16 Bayberry Lane Perc Test 20219Commonwealth of Massachusetts
City/Town of Northampton
t, f Form 12 — Percolation Test
A. Site Information
Harold Jordan and Renee Rossi
Avner Name
16 Bayberry Lane Assessors Ma 35 Parcel 229-001-1
Street Address or Lot # 01062
Northampton MA Zip Code
City/Town State ZCo
Harold Jordan and Renee Rossi
Contact Person Telephone Number
B. Test Results
1!11!19 11:20 am
Date Time Date Time
Observation Hole # 1 2
Depth of Perc 34"
Start Pre -Soak 11:20
End Pre -Soak Poured 24 gallons Sieve analysis
Time @ 12' Results: Class 1
Time @ 9'
Time @ 6'
Time 9 — 6'
Rate (Min./Inch) 2 rnpr
Test 2 Test Passed 0
Passed
Test Failed Cl Test Failed
Peter LaBarbera
Test PErtem*d er.
Daniel Wasiuk
Witnessed By
DEP Form 12 Percotation Test
Analytical Engineering, Inc.
Granby, MA & Newburyport. MA
Grain -Size Analysis of Soils
i
Sample I.U.
S-1
Delivered to lab by:
PR LaBarbera
On-site material:
16 Bayberry Lane, Northampton, Mass.
Description.
Burmister
c -f SAND, little Gravel, tr-Slit
Munselt color
Grain Size Distribution
100
_ .
I I
; Silt
90 Sand
GraveE
� I
Clay
80
-,--
c
70:
I
ii
50
i
i i
*6
U
40-,I
30-
i
#[1
a
20, ,
r I I I I I V�_ I I I i 11
10
0 .
10
1 0.1 0.01
0.001
Grain Size minus #10 fraction (mm)
Tested by: AEI IWAS
2116 - 17/2019 Methodology: ASTM D-422
W -tare (g) 129.00
Cumulative Cumulative
% Finer
Specification
Sieve
D (mm)
Weight (g) % Retained % Finer Cormoed to /10
94
4.75
199.6 70.6 14.84
8516
#'10
2
247.2 118.2 24.85
75.15
100.00
920
084
351.0 222.0 46.67
5333
70.97
#40
0.42
4615 332.5 69.90
30.10
40.06
#60
0.3
552.7 423.7 89.07
10.93
14.55
#100
0.15
568.1 439.1 92.31
769
10.24
#x200
0 074
585.0 456.0 95.86
4.14
5.51
Pan
f -
604.7 475-7
Method
D (mm)
% Finer
hydrometer
0,10057
700
hydrometer
0.07166
6.22
I
hydrometer
0.05125
5.44
hydrometer
0.03664
4.67
hydrometer
0.02610
3.89
hydrometer
0-01872
2.72
hydrometer
0.01328
2.33
hydrometer
0-00944
1.94
hydrometer
0.00671
1.55
hydrometer
0-00477
1.17
hydrometer
0.00338
0.97
hydrometer
0.00240
078
hydrometer
0.00157
039
Summary:
Sand
95 %
Silt
4
Clay-
1
Sample is classified as a:
Unified USDA
SAND
PLAN REVIEW - SYSTEM COMPONENTS
NORTHAMPTC',I BOARD OF HEALTH
212 MAIN STREET,
Ci #W TON, MA 01060
Lot Number Address,
OWNER
NAME
OWNER
ADDRESS
Fjlf ,C&b
Applicatiou No. V/r,2
TELEPHONE # ( _)
DESIGN
ENGINEERISANITARIAN
FACILITY DESIGNED FOR
A. Single or Multifamily dwelling
# Bedrooms Garbage Disposal yes
na
Total Design Flow 35�- G� gallons per day
B, Other (describe)
Design Basis
Total Design Flow
COMMENTS or PROBLEMS:
r� vI le e--
NORr (P ro v,A &j �1
yAMPT�JN gOA
NOR IIA�N SrRFEr RD OF NEALrk
NA . 'OiV, fviA 01060
Pager I of 16
//0.
gpd�����j
BUILDING SEWER
ITEMS TO NOTE:
Pipe diameter
Schedule of pipe
Watertight joints
Slope (min for 4" pipe is 0.01 or 1/$" per foot; desired slope is 0.02
or 1144" per foot)
Invert elevation at building _
Length
Alignment and grade
(manholes required at changes in both allPmelat and grade.)
