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Home My WebLink AboutSoil Testing Results - 445 BOSTON STREET 2/4/2002 BOARD OF HE,ALTH 'H A NDOV 'NCRTRR ANDOVER, MA 01845 f NoFtt:.. 97$°6�$®954® BOARD of HEALTH a APPLICATION FOR SOIL T'EST'S F0 2 5 2002 Ii DATE: ! MAP &PARCEL: LOCATION OF SOIL TESTS: OWNER. i � r ; ,—t c= i.�c• TEL. NO.: '1=� q a ADDRESS: ENGINEER: �—A C131 ;� ,7> TEL. NO.: CERTIFIED SOIL EVALUATOR: C t�- Intended Use of Lands Residential Subdivision °,Single Family Hom Commercial Is This: Repair Testing: Undeveloped lot testing: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$200.00 per lot for re airs or up ales. (If time is not critical, fee for repairs is $75.00) 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 disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH 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 I"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. Please Do Not Write Below This Line N.A. Conservation Commission Approval: �/-5- r Date Received: Check Amount. 1 '" ` 6 Check Date: �' NOONAN & Me DOWELL, INC. 25 Bridge Street, Suite 6, Billerica, MA 01821-1023 Voice (978) 667-9736 Fax (978) 671-9565 Email: n .................. August 28, 2002 Town of North Andover Office of the Health Department 27 Charles Street North Andover, MA 01845 RE: 445 Boston Street, Jon No.: 1770/029 Dear Members of the Board The soil testing that was witnessed at the above location is an uncompact till. The soil would break off the excavation side in a massive form and would break up easily (Friable). If you have additional questions regarding the above please contact me at your earliest convenience, Sincerely John L. Noonan, P.L. .-P.E. (0 R/office/letter/1770.029.doc to Land Surveyors Civil Engineers Environmental Planners O'N ILL ASSOCIATES LEUVEN OF UH/�Q SH JUUQL CIVIL ENGINEERS AND LAND SURVEYORS 234 Park Street NORTH READING, MA 01864 DATE JOB NO. (978) 664-8141 Fax (978) 664-8142 ATTENTION E-MAIL: oneill.eng @verizon.net RE: TO i 1-°t ha thD►—i s "k WE ARE SENDING YOU Attached ❑ Under separate cover via the following items: ❑ Shop drawings �-J-.Prints 60ans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change Order ❑ COPIES DATE NO. DESCRIPTION t2-02 vE? uZ�;�c c c t� -�c � PvS THESE ARE TRANSMITTED as checked below: �> For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ For issuance of certificate of compliance ❑ For review and comment er'j = j — P- ❑ FOR BIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS n cy" C�'t,.D �Si i t� 11✓ Cpl(t� l-S f�11 { . COPY TO �a,�2ce� �Jt.Jv�� -t SIGNED: a. If enclosures are not as noted, kindly notify us at once. O'NEILL ASSOCIATES CIVIL ENGINEERS AND LAND SURVEYORS 234 Park Street NORTH READING, MA 01864 DATE JOB NO. (978) 664-8141 Fax (978) 664-8142 i t r t ATTENTION E-MAIL: oneillm @ziplink.net RE: TO lM(A ()2.i 'Cs y WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change Order ❑ COPIES DATE NO. DESCRIPTION THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ For issuance of certificate of compliance ❑ For review and comment ❑ ❑ FOR BIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS �Q S-4) Y �'e., m" COPY TO (e- SIGNED: If enclosures are not as noted,kindly notify us at once. J GRAIN SIZE DISTRIBUTION TEST REPORT - C < < N - - - C C C C UT90 80 70 kw---T I I w z 60 -TT w Z 50 w U w 40 w 30 20 10 0 200 100 10.0 1 .0 0. 1 0.01 0.001 GRAIN SIZE - mm % +3" % GRAVEL % SAND % SILT % CLAY USCS LL PI e 0 . 0 30 . 5 54 .0 12 . 8 2 . 