privy cesspool(s) v/ conventional system
Other (describe)
Type of soil absorption system (trenches, chambers, p1t3.etc.) 2 o
de� w
O. teach -}r'enc:+l5 6a ' t_bny by 3 'r/ide
thle-k
5) Design flow baud on 310 CMR 15.203
a) Design flow of existing system_ gpd
Approved? yes approval date
no why?
b) Design flow of proposed upgraded system 518 gpd
c) Design flow of facility 496 gpd
6) Proposed upgrade of existing system is
a) Voluntary
Required by order, letter, etc. (attach copy)
V Required following inspection required by 310 CMR 15.301 (provide date
inspection form was submitted to the approving authority) (date)
b) Describe the proposed upgrade to the system
up love, 345
•
S
c) Which of the following are applicable to the proposed upgrade? .
42 Reduction of setback(s) (list setbacks to be reduced with proposed 'aback distances)
Percolation rate of 30-60 minutes per inch (state actual perc rate)
aernrraOV®roaM•vmns
FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVAL
PAGE 3 OF 5
no Up to 25% reduction in subsurface disposal area design requirements (state required
& proposed size)
n oo Relocation of water supply well (identify well, describe relocation)
Y.a Reduction of required separation between bottom of SAS & high groundwater
(specify proposed reduction & perc rate) -rr✓on, 5 +o 1-1.5 ' < 2 wt.n . I i v,c11
YID Other requirements of 310 CMR 15.000 that cannot be met (specify sections of the
Code)
System upgrades that cannot be performed in accordance with 310 CMR 15.404 &
15.405, or in full compliance with the requirements of 310 CMR 15.000, require a
variance pursuant to 310 CMR 15.410-15.417.
7) If the proposed upgrade involves a reduction in the required separation between the bottom
of the soil absorption system and the high groundwater elevation, an Approved Soil
Evaluator must determine the high ground water elevation pursuant to 310 CMR
15.405(1)(i)(1). The evaluator must be a member or agent of the local approving authority:
S
Distance from soil absorption system to high groundwater
11. 5 feet
As determined by:
Evaluator's name
Evaluator's signature
Date of evaluation !0/31
b4 Shyer w.-I-Af
Q lc-kr P1' a
14r.�%"i1p -
DO APPROVED PORN-MOM
FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVVAL
PAGE 4
8) Notice to Abutters �I ot) no-I- a e `i'In.> case,
No application for upgrade approval in which-the setback from property lines or a
private water supply well is reduced shall be complete until the applicant has
notified all abutters whose property or well is affected by certified mail at least ten
days before the Board of Health meeting at which the upgrade approval will be on
the agenda. Such notice shall include the date, time and place where the upgrade
approval will be disnm.4.
If the Department is the approving authority then such notice to abutters must be
completed prior to the date of submission of the application to the Department.
The notices to abutters shall include a copy of the completed application form and
shall reference the standards set forth in 310 CMR 15.402 through 15.405.
List of affected Abutters:
Date notified
Abutter Name
Address
Abutter Name Date notified
Address
Abutter Name
Date notified
Address
Date notified_
Abutter Name
Address
9) Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible (each
section must be completed):
a) an upgraded system/[[in full compliance with 310 CMR 15.000 is not feasible:i° obt5ih 6u.yi-icitn+ j'*& ce owN 45-'4 `{-v dioou C NAT
poss.blm 40 vr5 i ) t IM;+ ∎ vttc +Ili•
b) an alternative system approved pursuant to 310 CMR 15.283-15.288 is not feasible:
n,,4 • ppeppe,a%E. ‘e
VC APPROVmPDtM•12Tn5
FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVAL
PAGE 5 OF 5
c) a shared system is not feasible:
nearb1 1,00•e5 Gave. NL o1'"4 49s-1E ws .
d) connection to a sewer is not feasible:
w +
oi�4i-W U. h Se Cr C-in
10) An application for a disposal system construction permit, including all required attachments
(e.g. plans & specifications, site evaluation forms), must accompany this application. Is the
DSCP application attached? _yes no
11) Certification
'I, the facility owner, certify under penalty of law that this document and all
attachments, to the best of my knowledge and belief, are true, accurate, and
complete. I am aware that there may be significant consequences for submitting
false information, including, but not limited to, penalties or fine and/or
imprisonment for knowing violations.'
Facility owner's signature Date
Fran Fournier
Print Name
&obcvk 54-ovcv ylL198
Name of preparer Date
�913),2560-31-iob t9, Di bar 33!. , Afrouns4l
Telephone M & address of preparer
y✓LAA aJoe - /Z
NOTE: Title 5, 310 CMR 15.403(4), requires the system owner or operator to submit to the
Department a copy of the local upgrade approval upon issuance by the Board of Health and prior
to commencement of construction.
oo7rranvm row-uares