Manhole (Must have metal frame and cover at grade)
Pager 2 of 16
SEPTIC TANK
Tank size at least 200 % of design flow
(minimum tank size is 1,500 gal)
2" - 3" drop from inlet to outlet /
ex
Js
Minimum 41 liquid depth J
Tees extend 6" above flow line
Inlet tee 10" below now line (minimum)
Air space (31'above tees, 9" above flow lune)
Depth of outlet tee (minimum 14")
.Access manhole over center of tank and each tee
Number of compartments
Gas baffle on .new construction
Septic tank detail provided
Buoyancy calculation (if necessary)
On 6" crushed stone
Pager 3 of 16
DISTRIBUTION SOX
ITEMS TO NOTE:
Inlet elevations�O r �_
Outlet elevations
Drop (inlet - outlet)
Sump (6" mfnlmum) Baffle or inlet tee
All outlets at same elevation ventilation
Manhole cover to grade # of outlets
/ size of outlets (diameter)
Distribution laterals: No. Size
Detail Provided��
Aabrr 4 of 16
LEACH FIELD
Items to note:
Dimension of fleld(s): Length WIdth
Number of fields Field separation (10 ft. min)
Total area provided for disposal
(1 x w x no. of fields)
Gallons of treatment provided:
(sq. ft.)
Bottom area x loading factor (from 15.242) P -al.
(must be equal or greater than design flow)
Note: Leaching area .must be increased if garbage grinder is used.
Elevation of bottom of the field
(must be 4 ft/or 5 ft above max. high groundwater depending on Pere rate.)
Number of distribution pipes
Type
Length (100'm x.)
Slope (min. 0.005)
Spacing (6' max.)
Depth of stone beneath pipe
(min 6")
Plan states stone is double washed
2" cover of 1/8" to %" stone over pipe crown
Ends capped
Aggregate depth 6" minimum and 12" maximum
Depth of cover material above stone (min.911)
Construction of leaching facility in rdl? Yes _ No
Fill is specified as Titley on plan
Certification on fill submitted
Fill is specified for 5' around entire system
Separation between lines (6 ft maximum)
Separation between Unes and edge of bed - four feet maximum.
Pager 5 of 16
MW]
LEACHING TRENCHES
Number of trenches , length (max. 100') width (min.24)
Depth of stone beneath pipe (6"' min )
Leaching area available
bottom = length x width x no. trenches
sides = length x depth (2'max) x w x # of trenches sq ft:
TOTAL @ sq ft.
note: the effective depth shall be equal to the depth of the trenches below
the invert of the distribution pipe up to maximum of 2 ft.
Leaching are requirements:
Total leaching area (bottom plus sides) x loading factor = gallons treated
Loading factor is based on pert rate (see 15.242)
Total gallons treated by system design must be > design flow for ste
LEACHING AREA REQUIREMENTS SATISTIED7 Yes
, No
( note: leaching area must be increased if garbage grinder is used)
Ground water elevation: 4 feet or 5 feet separation
between trench bottom and max. high groundwater.
Trench spacing 3 x effective width or depth whichever is greater
Trench width 4 ft maximum
Pipe slope (min. 0.005 slope, or 6" per 100 feet)
Backfill depth (min. of 911)
Ends capped
Distribution lines exceeding 50 ft are vented.
Diameter of distribution pipe (min. 3')
Distribution line orifice (min. 318, max %")
The area between trenches shall be designated as reserve area only where
the separation distance between the excavation sidewalls is at least six feet.
FRI Is specified as Title V on plan
Certification on Fill submitted
Fill is specified for 5" around entire system
Pager 6 of l 6
PLAN REVIEW CHECKLIST
GENERAL INFORMATION
CHECK TO VERIFY THAT THE PLAN INCLUDES THE FOLLOWING REQUIRED
INFORMATION:
MASS. REG. SANITARIAN, or MASS. P.E. stamp and signature
4/ Scale of I" = 40' for plot plan
Scale of I" = 20' for system component details
gal boundaries of the facility being served including easements
which could affect the impact the system Installation/performance.