7 SM SIEVE PERCENT FINER SIEVE PERCENT FINER Location : inches number size 0 size 0 • ON SITE 2 100.0 4 77.5 1 .5 97.3 10 69 .5 1 93.8 20 60.2 Description : 0.75 91 . 6 40 49 .9 • LOAMY SAND 0.375 84. 6 50 44. 7 100 33.2 GRAIN SIZE 200 22.6 D60 0.832 D30 Or MASSACHUSETTS, INC. D10 0.0260 RE. IEVV Remarks : COEFFICIENTS B #200 WASH SIEVE Cc 0 . 65 CU 32.0 UTS OF MASSACHUSETTS, INC_ Project No. : 5 Richardson Lane Project : 445 BOSTON STREcT, N.ANDOVER, MA Stoneham, MA 02180 Date: 9/25/2001 Sample No. 9564 i V 09 � r r0 _.oz �o 10 t o �w o b", rn a C2 � U) GIq o i m a o 1 � � w a oo -' +J En T— } cn cv 1 0 i � U cad cn m w ' � W En Lr, -It (1) . t -T .o � � � � Lr, 4-j � � .. ca a-j o a ca aui Ii b ca � ' o 0 m q � P-4 cn pq o r ' FORM 11 - SOLI. EVALUATOR FORM Page 1 of 3 No. .Date: Commonwealth of Massachusetts *H-h t!kPi 0V&(' , Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed By: /�i c_h l �Ne'l-lt) Luke- P0.. Salk &,0)L &/S Date: ` 12-SJC-,f 3/2,7 d Witnessed By: —A)—ho ..PO ra v, O #-- ,.a +4 S sf`Uv) 'I . Ws. Thow��s� fYl�vree.r C��,�c�11 Y N , F}r,J ov e,-C T.kpn.c I 445 PJdS�Ov+ St.) N. Av%4c v,,w it) 7D/10((� °I-70--699---731r� ew Constructlon ❑ Repair Office Review Published Soil Survey Available: No E� Yes ❑ Year Published Publication Scale .... ........ Soil Map Unit Drainage Class _................ Soil Limitations ....... . ......... .... .... Surficial Geologic Report Available: No lJ Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) Landform ....._.......`......... .......................................................... Flood Insurance Rate Map: /,� Above 500 year flood boundary No ❑Yes L`1 Within 500 year flood boundary No 13/yes ❑ Within 100 year flood boundary No L�Yes ❑ Wetland Area: National Wetland Inventory Map(map unit) ..............................................................._ _---— Wetlands Conservancy Program Map(map unit) ...-........................._...................................._.._.........._.._.... Current Water Resource Conditions(USGS): Month Range:Above Norma! ❑Normal ❑Widow Norma! L1 Other Refemnees Reviewed: DW APMVM VONA-t2mi" FORM 11 SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. `f�( �� )^ Nj �►��4�'�%� On-site Review Deep Hole Number TP.— I Date: .9 2G ` O 1 Time: R01 Weather Location (identify on site plan) Land Use ....La W y+.:. Slope M Surface Stones Vegetation Landform Position on landscape (sketch on the back) r�P �1Ah Distances from: Open Water Body > Z00 feet Drainage way >Z5 feet Possible Wet Area > f 0O feet Property Line 7 feet Drinking Water Well (vv. 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, % Gravel) '40 F-1 L-L- °t I gw EL S 6/r, F-r+alole C. (Sr S L Z s Fy Ca k I e v2 v Co c=fed P��yr ,,, y ,,,�I�S+S iy'0A, � v Loam y MINIMUM OF 2 HOLES REQUtRtU A I Ev MY PROPOSED DISPOSAL AREA Par«tc Material l000+ooicf D.O.&&.ek: > 3 �� Dot to f otadwater Star,&V Water in the Hole: 12-0'( Weep&V f m Pit : IOC " Estimated Saasonel High Ground Water: YZ) r' DIP ArrttovF.a FOILM•11Wf95 FORM 11 - SOIL EVALUATOR FORM Page 3of3 Location Address or Lot No. kPfS 630 10� J+, , N, Aod 4v�.v Tr— I _Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole ........ inches ❑.