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851 On Site Review 2002 Location Address or Lot# Date PERCOLATION TEST(S) Time: ] Time: Observation Hole #1 Observation Hole #2 Depth of Perc l Depth of Pew Stall Pre-soak Start Pre-soak End Pre-soak End Pre-soak Time at 12" Time at 12" 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. SITE SITE I SITE SITE PASSED _ FAILED PASSED FAILED Performed by I Performed by Witnessed by Witnessed by Comments: NORTHAMPTON BOARD of HEALTH— Title 5— Site Review )le#: -I leDEEP #: rom fiches) OBSERVATION HOLE LOG* S1INIMUh1OFrifO HOLES REQUIRED AI LV CRY PFOPOSm DISPOSAL AREA orn chest Soil orison Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure,Stones,Boulders,Consistency.%Gravel) 1 J i Ii r :.. iv- i T ' l tetiai(geologic) . Depth to Bedrock I 7 1 >_-c Iroundwater.Standing Waterin fhe+Hoil. I Weeping from Fit Face I tatedSeasonal thgh'ramd Water rT' , .. )le#: DEEP OBSERVATION HOLE LOG* 'MINIrv1UM OF NJO HOLES REOUIRED AT EVERY PROPOSED DISPOSAL AREA rom fiches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure.Stones,Boulders,Consistency,%Gravel) genial(geolog c) I ta r I w groundx2Jer.:StandlnpwalerNfhe Hole I krneepingirorP Pit Fate