HomeMy WebLinkAboutSoil Testing Results - 114 STONECLEAVE ROAD 8/21/2006 TOWN OF NORTH ANDOVER f NORTH H
Office of COMMUNITY DEVELOPMENT AND SERVICES
HEALTH DEPARTMENT
400 OSGOOD STREET
NORTH ANDOVER, MASSACHUSETTS 01845 �'SS�CHS
Susan Y.Sawyer,REHS,RS 978.688.9540—Phone
Public Health Director 978.688.8476—FAX
liealthdept@townofnortliaiidover.com
www.townofnorthandover.com
APPLICATION FOR SOIL TESTS
DATE: W Z601 MAP&PARCEL: � X/V/
LOCATION OF SOIL TESTS:
OWNER: Jar K Contact#:
APPLICANT: vvX p, Contact#:
ADDRESS:
ENGINEER: Contact#:
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CERTIFIED SOIL EVALUATOR:
Intended Use of Land: Residential Subdivision Single Family Home Commercial
Is This: Repair Testing: Undeveloped Lot Testing: Upgrade for Addition:
In the Lake Cochichewick Watershed? Yes No t_�
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
➢ Proof of land ownership(Tax bill,or letter from owner permitting test)
➢ 8.5"x Il"Plot plan&Location of Testing(please indicate test pit sites on the plan)
➢ 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
Only Certified Soil Evaluators may perform deep hole inspections.
➢ Only Mass.Registered Sanitarians and Professional Engineers can design septic plans.
➢ At least two deep holes and two percolation tests are required for each septic system disposal area.
➢ Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH
representative.
➢ Full payment will be required for all additional tests within two weeks of testing.
➢ 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).
Y Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Ann val Date:
Signature of Conservation Agen
Date back to Health Department: (stamp in):
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Page 1 of 1
DelleChiaie, Pamela
From: Marianne Peters [mpeters @millriverconsulting.com]
Sent: Thursday, September 21, 2006 9:37 AM
To: Dan Ottenheimer; 'Lisa Kozel LeVasseur'; Marianne; Grant, Michele; DelleChiaie, Pamela; Sawyer,
Susan
Subject: Stonecleave Rd &Wintergreen Drive scheduled Sept. 29
The following 2 soil evaluations have been scheduled for Sept. 29th
114 Stonecleave Rd @ 9:00 a.m
Then over to Wintergreen Drive, immediately after Stonecleave
Marianne Peters
Mill River Consulting
2 Blackburn Center
Gloucester, MA 01930
978-282-0014 ph
978-282-0012 fx
www,r`iilli°fiver onsulting.com
9/21/2006
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