�/Depth weeping from side of observation hole inches LJ Depth to soil mottles V-O inches ❑ Ground water adjustment feet Index Well Number . ... Reading Date . Index well level Adjustment factor ..... .... Adjusted ground water level Death 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? Q If not, what is the depth of naturally occurring pervious material? Certification I certify that on 1995 (date) I have passed the soil evaluator examination approved by the impartment 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 za 1c, W AMov®ro&.UMIM FORM 11 - SOIL EVALUATOR FOR IM Pave 3 of 3 Location Address or Lot No. `f S Qe,� r,iA 24 N, Gr iov T19-2 , '7-P—3 Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole ......... _ inches ❑ Depth weeping from side of observation hole . ... . inches EDepth to soil mottles , inches rN +ivp,�y ❑ 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? Ve-S. If not, what is the depth of naturally occurring pervious material? Certification I certify that on 'LOCO) (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 Rua Date V(2-3/0 Arr:ovZD FORM-urns FORM 11 - SOEL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. ��, Pica N, P,-,jcva,Y- Qn-site Review Deep Hole Number• �P" 2- Date: .:.: ......, Time: rr, Weather Location (identify on site plan) Land Use Slope M Surface Stones Vegetation Landform ...._ �... Position on landscape (sketch on the back) S e-0 Distances from: Open Water Body 1.00 feet Drainage way 5 25 feet Possible Wet Area ? I oo feet Property Line > (0 feet Drinking Water Well �p !0o feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface tlnches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) g lob �- toYP_ e t 26 YP-VC S��v2 fw•n,�JHSts i Dogth m Qnx xlwatar: Stan&V Water in the Hole: / W+epir*frwn Pit F*": � fees mmad Seasorwl High Ground Water: DEF A rF"ROVED i 03M-LIM19S FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. "IY5 60dUZ1 St , N, Pr-L,C1lcve �.- On-site Review Deep Hole Number Date; .3.�Z �o2 Time: f Weather Location (identify on site plan) Land Use .. L,CA-.VV�.... Slope (%) Surface Stones Vegetation .. Gvct 5 Landform -.., . _.. Position on landscape (sketch on the back) S e9 p t v" Distances from: Open Water Body >2-00 feet Drainage way LS feet Possible Wet Area ;> I oc, feet Property Line > 1 o feet Drinking Water Well ?( oo. 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, % Gravel)9 fop — y <o� 0/pr fSL loyf-`1l F�ri'C1,1e 9 C— F�L V n C-0 IV+ �D o,c e- Pawn wwial toeobgid Dwthto ' " Ga `� wax in the How: d.� than.Pit Fes: Es*rwad Sossonat High Ground Waer: D"A"ROV®FORM-UNW95 FORM 11 - SOIL EVALUATOR FORNI Page 2or3 Location Address or Lot too. On-site Review Deep Hole Number Date: JET cal Time: WeatherL `/�~c� i o °fir Location (identify on site plan) Land Use _ /tom "°'' Slope (%) � v+'" Surface Stones _ ef-!G'''`am Vegetation Landform Position on landscape (sketch on the back) Distances from: 1 _ Open Water Body / feet Drainage way feet Possible Wet Area 100 1 feet Property Line feet Drinking Water Well ��`''�`�' �feet Other • ..... ._. ` `_-.- ,*-. °^'k'fDEEP OBSERVATION HOLE LOG' 'V ooev ev Depth from Soil Horizon Sol Texture Sol Color Sol Other Surface (inches) (USDA) (Munseln Mottling (Structure,Stones,Boulders, Consistency, % Graven N)Mt OF i Parent Material(geologic)` DepthwBdrock: 3/ Depth to Groundwater: Stands Water inthe Hole: / Z O �� f' Standing Weeping Isom Pit Face: / C� Estimated Seasonal High Ground Water: (`) A s en✓� d Al 0(e ✓.1 r DET APPRON"En FORM-t2107105 i FORM 11 - SOIL EVALUATOR FORM k Page 2 of 3 ::tom Location Address or Lot 11o. On-site Review s � i Deep Hole Number '_ Date:_.,. . ` ` - Timed ? Weather Location (identify on site plans Land Use Scope (°.6) Surface Stones Vegetation Landform Position on landscape (sketch on the back) Distances from: Open Water Body 0 feet Drainage way feet Possible Wet Area `''` ` feet Property Line __ feel Drinking Water Well ; ' 'j,. feet Other _.. DEEP OBSERVATION HOLE LOGS Depth from P 504l Horizon Sol Texture Sol Color Soil ether Surface(Inches) !USDA) (Munceln Mottling (Structure,Stones,Boulders,Consistency, % Graven Y- . C 1 , i Parent Material(geologic) A , '.