HomeMy WebLinkAboutSoil Testing Results - 61 WINDSOR LANE 12/2/2004 BOARD OF HEAI,'I'II
NORTH ANDOVER MASS. 01$454'.
975-688-9540 E4 `,
APPLICA'T'ION FOR SOIL 'PES'T'S
DATE .12 JOY-
MAP&PARCEL:
LOCATION OF SOIL TESTS: " " L� � '� i' "� `"
._ a � ( � / (
OWNER:. � :._/m (° .� :�> TEL.NO.. �1 . C
ADDRESS
ENGINEER: ��a�: i �ru �C'� �""�"�n� "� C��� `�°r(C TEL.NO. t^ "�, � a '
CERTIFIED SOIL EVALUATOR: ��� " „ ;t c ;°; r �w h"ail"
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$360.00 per lot for repairs or upgrades.
GENERAL INFORMATION
1. Only Certified Soil Evaluators may perform deep hole inspections.
2, Only Mass.Registered Sanitarians and Professional Engineers can design septic plans.
3. At least two deep holes and two percolation tests are required for each septic system disposal area.
4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative,
5. Full payment will be required for all additional tests within two weeks of testing,
6. Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the
location of all tests(including aborted tests).
7. Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A.Conservation Commission Approval:
Date Received: Check Amount: Check Date:
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Page 1 of 1
Dellechiaie, Pamela
From: Dan Ottenheimer[info @millriverconsulting.com]
Sent: Monday, December 20, 2004 9:01 AM
To: amcbrearty @millriverconsulting.com; Lisa Kozel LeVasseur; 'Pamela Dellechiaie'; Susan Sawyer
Subject: 61 Windsor Lane soils
Folks,
Attached are soil test results from 61 Windsor Lane.
Dan
Daniel Ottenheimer, President
Mill River Consulting
Septic System Management Services
2 Blackburn Center
Gloucester, MA 01930-2259
978-282-0014 or 1-800-377-3044
fax: 978-282-0012
wwmv .milli° vercoiist.ilting.cotii
(Ian o(4.,,)rnll Iriverconsulting..com
12/21/2004
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FORM 11.- SOIL EVALUATOR FORM
Page 1 or 3
No.
1
Date:
Commonwealth of Massachusetts
A/04 , n eor , Massachusetts
Soil Suitability Assessinen't 'i(or On-site Sewaa e is osal
Performed By: ......... ...., .J. -I..o...... Date: '> � ►
Witnessed By: .... n,At�.�V.,./�
.... ..,.... .� .j.3 fil....&g.e.r......C.04 V 1:�44
Iocation Address or Wr ,�"0(' 1^0.�te owner`$Name. �� �*
W#
' fl�����`, Telephone M 61 W+MA
A)oP`-i� Avjww, ,A4A -m it
Lew construction ❑ Repair
Office Review
Published Soil Survey Available: No ❑ Yes
Year Published .,118.1..... Publication Scale ti 's, .! Soil Map Unit
Drainage, Class • .•... Soil Limitations � ak
....Pa ' 1R....................
surficial Geologic Report Available: No Yes ❑
Year Published 4.n.... Publication Scale
Geologic Material (Map Unit)
Landform.
..t.............................................................................._........ _ ....
Flood Insurance Rate Map;
Above 500 year flood boundary No ❑Yes Psr
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 ,/V )qeM61-.,R0o4
Range :Above Normal [-]Normal C_,SBelcw Normal ❑
Other References Reviewed:
DEP APPROVED FORNI-12/09195
;FORM 11 SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot i4o. e (
t�JfY1d or one _ jvhA Aotjoftr
On.-site Review
Deep Hole Number
Time:.:1�:OQ:::. Weather
Location (identify on site plan) �o►t'::.,..leo!t'...:..:
m
Land Use :::...:... 1........ , j:::::::::.:.......::. Slope (%) Surface Stones,.... :.:. j1�:...:....:.: ,"—"."""'*.. .,.:.:
Vegetation "
Landform —.0)TU.4.1l.:Y\.::.:..:::..:::.:.::.:...::..:...
