HomeMy WebLinkAboutSoil Testing Results - 178 STONECLEAVE ROAD 4/11/2003 BOA OF +AI,I'I4
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NORTH ANDOVER9 MA 011845
97$®688-9540
APPLICATION FOR I T'EST'S
DATE: MAP &PARCEL:
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LOCATION OF SOIL TESTS: °"(� �
OWNER: TEL. NO.:
ADDRESS:
ENGINEER: 1:I iz/1 -'�. C TEL. NO.: ✓- , =?2
CERTIFIED SOIL EVALUATOR:
Intended Use of Land: Residential Subdivision amily Hame Commercial
Is This: ,r
Repair Testing: ' Undeveloped lot testing:
g
In the Lake Cochichewick Watershed? Yes No L'°r
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 repairs or
upgrades. (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 Sanitarian 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: Ch e Date: APR 2
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Location:® Owner's Name:
Map/Parcel: 2 Address: I��
Installer. Tel N: New tsisol Repair._
Date: �'�-f''� Wetlands Lone II'®' SollSymbol—ei Stiil IRi me k Soil Class
Deep Observation Hole Logs
Elevation Depth Soil Horizon Soil Texture Soil Color Soil hMottlin; % Gravel,Stones,etc;
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Parent Material_ 11.L.- Depth to Bedrock Standin;Water in the Hole: tVf eepin;from Pit Face `LESHGIY:
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Parent Material l L. Depth to Bedrock'` Standin;Water in the Hole:__QLWeepin;from Pit Face_jRL_FSHG%V.__?
Date Percolation Tests
Observation Hole
Depth of Pere t w
Start Plre-soal: d
Time at 12"
Time at 9"
Time at 6"
Time (9"-611) I
-Rate Min/Inch
Performed B v:
Witnessed Bv: t
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