HomeMy WebLinkAboutSoil Testing Results - 45 BRIDGES LANE 8/24/2004 BOARD OF HEALI&A ASS. 01 1 978-688-9540 L�IECE 004 APPLICATION F OR SO IL TEC, ANDOVER DATE: O MAP&PARCEL: !� ` TMENT LOCATION OF SOIL TESTS: ��)ii C Q1A J—A U OWNER• �h O aZ Ll I r'1 TEL,NO. ADDRESS: ENGINEER: � �Q;u ) � �ICL (� �' � �P7 EL.No.: X7 (A �' 17 b� 11 CERTIFIED SOIL EVALUATOR: J N7Am IM L t)S�j�� Intended use of land: Residential Subdivision Single Family Home Commercial Is This: Repair testing — Undeveloped lot testing Upgrade for addition T In the Lake Cochichewick Watershed? Yes No 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$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$360.00 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 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 1"-100')shall be submitted to the Board of Health showing 1 location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted, Please Do Nat Write Below This Line N.A.Conservation Comrnassion Approval 9' � t: m� 4. � 4 ' Date Received: Check Amount: Check Date: E 3 i i t r 6v PIT Z ��. 1so6 Gam. nor. �u � l41 ,3S i r Page I of I Dellechiaie, Pamela From: Dan Ottenheimer[info@miliriverconsulting.com] Sent: Friday, August 27, 2004 11:45 AM To: Susan Sawyer; amcbrearty@millriverconsulting.com; 'Pamela Dellechiaie' Subject: soil tests Sue and Pam, We are scheduled with NEES for soil testing 45 Bridges Lane�nd 121 Raleigh Tavern Lane on Monday ("�t 9/13. Enjoy the nice weather. Dan Mill " ,W/ R c o n s u I t i r) Daniel Ottenheimer,President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.milli�iverconsLilting.com info( millriverconsulting.com 8/27/2004 ix- Cl a. .y �I V,4 j, a t 1�l U.K Q5, r a f � r w MISSION iN cl) (r f r r r r� o Nre d �i? C4+ cj, 1N Utj/''UU4 21::31 1781:3341J115 TANGARDR PAGE 01 FORM 11 , SO[1_. '-VALUATOR FORM Date: 6t, / Cornnionwealth of Massachusetts Massachusetts ail uitcaliilt �sse ,�ment Or OIL-site Sera e L_is anal Date Performed By '. / Witnessed By. Lxa,wn eddress a Aeeroas,km L / &) ' r�li Y C✓ f� Te!eplWro/ struction 0 Repai —�--� -- Ofrice——Review Re view Published Soil Survey Available: No Yes Publication Scale�/:/� .. Soil Map Unit Year Published A� G ... Soil Lirnitat!ons Drainage Class .. Surficial Ge+alagic Rsport Available: No K Yes Year Published Publication Scale Geologic Material (Map Unit) .. ..... ... .......... ........... 1„andforrn ..... Flood Insoranze Late Map: Above 500 year flood boundary-No Ej F& Within 500 year flood boundary No 0 Yes Within io0 year flood boundary No eyes , Wetland Area: National Wetland Inventory hlap(neap unit) 'vVetlands Conselvat;cY Program Njq(snap unit Current Water Resource Condition:(USGS): Months Cl U Range :Above Normal Normal L.IBeIc Norma! U Other References h`.eviewcd: D6P APPROVED FORM.12107,195 dl:.:i.l 11�::���N1w� Thhltat=;F?GF: FHliE. �1 lb/,ltbf'L�h4. � FORM 11 - SOIL EVALUATOR FORIM Page 2 of Location Address or Lot i�o, qew a i)eep `foie Number / Date: Time: Weather[ Location (identify on site plan) Land Lase . ��'1:� `=r�s�G4�- SiQpe J%) r' Siirfaca StOnes -�....,. Vegetation LanJform Position on landscape Distances frprn: rG=yC r open Water fee. way r feet Possible Wet Area leas- NO Property Line /.'i�... feet Drinking Water Well ref feet Other DEEP OBSERVATION HOLE LOO _ J Death from 5011 Horizon! Solt TeYaure Soil Color Soil ether 5u face(lrrchES) IusbAi iMuriseelll Mottling IStructure,Stones,Boulders, t;onsistencY, 'p Gravel) 1 i � r r r er Depth tp Groundwater. Stanoling water in the.Hole: weeping from Fit Face: �. Estimated Seasonal High ;;rp;md Wator:^_—.