All dwellings, buildings existing and proposed impervious areas
Location of all existing and proposed impervious areas
�ocation and dimensions of the system including reserve area
Design calculations: Sewage now gpd
gpd gpd
Septic tank $ire required
" "provided gpd
G North arrow, existing and proposed contours
�ocation and log of deep bole observations test
— date of test
existing grade elevations for each test
Pager 7 of] 6
PLAN REVIEW CHECKLIST (cont.)
Name of approving authority representative
Name & approval no. of soil evaluator
Location and results of Pere test
Date of perc test
�Loeatian of water lines and other subsurface utilities on facility
Observed groundwater elevation in vicinity of the system
-Z,C-O-mplete profile of the system
_JZA note: on the plan listing; all variances to the provisions of
310 CMR, 15.00 and local requirements sought in conjunction withthe plan
—L -Location and elevation of benclunark within 5o to 75 feet of the facility
which is not subject to dislocation or loss during conjunction of the fi►cility
If dosing system is proposed:
complete design and specifications of the system
dosing chamber capacity; required provided
number of dosing cycles,
depth of cycles
PAger 8 of 16
PLAN REVIEW CHECKLIST (CON IT)
Recirculating Sand Filters
Complete plans and specifications
hydraulic profile
location of the treatment works and nearest existing street
street and lot number
Pager 9 of 16
DOSING TANK
Dimensions L x W x D= Vol.
Nui�r / size of siphons
Number aft�size of pumps (No. . Capacity gpm
Discharge size
Manholes to grade
Groundwater elevatiok(min. X ft below inlet)
Pump controls
Alarm (on separate power
Buoyancy calculations (if
Pump system calculations
Pager 10 of 16
LEACHING CHAMBERS/PITS
ITEMS TO NOTE
Manufacturer 0, 7 ,
Installation 1 GcC. - �--i✓ f/rr� �5
Bed Formation
Number of beds of trenches
Leaching area available:
ers)
Length
Width
Depth
,�D a/,X x 7 93s, �/I k = v�5,�o s.�2
bottom: (length x width x no. of pits)
sides: (2 x (length x depth (2'max.)+ (2 x Jr (width xx depth (2'max) x # of pits.
/-/,
Total leaching area available = / 5 -- sq. ft. 1,4e
LEACHING AREA REQUIREMENTS:
Total leaching area (bottom + sides) x loading factor from 15.242
-- ✓ ��' �j� gals. This must be greater than or equal to the design
flow for the system. Increase leaching area if garbage grinder is used.
Distribution Trenches: every 20 feet
Beds: area for pipe not to exceed
60 x 60 feet
Spacing Trenches: 2 x effective depth or width
Beds: 4 feet between excavation sidewalls.
Manholes (min -one 20" access per unit; a 24" diam for > 2,000 gal units)
z--- Stone around chamber ('12" to 48" of'/ " to 1 %" stone)
2" cover of i/S" to ''/_" stone
4' separation between max. high GW and trench bottom? Yes No _
Pager 11 of 16
rn t413J ��. l u1 r ruA t—j
1.4
I
t
PLAN REVIEW - SYSTEM SITING
Performed By: ............................................. Approval # .................
Witnessed By:..... ........................................ Date .....................
Location Address or Owner's Name,
Lot Number: Address and
Telephone No.
Office Review
Published Soil Survey: NO YES
Year Published ............Publication Scale........... Soil Map Unit ............
Drainage Claes ............ Soil Limitations ......................................
SurtIcial Geologic Report Available: No Yes
Year Published ............. Publication Scale .................
Geologic Material (Map Unit) ........................................
Landform............................................................
Flood insurance Rate Map:
Above 500 year flood boundary No Yes
Within 500 year boundary No Yes
Within 100 year flood boundary No Yes
Pager 12 of 16
Area:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map (map unit)
Current Water Resource Conditions (USGS): Month
Runge: Above Normal Normal . Below Normal
Other References Reviewed:
M n"n"Rt setback distances (where applicable) shall be shown on the plan for the proposed
disposal facility (septic tank and soil absorption system.)