� r� i � � OspCxoBadrvdc. r✓� Death to Groundwater; Standing Water in the Hole: Weeping from Pit Face: fstirtated Seasonal High Ground Wster: �'i i DET APPR01*7Ea FORM-010719S Massachusetts Department of Environmental Protection Supplemental Transmittal Form (to accompany supplemental material to previously submitted applications) 1, Obtain from the upper right hand corner of the original application's Transmittal Transmittal Form: Number W029553 2-. (a) Facility Name: (b) Facility Address: 'Fa Q1.4. Y Information Connolly Residence 445 Boston Street i (c) Facility Town/City (d) Telephone Number: North Andover _ (978) 698-7310 3. (a) Permit Name: (b) Permit Code: (from or;n;nal annr,cat;oni__ Permit Information Title 5 Variance LQ,R Pi/VP59b (c) EOEA(MEPA) file#: (d) Telephone Number: 4. ❑ ;(a) Response to Request ® (b) Response to Staternent of Check for Additional information Deficiency Reason For ❑ (c) Supplemental Fee ❑ (d) Withdrawal of Application Supplemental Payment Submission e) Other (please specify below): E J I � 5. (a) Name of individual or firm (b) Affiliation with application, i.e. Form preparing this submission: applicant, consultant to applicant: Prepared by c Contact Name: (d) Contact Telephone #: Revised 11/99 FORM II - SOIL EVALUATOR FOR1I r° Page 2 or 3 Location Address or Lot iJo. On-site Review _ Deep Hole Number Date:- r Time: Weather F' Location (identify on site plan) ` Land Use < '''` j Slope (%) Surface Stonesr': Vegetation Landform Position on landscape (sketch on the back) . -. .. Distances from: Open Water Body feet Drainage way feet Possible Wet Area ' feet Property Line feet Drinking Water Well �'� t'' feet Other I DEEP OBSERVATION HOLE LOG' i Depth from Soil Horizon Sol Texture Soil Color Soil Other Surface(inches) (USDA) (Munseln Mot;Gng (Structure,Stones,Boulders,Consistency, % Graven Y' ' Y J , r r , Parent Material(eeoiogic) o t>dr; Depth to Groundwater; Standing Water in the Hole: Weeping from Pit face; Estimated Seasonal High Ground Water: DEr APPROVED FORM-t2ro7195 GRAIN SIZE DISTRIBUTION TEST REPORT `t N ca p O O O O O 100 M tn � M O - � 90 I 80 70 w I z 60 LL 7 z 50 w U Of 40 d 30 I I 20 10 t . 0 I 200 100 10.0 1 .0. 0. 1 0 .01 0.001 GRAIN SIZE - mm % +3" % GRAVEL % SAND % SILT % CLAY USCS LL PI • 0 . 0 30 .5 54.0 12 .8 2 . 7 SM SIEVE PERCENT FINER SIEVE PERCENT FINER Location : inches • number size size • •0V SITE 2 100.0 4 77.5 1 .5 97 .3 10 69.5 1 93.8 20 60.2 Description : 0 .75 91 . 6 40 149.9 • LOAMY SAND 0.375 84.6 50 44.7 100 33. 2 GRAIN SIZE 200 . 22.6 D60 0.832 D30 L OF M SSAC USETT , INC. D10 0.0260 R SEW Remorks: COEFFICIENTS B #200 WASH SIEVE Cc 0 . 65 Cu 32 .0 UTS OF MASSACHUSETTS. 1 NC: Project No. : 5 Richardson Lane Project : 445 BOSTON STREET, N.ANDOVER, MA Stoneham, MA 02180 Date: 9/25/2001 Sample No. 9564 n td cn �-d rt 0 w w b r° o rt tD . n w a F- o N• w co n N En rt n v rt In .� O r V �:• 0N4.- P) • (o 4-- �.n m � En A--,Q r-b w h, En w En r• w n rt (D a r 0 w 0 U) rt a !n r rt l3"Y O °Ow m r , ��5 W i i e Pi v .ter N. O pe N• opo z Fi r � _ Cn .114 o (D O n En EDT (D O co CD QN g Cj 6n to o 0 1�• F - GRAIN SIZE DISTRIBUTION TEST REPORT - - - '- '- N00 O O O O 0 0 O 100 O M N M M Cq 90 %J 80 70 W z 60 W z 50 W U W 40 n 30 20 10 0 200 100 10.0 1 .0 0. 