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Home My WebLink AboutSoil Testing Results - 1020 SALEM STREET 7/11/1997 Town of North Andover, Massachusetts Farm N°• ' NORTH BOARD OF HEALTH �(n� �0�2T4ED '61 1 7�pL 4 o� n v. °� w,< , ^m APPLICATION FOR SITE TESTING/INSPECTION 0 OATS. SACHU5�� Applicant NAME ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAI RMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. NOW III` d@ a• a° e�a0 .�� 4• _as fJ� ..., N � BOARD 0OF HEALTH �0. «°0*a.o-r«-. 146 M T L. 688-9 540 �dsACIM NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: _ LOCATIO OF OIL TESTS: /.. -/ ��,�, . 2�, (06(-P,o._. elf Assessor's map & parcel number: OWNER: j.cC&c` f TEL. NO.: r!a 31 �II ADDRESS: 2 ENGINEER: S-y,,),,�,, ,, _ TEL, NO.: G 0E,.._ 12L, CERTIFIED SOIL EVALUATOR; ' ( w Intended use of land: residential subdivision 'ingle family homecommercial THE FOLLOWING MUST BE INCLUDED WITH THIS FORM; 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of $175.00 per lot for new construction. This covers the two deep holes and two percolation tests required for each lot. Fee of$75.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the SOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan (no smaller than 1"A 00') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. hGRM lX - Soil, EVALUATOR FORRI Page t of 3 Date: �r No. = �--- Camt;manwealth of Massachusetts ,te, q j,, Massachusetts Soil , r�itabxli asses zest (or (Jrz-s ewe is a l Date: �t� �1� ate: ° Performed By' 4..... Witnessed By: I� p pwncr 5 Name, Pell l vcauon AMJrass Or �W Ad 1 / 0,1?4 �': I 1 9"Cicplwro N / ,w�a c, YS Aftcss,and �,._� � Lew °��e~c�e r,~ww . t ,M'!�''�'l .n.tJ� Ir../. ,R.s (�"I':. .....:... / �""ea ... Z, �.,� s✓i..J, 11'w*e,a oar"t,^ nst;ruction M Repair ❑ Office Review Published Soil Survey Available: No ❑ Yes , Year Published kl Publication Scale p��oo� c:�� Soil Map Unit Drainage Class z c° � o .0 it L lmltations Surficial Geologic Report Available: No Yes ❑ Published Publication Scale r ,.),,ogic Material (Map Unit) I ; A Insurance Rate Map: c ✓e 500 year flood boundary No r,= Yes �tflin 500 year flaod boundary No ❑Yes ❑ Thin 100 year flood boundary No Dyes 0 ' ;eland Area: +�2 1 ��1 ma unity � 'a Ma:ional Wetland Inventory p ( P ) %','"tlands Conservancy Program Map (map unit) (-,un'ent Water Resource Conditions (USGS): Month :<,,,,ge :Above Normal ❑Normal ❑Belc�� Normal !,,er References Reviewed: LAT APPROVED F'OR69• 12/07195 FORM 11 - SOIL EVALUATOR FORM ' Page 2 of 3 Location Address or Lot IJa. ' On!:site-Review C a 0 Weather Deep Hole Number �°f � ..�. Date: '7.._ 1 111 61`. Time: Location (identify on site plan) Land Use r d° .:._ _,,. ff�� Slope (%) ✓0[N Surface Stones Vegetation Landform Position on landscape (sketch on the back) . Distances from: Open Water Body !� �00 feet Drainage way feet Possible Wet Area /Y Q. feet Property Line �, ° feet Drinking Water Well tuo feet Other DEEP OBSERVATION HOLE LOG* Depth from fSoilorizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Be Consistency, `. l n : . ( - `t o4 x �f� t C l7 I� C �r /vi `,f0E.. S1 a� Parent Material (geologic) "" 4LAS"ic C)c7l"" �� Depthta8edrock: '� 9 -- Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: -- Estimated Seasonal High Ground Water: DGP APPROVED FO"t-12/07/95 1�OtZM 11 _ SOIL LVALUATOIZ 10104 Page 3 o1' 3 Location Address or Lot No. Determination for Seasonal Hizh Water Fable Method Used: ❑ Depth observed standing in observation hole inches 7 Depth weeping from side of observation hole inches F 17 Depth to soil mottles q0 inches Ground water adjustment feet Index Well Number Reading Date Index well level Adjustment factor Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? e► If not, what is the depth of naturally occurring pervious material? Certification I certify that on <f 141 5- (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date DEP APPROVED FORM- 12/07/95 FoIZM II _ t)II, I:�'ALUA'roR FORNI Page I cal" 3 Fate: 'i 1 " �� . X10. �P ��'- ` — Cor!