Septic Tank
Property line 1.0
Cellar waWinground
swimming pool
Slab Foundation
Water supply
pressure Line
Surface waters
(except wetlands)
10
10
10
25
Soil Absorption
System (SAS)
10
Pager 13 of 16
20
25
10
50
r
Septic Tank SAS
--Bordering vegetated
wetlands, suit nurshes,
inland and coastal banks 25 50
SURFACE WATER SUPPLY
Reservoirs and impoundments 400
Tributaries to SWS 260
Wetlands bordering SWS or
tributaries thereto 100
Certified Vernal Pools 100
Private water supply well
or suction line 50
PUBLIC WATER SUPPLY WELL
Gravel packed
400
Tubular
250
Irrigation well
10
Open, subsurface, or
surface drains which
discharge to SWS or
tributaries thereto
50
Pager 14 of 16
400
200
100
100
100
400
250
25
100
Soil Absorption
Septic Tank System
!r,~
r ` Other open, surface or
subsurface drains (ex-
cluding foundation drains)
which intercept seasonal high
groundwater 25 50
Other open, surface of
subsurface drains (ex-
cluding foundation drains 5 10
%/
Leaching and catch
basivas & drywells 10 25
Y Downhill slope N/A 15' (min) to
top of
3:1 slope
v
Inspection Port(s)
kl-'Ma;nctic Tape
erect # of deep bole per code revision
Note: slope stabilization shall be provided (Including
retaining; walls) when an adjacent dowrddfl slope
to a disposal facility is greater than 3:1.
Pager 15 or 16
EFFLUENT LOADING RATES
(gpd/sq. ft./day)
PERC.RATE
SOIL CLASS
(min./in.)
CLASS I
CLASS II CLASS M CLASS IV
<5
0.74
0.60 - -
6
0.70
.0.60 - -
7
0.68
0.60 - -
8
0.66
0.60 - -
10
-
0.60 - -
15
0.56
0.37 - -
20
0.53
0.34 - -
25
-
0.40 0.33 -
30
-
0.33 0.29 -
Loading criteria listed below apply only to the upgrade of existing systems pursuant
to 310 CMR 15.405 (1) (c) or systems constructed pursuant to 310 CMR 15.417
40
60 -
Pager 16 of 16
0.25
0.15
Y. CITY of NORTHAMPTON
PUBLIC HEALTH DEPARTMENT
Public Health Director -- Merridith O'Leary, RS
Municipal Building — 212 Main Street -- Northampton, MA 01060
Phone (413) 587-1215 M Fax (413) 587-1221
hip: //www. northamptonma.gov/245/Health
Onsite Septic Construction Pern
Commission ReviE
NOTE: As of 1/1/11, septic System Permits will not be i
of Health until we receive this form signed by the Northa
Staff member. The conservation Commission can; be reac
o Sarah LaVall!2�y. Conservation Preservation and Land Use Planne
Property Owner:
Address:
lu
PuiblicHealth
Prevent. Promote. Protect.
Co y
15 Gam,'
7v � ��5 W M M
SLaValle northam tonma. ov
Office of Planning & Development
210 Main Street, Room. 11, City Hall
Northampton, MA 01060
C-1
Engineer: /
Conservation Preservation and Land Use Planner
Date:
❑ New Construction 0
/Uo�, oti
Repair Construction _ tieel
(8e %14- Nat �nl � /ICI,tCJ/ ,
212 Main Street, Northampton, MA 0.1060
Ph (413) 587-1214 Fax (413) 587-1221
City of Northampton Board of Health 2017
' t 212 Main Street
' Northampton, MA 01060
413-587-1214 -
PERC TEST WITNESS FEE
��/� 200.00 per 3 hours
!/
Permit Number: o $75.00 per hours after 3 hours
Fee Collected: eir Cfee W�cl% FEE'S ARE NON-REFUNDABLE
Perc Test Date: January 11, 2 019
APPLICATION MUST BE SUBMITTED IO BUSINESS DAYS PRIOR TO THE SCHEDULING OF A PERC TEST
Application for Percolation ("Pert") Test
Date of Application: January 10, 2019
9
Home Owner Name: Harold Jordan and Renee Ross;
