132 Soil Eval Form 2001 Mitun 11 -SOILEVALUATOR FORM
t 6 Pace 1 0! 1 FORM 11 . PERCOLATION TEST
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FORM II - SOIL EVALUATOR FORM
FORM II -SOIL EVALUATOR FOR Page 3
Page I of
,/ Determination for Seasonal High Water Table
No. Date: '/ Qi Method Used'
A 6 a_Coommon a ith of Massachusetts
Er/Depth �(
t=/N I✓ . Massachusetts
observed standing in observation hole }" inches
Soil Suitability/2 -siie Sewage Disposal aml a-pth weeping from side of observation hole f/f inches
Performed By L RLI✓ej� ✓ �•rA-77r/62i sGDepth to soil mottles 110 inches
wttncescd By _ 1 Date: 1,9,��O/ L / I
7E�x AVc E,�v v ICs C 1960' rv`
Ground water adjustment 7 ] feet
=,..“-...., C/4/ �- �` Index Well Number Reading Date Index well level
. /.7d. WL s M�ryrrf « S '� 00 Adjustment factor Adjusted ground water level \ / 0
New conswalon ❑ Repair t W/Pr°teRa J
Orrice Review L/ 2Q- rigs Depth of Naturally Occurring Pervious Material
Published Soil Survey Available: No ❑ Yes � 6y�
Year Published 3 p Does at least four feet of naturally occurring pervious material exist in all areas
Publication Sole �1/e}rp� ap O /s��r observed throughout the area proposed for the soil absorption system?
Drainage Class Soil Limitations yy // Gt
Surfcial Geologic Report Available:No ❑ Yes L.W 07 416/N 6 4h/)i.ZS
Year Published Publication Scale Tq � bU -Ten. S0."-AP
II not, what is the depth of naturally occurring pervious material,
Geologic Material(Map Unit) 4np.�1. et L 607 L`f Ref.f-F
Laedforen L'UT-NJASFh- PCM/ �/ t
Cacti/iratioR
Flood
bov Insurance Rate Map: / /j�� G /
Above 500 year flood boundary No 0Y/es L,_�/ I certify that on el D (date) I have passed the examination approved by the
within 500 y.., flood boundary No t�I�G V//ci ❑ Department of Environmental Protection and that the above analysis was
Within 100 year flood boundary No It ea ❑ performed by me consistent with the required training, expertise and experience
Wetland Area: q,,/�/'�y�O described in 310 CMR 15.017.
National Wetland Inventory Map(map unit) /1//� C_ WS r11—TEP , //�/t/
wetlands Continency Program Map(map i0 Signature Date lj:(/
Current Water Resource C onditions NSG cut Mont
t Range•Above Normal ❑Normal v Normal ❑
Other References Reviewed.
1.