(Imonwealtll of Massachusetts Massachusetts S� i� Suitabilz .Lssessment ®r Qn-se e S'ewa e ors Deal Date; Performed By ) ,� Witnessed By. ( r} pww's Name RC', s 1\Ce7 L.oaaunn nddross orgy 1, as11 . iwlc'�"d . �("121 e lib �f ..Address,arvJ Lvr a L=d e y�^y""P � Tcln norx 1 " ,/� ry,Yl'.ry'„ /+a"'LAr.�✓T'y�}Vid r' J al m3 ,., .�,91/'"E-�°. 1 f d tJ. ew construction ] Repair Q office_Review Published Soil Survey Available: No Yes t r P � � ,� Soil Ma Unit Year Published t q Publication Scale Drainage Class Limitations Surficial Geologic Report Available: Na Yes Year Published Publication Scale Geologic Material (Map Unit) L,andfotTn Flood Insurance Rate Map; Above 500 year flood boundary Na 11 Yes Within 500 year flood boundary No ❑Yes Within 100 year flood boundary No ❑Yes Wetland Area: National Wetland Inventory Map (map unit) )` Wetlands Conservancy Program Map (map unit) ........ . . .. . . Current Water Resource Conditions (USGS); Month Range ;Above Normal ❑Normal 013ek-i Normal N ._.._,. ._. Other References Reviewed: DLP APPROVED P0101 12/07195 FORM II - SOII, E;VAL,UA'TOR FORM ' I'age 2 of 3 Location Address or Lot No. On-site Review yy Deep Hole Number T"? Date: I I I I Time: Weather ° Location (identify on site plan) Land Use f W°e ,- Slope o Surface Stones Vegetation /11,A .A4) �:'l 7.. �.p.J.4. c:�C", °" C.h,n; -' ..r w✓ " ., ✓Ca C;' "9 . . Landform Position on landscape (sketch on the back) Distances from: Open Water Body > `` feet Drainage way ` feet Possible Wet Area ,; i feet Property Line feet i Drinking Water Well f 0 0 feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones,Gravleljrs, Consistency, l .", l "„ 1/0 of r s I" v 6"- C3 4 Parent Material (geologic) +�� 1 b� c DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: —rl Q 6 Weeping from Pit Face: ll/0,"1G- Estimated Seasonal High Ground Water: "3 kiDEP APPROVED FORM-12/07/95 Page 3 of 3 _. Location Address or Lot No. G 1 •�- Deteaninatio- br ea ,r Table Method Used: 0 Depth observed standing in observation hole inches Depth weeping from side of observation hole inches Depth to soil mottles .. '� inches ❑ Ground water adjustment feet Index Well Number Reading Date Index well level Adjustment factor Adjusted ground water level _. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system, If not, what is the depth of naturally occurring pervious material? Certification I certify that an (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CIVIR 15.017. Signature Date . u1;P APPROVED FORM 12/07/95 O}tM 11 - ()1). 1?VAI,t1AT()I� FORM Page I of 3 Date, Commonwealth of Massachusetts . „a Massachusetts Soil , �ertabrlt ,Assessment , �r �c-site Se�e D4 Date; r Performed By Witnessed By; s and 1 � ,( , s i � ^Q{ 1d 1 Y 1 1^ Address of 1-0. ._ 4 .Addles �YIh ✓ eRrizs )0-i r'1' b�. Lew °C.�t,'P�,�C%wN �:a c�a��°1'" • Construction Repair ❑ Office R.eview No Yes Published Soil Surve y Available: g0c,60 Soil Map Unit �1 A ` Year Published 1 ( Publication Scale 1 � , Drainage Class �� pll Limitations Surficial Geologic Report Available; No ® Yes Year Published Publication Scale ...... . Geologic Material (Map Unit) La.ndform I . Floor! Insurance Rate Map: Above 500 year flood boundary No ❑Yes Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No ❑Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (snap unit) Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Normal (Q Belcw Normal Other References Reviewed: D1,1'APPROVED FORM• 12101195 FORM 11 - SOrL, EVALUATOR F0jZ l Page 2 of 3 Location Address or Lot No. I�•-�� On-site Revie > w 6 a Deep Hale Number µ' Date: �� f ' Time: I Weather Location (identify on site plan) Land Use ,. l Surface Stones Vegetation Nk m '`��LS w Slope (o("1 o ) .. V ., r Landform - Position on landscape (sketch on the back) Distances from: Open Water Body Z'," feet Drainage way ;'/0 0 feet Possible Wet Area > 1 c cs ifeet Property Line �?rte feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG` Depth from Soil Horizon Soil Texture Soil Color Soil . Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % ii r" %= .. f"r1(' ... . .�rr p�*,y �^" c� .�'�. swd' r�.tJ C,...�� ,^1✓°t d� .£-..t.1 t14�r".. �., 6 7 M:... .J, L" j<W�L d' It / Ica jt e ( , a '° a,t-Ac^P 5. c... TO v . 7m ;. Ca rW1 rVt t,.AJ _r — , Parent Material(geologic) �t'�a�°�rrs�rm c'��"� C��,�-w �Ga Depthto8edrock: Death to Groundwater: Standing Water in the Hole: st.' Weeping from Pit Face: � � — r Estimated Seasonal High Ground Water: �� ✓ killEP APPROVED FORM- 12/07/95 FORM XL _ SOIL LVALUATOSZ FOWN4 Page 3 or 3 Location Address or Lot No. �� r.. � Sede Val /V Oo Determination or 'easonal High Water Fable Method Used: ❑ Depth observed standing in observation hole inches El Depth weeping from side of observation hole inches Depth to soil mottles 03" inches ❑ Ground water adjustment .... . feet Index Well Number Reading Date Index well level . Adjustment factor Adjusted ground water level ., . Depth of Naturals Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on �� w (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date 2 M-11 APPROVED FOILM• 12/07/95 FORM 11 - Soho EVALI)ATOR I�ORM Page I of* 3 Date: Na. Commonwealth of Massachusetts /J4 (-VVq 00,j e , , Massachusetts � z� � ) �s�te e z xs � Z 'oi urh b � y 006 IJ006 Dater f'`I Performed By; Witnessed By. 6wkr`s Namc YGkk"w� 1 IX �� " ✓. " �1 '✓1 ` ' /. 1 aim Addio ,and evl . f P,r re ew construction �1 Repair El _Office Review Available: o ❑ Yes , 1 � 0 Soil Map Unit 4 11 , Publication Scale or Survey 1 Year Published i161 ., Drainage Class x .t...9, /,r4,. Sail Limitations Surficial Geologic Report Available: No Y Yes ❑ Publication Scale Year Published ...._ .....,. Geologic Material (Map Unit) Landforrxl Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No Oyes ❑ Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Normal ❑Belc�v Normal _. Other References Reviewed: DEP ArPROM)1'010. 12/07/45 FORM 11 m SOIL EVALUATOR FORM I'age 2 of 3 Location Address or Lot No. I.-OT ) sT, ✓ r� M On-site Review Deep Hale Number Date: t� "' D C -, ' I rof' ` ' Time: ! ' Weather Land tUse(identiC�fy on Trite plan) Slope M l /o Surface Stones Vegetation Landform _ Position on landscape (sketch on the back) Distances from: Open Water Body '" `' feet Drainage way >/ ~`' feet I Possible Wet Area a `G1 0 feet Property Line C) feet Drinking Water Well >tc:,c, feet Other e DEEP OBSERVATION HOLE LOG* Depth from foilHorizon Soil Texture Sail Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % losr l � IS 1-3 t tr.)w Y"165 .j e12,b 4 t it C,7 wl „ . ' 4. 1'04,`x'91^, ? rarbC ( _(4AIra)iTJ) t==240 61..6. I'D t-oc'.s ' t W " r �' G r P'1 :G C W,,. ��yY C. . A 4) y .. Y Parent Material (geologic) dlYC°acedr ( ��"(i f " DepthtaBedrock: Depth to Groundwater: Standing Water in the Hole: /t/o/V6 Weeping from Pit Face: ,'v >-Aj Estimated Seasonal High Ground Water: °�,. �r DEP APPROVED FORM• 12/07/95 1101tM 11 - SOIL LVALUA' OTZ lt()12i0� 13age 3 of 3 Location Address o► 1,ot No. X T ./e a_____r_ ., AJ . Determination for Seasonal Hieh Water Table Method used: El Depth observed standing in observation hole inches El Depth weeping from side of observation hole . . inches Depth to soil mottles � � inches 0 Ground water adjustment feet Index Well Number .... Reading Date .. Index well level Adjustment factor Adjusted ground water level Depth of Naturals Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on jrC/ /21/,5- (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date UV APPROVED FORM• 12/07195 FORM 11 - SOIL EVALUATOR FORI�I Page I cif 3 � to Date: No 17 Commonwealth of Massachusetts , Massachusetts Foil Suitabzrrty Assess merzt for On-site Sewage �osal Performed By: Qe�` cx.rv+•;,�.. �- � �vr� `�.'