Address: 16 Bayberry Lane
City/Town/State/Zip Code: Florence
SOIL EVALUATOR LICENSE NUMBER: 1328
R.S.(X Engineero
ADDRESSEnvir)nmental Planning Associates, P.D. Box 351, South Deerfield, MA 01373
PHONE 413-665-7903
E-INTAIL enpl-an@comcast.net
EXCAVATOR Richard Jaescke
(hack -hoc oneratc,
ADDRESS 774 Bridge Rd., Northampton, MA 01060
PHONE 413-584-7898
CHECK LIST
❑ New Construction
® Repair/ ipgrade
***Number of Lots to be Pere Tested —New Construction only- Give Lot Numbers***
® Dig Safe Sign -Off: Gas/Electrical # 2018-4902084
❑ Trench Perinit/Info Sign Off from DPW (413) 587-1570
For Goad .MMM Ute Only
: CITY of NORTHAMPTON
PUBLIC HEALTH DEPARTMENT
ti y BOARD OF HEAL T11 MEMBERS: Donna Salloom, Chair — Joanne Levin, MD --Suzanne Smith, MD
STA FF.- Merridith O'Leary RS, Director — Daniel Wasiuk, Inspector — Edmennd Smith, Inspector — Jennifer Brown, RN, Nerrse
October 31, 2018
Harold Jordan
16 Bayberry Lane
Florence, MA 01062
RE: Sewage Disposal System Inspection
16 Bayberry Lane
Dear Homeowner:
The Northampton Board of Health is in receipt of a report on the Subsurface Sewage Disposal System
Inspection conducted by Marcus Millett at your property, 16 Bayberry Lane, on September 28, 2018. That
inspection report indicates that your subsurface sewage disposal system fails to protect the public health
and the environment as defined in Section 15.303 of CMR 15.000, State Environmental Code, Title 5.
Therefore, in accordance with the provisions of 310 CMR 15.000 of the State Environmental Code, Title 5,
and under authority of Massachusetts General Laws, Chapter 21A, Section 13, you (or the subsequent
owner of the property) are hereby ordered to repair the subsurface sewage disposal system at 16
Bayberry Lane, within two years of the date of the original inspection, (September 28, 2020). If
further degradation of the sewage disposal system occurs (e.g. sewage flowing to the surface of the
ground), you may be required to complete the repairs sooner.
All work to repair/upgrade your subsurface sewage disposal system must be performed by a licensed
sewage disposal system installer, in accordance with the requirements of 310 CMR 15.000, and with plans
approved by the Northampton Board of Health.
Please be advised that you are entitled to a hearing on this order to upgrade your subsurface sewage
disposal system, provided that you file a written petition requesting such a hearing in the Board of
health office within seven (7) days of the receipt of this notice.
Please feel free to contact the Board of Health office, at 587-1214 if you have any questions concerning
this matter.
Thank you for your anticipated cooperation in this matter.
Sincerely,
Daniel Wasiuk
Health Inspector
212 Main Street, Northampton, MA 01060
ph (413) 587-1214 Fax (413) 587-1221
■
BOARD OF HEALTH
. MEMBERS
JAY FLEITMAN, M.D., ACTING CHAIR
SUZANNE SMITH, M.D,
DONNA C. SALLOOM
DIRECTOR OF PUBLIC HEALTH
XANTHI SCRIMGEOUR, MHEd, CHES,
CITY OF NORTHAMPTON
ltiASSACHUSE TTS 01060
OFFICE OF THE
BOARD OF HEALTH
212 MAIN STREET
(413) 587 -1214 NORTHAMPTON, MA 01060
FAX (4131) 587 -1221
CJ /6 l
/ ste Suitabi£it or On -Site Sewn a Dzs asa
q
Project Number. Date:
Performed by. ee k l Equipment Operator.
