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51 On Site Review PERCOLATION TEST(S) Time: Time: Observation Hole #1 Observation Hole #2 Depth of Perc - Depth of Perc G � n Start Pre-soak - l Start Pre-soak End Pre-soak End Pre-soak Time at 12" Time at 12° I, Time at 9" Time at 9" Time at 6" Time at 6" Time(9"—6") 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. t. • -... ■ g i.. ■. Performed by I Performed by - - Witnessed by Witnessed by Comments: Address or Lot N NORTHAMPTON BOARD of HEALTH - Title 5- Site Review 5 1 �� I Owner _ DEEP OBSERVATION HOLE LOG' 'MINIMUM OF IWO n '1es) Soil Horizon Soil Texture (USDA) i c)-10 Time Time Other (Structure,Stones,Boulders,Consistency,%Gravel) „. Owner's ),) C e 7 1 (pl VA-c4 Weather Phone It Id Use 1 We ping from Pd Face 1 %Slope Surface Stones idform Ve.etation Start Time n on Landscape( later Body ketch on the back) feet Distances Drinking Water Well Stop Time feet Property Line feet D Wet Area feet Drainage Way feet Other feet DEEP OBSERVATION HOLE LOG' 'MINIMUM OF IWO n '1es) Soil Horizon Soil Texture (USDA) Sod Colo (Munsell) Soil Mottling Other (Structure,Stones,Boulders,Consistency,%Gravel) ),) C e 7 S M -� ° ,-.-� - INS— c" L_ Ib! ,fr.) ti / MI(geologic) I I Depth to Bedrock I I to groundwater Standing Water in the Hole 1 We ping from Pd Face 1 Estim ted Seasonal High Ground Water DEEP OBSERVATION HOLE LOG' *MINIMUM OF TW '-s) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure,Stones,Boulders,Consistency.%Gavel) al eol k Death to Bedrock to groundwater Standing Water in the Hole I We ping from Pit Face slim ted Seasonal High Ground Water