1162 Site Suitability 2016 IJcolb of Natal-alit Un W111Y PFr nyus Maggoty
Does at least four feet of naturally occurring pervious■mt.:trial exist in all atma observed throughout the area proposed for the sod
absorption system?_
If yes,what is the depth of naturally occurring pemoue I uterial^
If not, what is the depth of naturally occurring pervious r uitensl?
Deep Hole Number.
Location(identify on site plans:
Land UseNegetanon fawn gnxs
t.odform
Position of Landscape:
Distance from
Date
'ht-Site Review
iv Weather:Cool&Overcast
S(AiN/fy
Sin to(•,)'. Surface Stones. none
Open Water Body /�/ Fet Drarmgeway
Possible Wet Area �7�4 ,Fn' Property Line
Drinking Water Well Feet Other
7.P.a 1-1
Feet
Feet
Feet
r ^; -V THIN I e s
Depth from
Surface
Soil
Horizon
Soil Texture
(USDA)
cofl Color
(Nouse11)
Soil
Other(Structure,Stones,Boulders
Consistency, V.Gravel)
&"
Ate-,r
F3z- Ps
/o/, 3
7f,
4e./..7 / ks 7
Poem Material(geologic)1�C,4/r(f/4q
PdalkinfanniaiMPL Standing Water in the Hole:
Estimated '..'.onus Htgb Ground Water >
Depth to Bedrock: >
Wcepmg from Pit Face'.
BOARD OF HEALTH
MEMBERS
CITY OF NORTHAMPTON
MASSACHUSETTS 01060
AY F%E(TMAN,M.D.,ACTING CHAIR
SMARM SWIM,Y.D.
DONNA C.SALLOOM
OInnCTOR OF SIAM HEALTH OFFICE OF THE
MOWS RIMDEOIR,MHEd,CHES, BOARD OF HEALTH
(413)507-1214
FAX(413)037-1221
roject Number I//�
aformed by u�
(calm Inspector])WGSr)
/� Site Addrest
16 let AI (14153 —
212 MAIN STREET
NORTHAMPTON,MA 01000
Site Suitability for On-Site Sewage Disposal Date 5 „41 I/✓ E9wpm urator fire, L Mam
S 4,41,/led
/✓
client N me&Addrest %.a/
New Construction D Repair lie e - 1/573✓✓
Qmapairi
ubhsbed Soil Survey Available' No O Y a Class Soil Limitations Published Publication Scale Sqn Map Unit Drainage
Geologic Report Available: No D Yes D
Year Published Publication Scale Geologic Material(Map Caul Landfortn
hod Insurance Rate Map:
Above 500 year flood boundary 0 Within 500 year flood boundary D Within 100 year flood boundary 7
Vedand Area:
National Wetland Invetory Map(Map Unit) Wetlands ConservacY Program Map(Map Unit)
:wrest Water Resource Conditions(USGS): Month
Range:
Above Normal 0 Normal 0 Below Normal 0
*her References Reviewed:
rerootattOf
lift aV• ••
Time
Measurement
Time
Measurement
me 1-1
legit Saturation
-
Begin Saturation
_
End Saturation
led Saturation
"
`Z../�
iaps
9"depth
Measurement
ur(enement
"depth
f:79
J
6"depth
Measurement
6awuement
,lapsed Time
c'/I -
I ov
Elapsed Time
itle0
'OVOID n'on Rate <2 min. m q�f/
atom of Percolation Test Hole de .7 Bottom of Percolation Test Hole.
-
femod Used
Depth observed standing on observation hole> ❑ Depth weeping from side of observation hole inches
1 Depth to soil mottles_inches ❑ Ground water adjustment inches
idea Well Number Reading Date Index well level _ ___