�` ... Date: 7,o2�.S 9"7 Witnessed By: �/- 0,wr,l Name, PG'�.0 L,ncatron Addros or ,..271 1. Address.4nd Rlbe,,f p E9�adZ1 3d2� °{M ` `e 671 �� T U phone l '�N ST EE$ /1,/1 1.-.�v� c `�a ew Construction N Repair ❑ office Review Published Sail Survey Available: No ❑ Yes Year Published t,�-/�i! Publication scale Soil Map Unit ��"G y,�el S)? it Limitations Drainage Class Lrr� > Surfreial Geologic Report Available: No FJ Yes ❑ year Published Publication Scale Geologic Material (Map Unit)_. . L,an d form Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No ❑Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) P OJQ Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Normal ❑Belo/ Normal Other References Reviewed: Dh:P APPROVE,1`oRM• 12/07195 FORM 11 - SOfL E?VALUATOR FORM Page 2 of 3 Location Address or Lit No. L a� I Salewl Sr /l/. a�e/z On!:site-Review �� Date: '7 1,�±�)q� Time: 1 ', 3U Weather 00,P,-CC4 Deep Hole Number - c�U� Location (identify on site plan) o..,.:. Land Use Foresfi Slope ( /o) ID Y& Surface Stones Vegetation Landform Position on landscape (s.ketch on the back) Distances from: Open Water Body > -,uc feet Drainage way ;7 °' feet Possible Wet Ar6a 7 1 G v feet Property Line <!ar fegt Drinking Water Well 7 feet Other DEEP OBSERVATION HOLE LOGO Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulldllrs, Consistency, % J o - 22 0 I I t 1 1 1 ,I is (,.2 Parent Material (geologic) Po DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: `` N 0 n✓C Weeping from Pit Face: f-7 U i9 Estimated Seasonal High Ground Water: / ,:f� DEP APPROVED FORM- 12/07/95 F01ZM I - SOIL LVALUAT012 FORM Page 3 or 3 Zf Location Address or Lot No. L.A.- .SctlC,V11 -Sfree I 1U, A eNc07u e,,c Determination for Seasonal High Water Fable Method Used: C, JC z le N J 4e�U- w i h eCq ,v ca ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of observation hole inches ❑ Depth to soil mottles inches ❑ Ground water adjustment feet Index Well Number Reading Date Index well level . _ Adjustment factor Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification 1 certify that on (date) 1, have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017, Signature Date DFP APPROVEM FORM• 12/07195 2 � W - t z u St q fie �✓�,�"ffff� i�� a �n 1� f 1J! 1 V H i ° �G t 55 G f �Co s f ft 4.-ol" I �! v 7 %yt'ss. �D I � F ✓(1 • c) � 4 "f r (34- 2 _ ( y—� _--- ---- - / ` M i .k x.. f/ „aw );rtt�wr mGa¢ r1 � i " i cold i ✓ d i�.rh ,f(I i r�✓��a7 is now r ,✓/' ✓ ��Ii�✓i �� r"f� �I✓1 �a 4 "* 4 c e/ i � A r 1 F a m� /Al✓d W a. r � r �era{�& y-^�1 iU uW> "" r� rro mx�� ✓ lr'� �` rv�i" W. at �,W�F�'� �+�✓�.'"��1 B w „ aW Nr M" r i . Y , „ W I , , 1 J , az 3 01/a SS G Rim DOX � d a ma I i Y' M y //�� *. y t ✓1z s � ...— � `p/�,ry (,/� �.'✓ i �f a �� z�� yr " ^ E { { u DATE: LOCATION: , P B0H WITNESS: LIAOPERCOLATION TEST# BOTTOM DEPTH OF PERC TEST: TIME OF SOAK: r (At least 15 minutes long) TIME AT 12" _ / C i � _ AP1 a TIME AT9" ' A ° I'I TIME AT 6" f I OVERNIGHT SOAK TIME STARTED NEXT DAY SOAK: (At least 15 minutes) TIME AT 12" TIME AT 9" TIME AT 6" DATE: LOCATION: C ENGINEER: : ° BOH WITNESS: PERCOLATION TEST# BOTTOM DEPTH OF PERC TEST: ' �' t TIME OF SOAK: A kl'1 (At least 15 minutes long) TIME AT 12" ,`/ A ,0 TIME AT 9 TIME AT 6" OVERNIGHT SOAK TIME STARTED NEXT DAY SOAK: (At least 15 minutes) TIME AT 12" TIME AT 9" TIME AT 6" DATE: LOCATION: ENGINEER: SOH WITNESS: PERCOLATION TEST ' c� ICrI BOTTOM DEPTH OF PERC TEST: _ � e°J 11 TIME OF SOAK: _ `/ � (At least 15 minutes long) TIME AT 12" _ o / .'/ , r� Y A TIME AT 9" f TIME AT 6" OVERNIGHT SOAK TIME STARTED NEXT DAY SOAK: (At least 15 minutes) TIME AT 12" TIME AT 9" TIME AT 6"