1 0 .01 0 .001 GRAIN SIZE - mm % +3" % GRAVEL % SAND % SILT % CLAY USCS LL PI • 0 . 0 3 . 2 56 . 9 36 .0 3 . 9 SM SIEVE PERCENT FINER SIEVE PERCENT FINER Location : inches number size • size • *ON SITE 0.75 100.0 4 98 .2 0.375 99 . 4 10 96 .8 20 92 . 7 Description : 40 85 . 6 •SANDY LOAM 50 81 . 4 100 68 .3 GRAIN SIZE 200 48 .5 D60 0.111 D 30 D10 0.0108 Remarks: COEFFICIENTS #200 WASH SIEVE Ca 0 . 97 Cu 10 . 3 UTS OF MASSACHUSETTS, INC- Project No. : 5 R i cFta rdson Lane Project : 445 BOSTON STREET, NORTH ANDOVER, MA Stoneham, MA 02180 Date : 3/29/2002 Sample No . 7356 j j� r+ ° w w � l (D a (D b Lo- ~W W O rt Fmo • .-J p .. g 0 N G rt H o--� (D -J- 0) � E U] w W W M F'• W Fry In of V'� O F• I-- rt O rt p, F (Wi rt (D (D rt O O a W H. 0 p$r a rt w o N• ai m C� .119 0 m rt (IQ a� - rt z d ID ca (mob O 60 -QO 10 01/13/2002 14:30 19786648142 0 NEILL PAGE 02 PRESSURE DISTRIBUTION NETWORK COMPUTATIONS SYSTEM VARIABLES DISTRIBUTION LATERAL FLOW LATERAL INSIDE DIAMETER (IN) 1.00 ORIFICE ORIFICE SEGMENT LATERAL LENGTH EACH LATERAL (FT) 30 NO. FLOW GPM VELOCITY FLOW NUMBER OF LATERALS 7 (GPM) (FPS) (GPM) MANIFOLD INSIDE DIAMETER (IN) 3.00 7 1.28 365 8.93 MANIFOLD LENGTH (FT) 34 NUMBER OF MANIFOLD ORIFICES 0 FORCE MAIN INSIDE DIAMETER (IN) 3.00 MIN. SYSTEM FLOW® 63.82 GPM FORCE MAIN LENGTH (W/FTGS) (FT) 45 ORIFICE SIZE (IN) 0.25 ORIFICE SPACING(FT) 5 LATERAL RESIDUAL HEAD(FT) 3 F.M. HIGH POINT-DISPOSAL FIELD 97.00 PUMP OFF ELEVATION 92.00 HAZEN-WILLIAMS COEFFICIENT 150 WEEP HOLE SIZE(0 IF NONE) 0.25 PRESSURE DISTRIBUTION SYSTEM CURVE COMPUTATION SYSTEM LATERAL FRICTION LOSS NETWORK STATIC DYNAMIC FLOW FLOW FORCE MAIN LOSS LOSS"" HEAD (GPM) (GPM) (HW100t) (Hf) (Hf) (H,) (TDH) 10.00 1.43 0.03 0.01 3.93 8.00 11.94 15.00 2.14 0.07 0.03 3.93 8.00 11.96 20.00 2.86 0.12 0.05 3.93 8.00 11.98 25.00 3.57 0.18 0.08 3.93 8.00 12.01 30.00 4.29 0.25 0,11 3.93 8.00 12.04 35.00 5.00 0.34 0.15 3.93 8.00 12.08 40.00 5.71 0.43 0.19 3.93 8.00 12.12 45.00 6.43 0,53 0,24 3.93 8.00 12.17 50.00 7.14 0.65 0.29 3.93 8.00 12.22 55,00 7,86 0.77 0.35 3.93 8.00 12.28 60.00 8.57 0.91 0.41 3.93 8.00 12.34 65.00 9.29 1.06 0.47 3.93 8.00 12.40 70.00 10.00 1.21 0.54 3.93 8.00 12.47 75.00 10.71 1.38 0.62 3.93 8.00 12.55 80.00 11,43 1.55 0.70 3.93 8.00 12.63 85.00 12.14 1.73 0.78 3.93 8.00 12,71 90.00 12.86 1.93 0.67 3.93 8.00 12.80 *R Static loss= difference between lateral and"off float" elevations+ lateral residual pressure r • ' l �i■■i■■s/rt�■■■lri�si■■■■■■■N■■■■ ■■i■■■■rir■■■■■i■■■■!■■■■■■�■■Orr■/ STANDARD IMPELLER SIZE ■■rer■■■■!■■■■r■■rrsi■rrrr■■■■■■■■■ ■■■■Ar■i■s■!■■eE■■■■■■■■■■■■Orr■r■■ , HP Imp. 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I. c� r� C-vrve. bee-n pJa4W or) my-xr Aekc-4� vi�vsl s�,��; v�rx�; S• F1An s will be r�rse,� +<D n P+ iS.oc i ry--� i rne�Me r— on to, CoLr s �s�ee ,S r t1 hAhc ov� C:\projects\Forms\Fax Form.doc r �, FORm 12 - PERCOLATION TEST (J Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS , Massachusetts Percolation Test Date: Time:, Observation Hole # Depth of Perc Start Pre-soak A End Pre-soak Time at 12" "Y Time at 911 Time at 6" Time (9"-6") Rate Min./Inch Minimum of 1 percolation test must be performed in both the Primary area AND reserve area. Site Passed ❑ Site Failed ❑ .................................................... PerformedBy: ................................................................................................. Witnessed By: Comments: DEP APpitoVED FORM 12/07/9S