—., •— utr APPROVED FOKM• 1210T95 1E_1f Uti/2UU4 t1:del 1 181'j4._111 F? _ 1/sNGARDF PAGE f�:l FORM 11 SOIL 1;'4 ALUATOR F0101 Page v of 3 Location Address or Lot No. (fin-site em,ie w Deep Hole Number � Delte:'Y°�llla Time: . � Weather. Location (ita ntity an site plan) �-!014.x'...,.. .� �F, •.•..7�L-�' . .. . .. . Land Use /I //U e. Slope (°(01 -- Surface Stones Vegetation Landform Position on landscape � ��� Distances from: Open 0rater Body 7 4f: feet Drainage way '�` � feet Possible Wet Area /! feet Prcperty Line / feet Drinking Water Well ✓�' feet Other . DEEP OBSERVATION HOLE LOG � Depth from ~Soil H,orizcr, So ii Textvra So(i Color Sed 01her Surface Itncnea) (USDA) (Munse)l.. Mottling istn)cnue,Stones, Doulder7, Gonsis,,vicv, Orave!) I .► /JN1 i Earent Material(geola®icl "i"�� � �s UapthtoBedrock De tp h to Grpundwaim Staniin9 water in the Hole:w Weeping ira~ Pit Face, —i -Estimated Se890r.a1 High Crauhd 1Va�ar; ,�,�, —_.._ .r-----------� •---• ...__.- UEP APPRO'MI)F0101•1210914$ 1LJj05/2U04 . 21:'31 173 3'3J[115 TA.HG`,RUR PAuE 04' FOYUVi .t I SOIL LVAUJA1'()R f OR�N,J page 3 of 3 r Location Address or 1;aat `Vo, Determination or Seasonal HiM Water Table Method Used: 0 Depth observed standing in observation hole ... inches Depth weeping from side of observation hole .. .. inches Depth to sail mottles . ' . inches © Ground water adjustment feet �" ��,• Index Well Number Reading Date .... ........ Index well level Adjustment factor Adjusted ground water level Depth_of Naturals Occurrina Pervious Material Does at least four feet of naturally occurring pervious material exist in pii areas observed ,hr A oughout the area proposed for the soil absorption system? i If not, what is the depth of naturally occurring pervious material? Certification I certify that on (date) I have passed the sail evaluator examination approved by the Dep r meet of Environmental Protection and that the above analysis wes performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature ' C �, - Date DEP.kPPROMI FORM•i 2/0919S Commonwealth of Massachusetts City/Town of u Percolation Test a Form 12 �M Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. Important: A. Site Information When filling out forms on the computer, use Elizabeth Koenig only the tab key Owner Name to move your 45 Bridges Lane cursor-do not Street Address or Lot# use the return key. North Andover MA 01845 City/Town State Zip Code rab Contact Person(if different from Owner) Telephone Number B. Test Results rerran 9/21/04 9 a.m. 9/22/04 9 a.m. Date Time Date Time Observation Hole# PT 1 PT 1 Depth of Perc 36720" 36720" Start Pre-Soak 9:01 9:08 End Pre-Soak 9:16 9:23 Time at 12" 9:16 9:23 Time at 9" 9:46- 9.75" 10:08 Time at 6" 4 hr. Soak Required 11:10 62 min. Time (9"-6") 25 Rate (Min./Inch) Test Passed: ❑ Test Passed: Test Failed: ❑ Test Failed: ❑ Benjamin C Osgood, Jr., P.E. Test Performed By: Andrew McBrearty, Mill River Consulting Witnessed By: Comments: t5form12.doc•06/03 Perc Test•Page 1 of 1