Position on landscape (sketch on the back)
Distances from: s
Open Water Body :644.,.., feet Drainage way...ti4°oa.:::. feet
Possible:Wet'Area•,.4.,00....,. feet Property Line .:.,:3j .:.- feet
Drinking Water Well :15�'. feet Other
DEEP OBSERVATION HOLE LOG*
Depth from Soil Horizon Soil Texture Soil Color 'Soil Other
Surface.(Iriches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency, %
Gravel)
O 36 F,II .�
IOY 3),6 ID�'o 6K-wv.
R
qN - ,S1 . 13
-: �oYR" ro
!3'9� 'Stones
5/3 5 u 10016 Grrav,
q
107- G 5 L- asY �sga cebb,
IS�'a 5{anes .
,p°fa �o�(jGrS
HOLES RE
Parent Material(geologic) 10 ,- DepthtoBedrock:
Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face:
11
Estimated Seasonal High Ground water: 51
DEP APPROVED FORM-12!07/95
FORM 11 SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. � Ao per-
On.-site Review
Deep Hole Number .:::wP�:..::. Date:,�.��1.. :�`� Time•..8'-30.-- Weather Air U
Time: :::.._
Location (identify on sits plan) ..We.A,
Land Use .,, Ncf,..Paf�' !a.�...::.... Slope (%) ...�.:ap.,.. Surface Stones
Vegetation ., ':C'4�.S ::.,.:....�.: . ......
....:...
Landform Dirt-Dirt r :.:... ..... ..
Position on landscape (sketch on the back) .. .:., 1K1?► '}.:.::,.,..., ,.:,.:-,::,:,.:.::::,,,,;,,.,N,..x-,: ,. r-
r..:::.::.:,..,.....:,.:.: ,.:.....
Distances from: t
Open Water Body :.4 .,,.., feet Drainage way.6�.:,:. feet E
Possible:Wel4Area•.(iM..,, feet* Property Line feet
.Drinking Water Well feet Other
DEEP OBSERVATION HOLE LOG*
Depth from' Soil Horizon Soil Texture Soil Coloe -Soil Other
Surface-(Iriches): _ (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency, 0/9
Gravel)
A/Fill . 151- 10YR
NO Bw 101A 0
5)3 t t>r
PPOSED DISPO AL AREA
Parent Material(geologic) Akl&� Tal ' . Dep"oBedrock:
.Depth to Groundwater: •'Sta s nding Water in the Hole: '^ Weeping from Pit Face:
-
Estimated Seasonal High Ground Water.
DEP APPROVED FORM-12107/95
FORM 11 - SOIL,EVALUATOR FORM
Page 3 of 3
Location Address or Lot No. ( tytdsor �avle , / Lt4JbVeJ'
Determination for Seasonal High Water Table
Method Used:
El Depth observed standing in observation hole................... inches
❑ Depth weeping from side of observation hole................... inches
Dep1h,to soil mottles ..5:q....:.. inches(TPI)
❑ 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? A
1f not, what is the depth of naturally occurring pervious material?
Certification
I certify that on Noo cggiS (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 ! a 7 d
DEP APPROVED FORM-12/07/95
Commonwealth of Massachusetts
City/Town of
Percolation Test
a Form 12
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 Rick Glover
only the tab key Owner Name
to move your 61 Windsor Lane
cursor-do not Street Address or Lot#
use the return
key. North Andover MA 01845
City/Town State Zip Code
� (978) 691-0070
Contact Person(if different from Owner) Telephone Number
B. Test Results
12/15/04 1:13 12/16/04 8:08
Date Time Date Time
Observation Hole# PT1 PT1
Depth of Perc 71"/20" 71"720"
Start Pre-Soak 1:13 8:08
End Pre-Soak 1:28 8:23
Time at 12" 1:28 8:23
Time at 9" 1:58 na 10" 9:21
- 10:21
Time at 6"
60 MIN.
Time (9"-6")
Rate (Min./Inch) 20 MINANCH
Test Passed: ❑ Test Passed:
Test Failed: ® Test Failed: ❑
Thomas Hector New England Engineering Services Inc
Test Performed By:
Andrew McBrearty, Mill River Consulting
Witnessed By:
Comments:
t5form12.doc•06/03 Perc Test•Page 1 of 1