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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