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933 Soil Suitability 2013 • Commonwealth of Massachusetts :.' G0 City/Town of Northampton Fee:_$200 Paid? YES e:= Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal A. Facility Information Jeff&Susan Doyle Owner Name 933 Westhampton Road Street Address Map/Lot# Florence MA 01062 City State Zip Code B. Site Information 1. (Check one) ❑ New Construction ® Upgrade ® Repair 2. Published Soil Survey Available? ® Yes ❑ No If yes: 1981 1:25000 Hge Year Published Publication Scale Soil Map Unit Hinckley Loamy Sand None Soil Name Soil Limitations 3. Surficial Geological Report Available?❑ Yes ® No If yes: Year Published Publication Scale Map Unit Geologic Material Landfarm 4. Flood Rate Insurance Map Above the 500-year flood boundary? Z Yes ❑ No Within the 100-year flood boundary? ❑ Yes ® No �! Within the 500-year flood boundary? ❑ Yes Z No Within a velocity zone? ❑ Yes Z No 5. Wetland Area: National Wetland Inventory Map Map Unit Name • Wetlands Conservancy Program Map Map unit Name 6. Current Water Resource Conditions(USGS): Month/Year Range: ❑ Above Normal ❑ Normal ❑ Below Normal 7. Other references reviewed: - -- -- ?\ Commonwealth of Massachusetts L-1,71 City/Town of Northampton Fee:_$200 Paid? YES r _r,— Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: Test Pit#1 5/3/2013 1 PM Sunny Dry P Date Time Weather 1. Location Ground Elevation at Surface of Hole: 100.5 Location (identify on plan): See Plan ): 2. Land Use Lawn None 1 - 5 (e g.,woodland,agricultural field,vacant lot,etc) Surface Stones Slope(%) Grass Outwash Plain Rear yard of house lot Vegetation Landform Position on Landscape(attach sheet) >100 >25 >100 3. Distances from: Open Water Body feet Drainage Way feet Possible Wet Area feet Property Line feett Drinking Water Well feet D Other feet Glacial Outwash 4. Parent Material: Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ® Yes Ill No If yes: 90 Depth Weeping from Pit Depth Scantling Water in Hole Estimated Depth to High Groundwater: 84" 93.5 inches z\ Commonwealth of Massachusetts , �� City/Town of Northampton Fee:$200 Paid? _ mt ' Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number Retloximorphic Features Coarse Fragments mottles %by Volume Soil Depth(in.) Soil Horizon/Soil Moist(M :Color- (mottles) Soil Texture y Soil Consistence Other Layer Moist(MUnsell) (USDA) Cobbles Structure (Moist) Depth Color Percent Gravel Stones A 10YR3/3 FSL 0 0 Massive Friable No B Hor. C1 10YR3/4 84" 10YR3/2 5% M/C Sand 5 5 Massive Loose 87"- 110" C2 2.5YR3/4 L Sand 1 0 Massive Loose Additional Notes: /✓D 3 )Yo 41aoA✓ Fo v ivb . L•wto 577ei 'b'D G4/.t'ef/ tin's 1�3 o, _y. 3 Com-5 f,Co,.r, /Jo r s t 5,>E r ov, /D ,A-7 Te3-r A7 * ?S Commonwealth of Massachusetts a City/Town of Northampton Fee:_$200 Paid? YES r - - � Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal v ,:s C. On-Site Review (continued) Deep Observation Hole Number: Test Pit#2 5/3/2013 1 PM Sunny Dry Date Time Weather 1. Location Ground Elevation at Surface of Hole: 101.0 Location (identify on plan): See plan 2. Land Use Lawn none 1-5% (e.g ,woodland,agricultural field,vacant lot,etc) Surface Stones Slope(%) grass Outwash Plain Rear Yard of house lot Vegetation Landform Position on Landscape(attach sheet)>100 3. Distances from: Open Water Body Drainage Way >25 Possible Wet Area feet feet feet feet feet Property Line feet Drinking Water Well fee50 Other feet Glacial Outwash 4. Parent Material: Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ® Yes ❑ No If yes: 9p Deepth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 84" 94.0 inches elevation ?..\ Commonwealth of Massachusetts Co City/Town of Northampton Fee:_$200 Paid? YES r _ —`1 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: Test Pit#2 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) _ __Soil Texture Y.by Volume Soil Soil Depth(in.) layer Moist(Mansell) - - - (USDA) Cobbles Structure Consistence Other Depth Color Percent Gravel Stones (Moist) Stones 0 - 16" A 2.5Y3/3 FSL 0 0 Massive Friable B 2.5Y4/3 FSL 0 0 Massive Friable 42" - 108" C 2.5YR3/4 84" 10YR3/2 5 M/C Sand 5 5 Massive Loose Additional Notes: tie Ct3 s No>c ) aon/ L ,yc Pvs,lr- • UP raeom Nays E Sire-. 114 -3 )4 o,c; 2 a,v ,}T -7-1917* *1 Commonwealth of Massachusetts s-.c - +'. u City/Town of Northampton Fee:_$200 Paid? YES %._t =rV Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1 Method Used: ❑ Depth observed standing water in observation hole A. B. inches inches ❑ Depth weeping from side of observation hole A. B. inches inches ® Depth to soil redoximorphic features (mottles) A. 84" B. 84" inches inches ❑ Groundwater adjustment(USGS methodology) A. 8. inches inches 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? El Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: aches Lower boundary: aches Commonwealth of Massachusetts _py City/Town of Northampton Fee:_$200 Paid? YES nb Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. I further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form, ar rate and in acc an -th 310 CMR 15.100 through 15.107. 5/3/2013 ' nature of Soil Eval r Date James A. Gracia, PE SE#921 7/27/1995 Typed or Printed Name of Soil Evaluator I License k Date of Soil Evaluator Exam Dan Wasiuk Northampton Name of Board of Health Witness Board of Health Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the dale of field testing, and to the designer and the property owner with Percotation Fest Form 12. Commonwealth of Massachusetts ; ,"'. 0 City/Town of Northampton Fee:_$200 Paid? YES - _r Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: St€ eft;c Sys7r ?LA-Ai F it -737 67 Lac6a A/S.