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51 Site Review 2000 I 51 All 4A- 1-1- 4jJ IT PERCOLATION TEST(S) Time: Time: Observation Hole #1 Observation Hole #2 Depth of Perc i Depth of Perc Start Pre-soak / J 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 on test must be perform din both the primary area AND reserve area. Performed by Witnessed by Comments: IPerformed by I Witnessed by I NORTHAMPTON BOARD of HEALTH- Tide 5-Site Review Location Address or Lot# st r I l' Owner Date- Time Owner's Jill 1-- Address �v- — Engineer I V A 1- Pu Weather Phone If Land Use %Slope Surface Stones Landform Ve.etation Start Time Poslbonon Landscape(sketch on the back) Distances Stop Time Open Water Body feet Drinking Water Well feet Property Line is Possible Wet Area feet Drainage Way feet Other DEEP OBSERVATION HOLE LOG* Deep Hole A: *MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Depth from Sol Horizon Sod Texture SalCobr Sad Other Surface(Indies) (USDA) (Monsell) Malang (Strumne,Stones.Boulders.Consistency.% ) ' ,fiuJ n... D � � SL 6 /Ir©r/� S l m \ --II ■ 4yc ) ;,/ a 9`'v1 a) ,1 i ' iY I' �— O l ' 6 Parent Mania!(geologic) i I Depth to Bedroc / by "' Depth togroundwater Standing Water in the Hole ) I a-9" I Weeping from Pit Face I /il 6 I C. Estimated Seasonal High Ground Water DEEP OBSERVATION HOLE LOG* Deep Hole it *WUHAN OF-TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA _._. - Deptheom Soil Horizon Soil Texture Soa Color Sol Other Surface(Inches) (USDA) (Munselp Mottling (Structure.Stones.Boulders,Consistency,14 Parent Mahal(geologic) I I Depth to Bedrock I Depth to groundwater. Standing Water in the Hole I Weeping from Pit Face Estimated Seasonal High Ground Water r