Heath Inspector � 1 I X
r
Site Address Client Name U° Address i
New Construction Q Repau
Office Review
Published Soil Survey Available: No O Yes
Year Published Publication Scale Soi ap Unit Drainage Class Soil Limitations
Surficial Geologic Report Available: No O Yes Q
Year Published Publication Scale Geologic Material (Map Unit) Landform
Flood Insurance Rate Map:
Above 500 year flood boundary D Within 500 year flood boundary ❑ Within 100 year flood boundary Q
Wetland Area:
National Weiland Invetory Map (Map Unit) Wetlands Conservacy Program Map (Map Unit)
Current Water Resource Conditions (USGS): Month
Range: Above Normal C1 Normal Q Below Normal O
Other References Reviewed:
PPrcnlntinn Test Results
Perc 1-1 Time Measurement
Time
Measurement
Begin Saturation J Begin Saturation
End Saturation End Saturation
Measurement o Measurement
6" depth 1 6" depth
Measurement Measurement
--- _
ElElapsed Time Elapsed Time
apsed
9" to 6"
Percolation Rate <'�inm. m erco a o" n l�atcr
)3ottom of Percolation Test Hole: " i�.%r Bottom of Percolation Test Hole:
-
method UsedViIAe
Depth observed standing on observation hole.> ❑ Depth weeping from side of observation hole _inches
�(Depth to soil mottles _ inches ❑ Groundwateradjustment inches.
nIndex Well Number Reading Date Index well level
Depth of ldaturally Occurine Pervious Material
Does at least four feel of rally occurring pervious mz:terial exist to all areas observed throu¢hout die area proposed for die soil
absorption system?
If yes, what is the depth of naturally occurring pervious rlaterial?
Itrtet rorlratiile depth of naturally occurring pervious material;
T.P. # 1-1
Gn-Site Review
Deep Hole Number: % Date: y Tin ie: -,,i Weather Cool & Overcast
Location (identify on stfte-plIt,-
Land LiscNegetat�on"Lauv/gruss 1 i Slope {%): surface Stones: none
Landform:
Position of Landscape:
Distance from: � - q
lV
Open Water Body'� eei- Drainageway Feet
Possible Wet Area CIJL �' Fect Property Line Feet
Drinking Water Well <t (� �(� r Feet Other r� 5rr:C lL' �� Feet
i
Parent Material (geologic)
De tb to -Groundwater. Standing Water in the Hole: /I lwe Depth to Bedrock: >
Fstimated Seasonal High Oround Water: n Weeping from Pit Face: ff ,J`
� ii✓
Depth from
Surface
rhes
SoilSoil
Horizon
TeVutre-
(USDA)
'Soil Color Soil Other (Structure, Stones, Boulders,
(Munsell)_ mottl ng Consistency, %Gravel)
--
i
Parent Material (geologic)
De tb to -Groundwater. Standing Water in the Hole: /I lwe Depth to Bedrock: >
Fstimated Seasonal High Oround Water: n Weeping from Pit Face: ff ,J`
� ii✓
l Commonwealth of Massachusetts
title 5 official Inspection Form
ubsurface Sewage Disposal System Form - Not for Voluntary Assessments
6 Bayberry Lane
roperty Address
Harold Jordan
Owner Owners Name
information is
required for every Florence MA 01062 9/28/2016
page. CitylTown State Zip Code Date of Inspection
Important: When
filling out forms
on the computer,
use only the tab
key to move your
cursor - do not
use the return
key.
ISI
IBJ
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
A. Inspector Information
Marcus Millett
Name of inspector
Homestead Inc.
Company Name
1664 Cape St.
Company Address
Williamsburg
City/Town
413-628-4533
Telephone Number
B. Certification
MA
01096
State Zip Code
SI -13748
License Number
I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5
(310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address
listed above; the information reported below is true, accurate and complete as of the time of my
inspection; and the inspection was performed based on my training and experience in the proper function
and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined
that the system:
1. ❑ Passes
2. ❑ Conditionally Passes
3. ❑ Needs Further Evaluation by the Local Approving Authority
4. ® Fails
. �k-�
1 October 2018
Inspector's Signature Cate
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEA) within 30 days of completing this inspection. If the system has a design flow of
10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate
regional office of the DEP. The original form should be sent to the system owner and copies sent to
the buyer, if applicable, and the approving authority.
Please note: This report only describes conditions at the time of inspection and under the
conditions of use at that time. This inspection does not address how the system will perform
in the future under the same or different conditions of use.
LSmap doc • rev 712SM1e T$le 5 Ofrac�al In"cbon Form Subsurface Sewage pis
pawl System •page 1 or id