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HomeMy WebLinkAboutSoil Testing Results - 94 GRANVILLE LANE 9/29/1999 01 0 HQ��W T TH 146 MAIN STREET TEL,. 688-9540 � o CNUSEt CHU6 NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TEST DATE: LOCATION OF SOIL TESTS: r1 Assessor's map & parcel number: „' "-1i TEL. NO.: ADDRESS: Ca d ENGINEER: TEL. NO.: CERTIFIED SOIL EVALUATOR: i � e Intended use of land: residential subdivision, single family home, commercial 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 $175.00 per lot for new construction. This covers the two deep holes and two percolation tests required for each lot. Fee of $75.00 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. 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. ff .m,�. .,�. f ( "..�j {'„>f ..._, �c:� .�..7� f-`,�(, ..�,'�,.,,Wt( 1 1gS I Ii4i `�14Z —144 --146 142 /'LO.T 43,St,I S.F. LEAGNIIJGTk2E1JG1a (TYY�.) / # tZESEl2\/E �t2EA (TYP.) ro !V \ r 1 3 LOT Z(o 1 ,, �� ,� ��� LOT 0-8 zp r ' / N9 A2 1 , I�ETI�IK11M G �/�LL;; /1Aro +1i u. r-iii tiff t .f r7ifi 1 S � \ _,.. �.� .:: .r.! •:aril��: :c I.I:i��: / \J A(P so Sl \ -�>N Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH Eo 16 19 0 4 0,' A' APPLICATION FOR SITE TESTING/INSPECTION OAT- CHJJS Applicant— ADDR ss TELEPHONE NAME Site Location Engineer ADDKtS --T—ELEPHONE NAME T est/l nspection Date and Time q UNAI KIVIA11,BOARD OF HEALTH Fee— Test No. 3 S.S. Permit No._D.w.c. No.—C.C. Date—Plbg. Permit No.— Page 1 of 3 No. ��� � ���5" � +� Date: b Commonwealth of Massachusetts � r S uitg �r°t� �s e� ent � n,!s e Suva irs osa rr0,. c.t ' 1111.... pert"ormed By: .,........ ?ac ... I)ute: Witnessed By �� ,�. ..............1,,111,, ....... . 1'lNtw. MARCo.. 6rquro l e 1,=,;on ni a Al IL's- New ti .Lea 7 rP ,uvr�c l.a r 1`lf r1,�1 G7QW L�/2� /tZ�} t7 L� Tc4cp!yart: Y '. Construction 0 Repair —6 5-- 7 t4l j ice Review Published Soil Survey Available: No Yes Year Published 061 ...... Publication Scale Soil Map Unit JRoD Drainage Mass VV CLL 1 +fit. . r . Sail Limitations P ....... ........ C Surficial Geologic Report Available: No X Yes Year Published Publication Scale Geologic Material (Map Unit) Landforni ...... Flood Insurance Rate Map: Above 500 year flood boundary No []Yes Within Sob year flood boundary No [. Yes Within 100 year flood boundary No OYee El Wetland Area: National Wetland inventory Map (map unit) ........ ......-... .. ....'. ..."..- Wetlands Conservancy Program Map (map unit) ......................... .. ............ Current Water Resource Conditions (OSGS): Month Range :Above Normal Normal D Belcw Normal Other References Reviewed: ------ trrr AYPROVEW FORM-1210'119$ �p ink `a, FORM 11 d SOR, EVALUATOR:v6iim Page, Z of 3 Location Address or Lot No. 4,v Ile X V Ati On-site R'evi U2 Deep Hole Number I-P. /. Date;....I��.� 99 Location (identify on site plan) . ....,1 � c?�!Tw.,._. Lend Use Slope (%) Surface Stones Vegetation . .. -' w^y. ......., ...,„ .. -.,:.1. Landform ... � hfttL�,�. .....:j'p, r ,,G�/.RUC/C, Position on landscape (sketch on the back) .. :. Distances frorn; Open Water Body } Y00. feet Drainage way feet Possible Wet Area `lad?; feet Property Linea.:.. feet Drinking Water Well :.~...:., feet Other DEEP OBSERVATION HOLE LOG" Depth from Soo Horizon Soil Texture Soil Color Suit Other Surface (Inches) (USDA) (Munsell) Moulin{ (Structure,Stones, Boulders, Consistency, % Gravel) Parent Material(geologic) . '�� Ai C��� ?1� gi �- Dapftogedro&: Depth m Grou er. Standing Water in the Hole: MOVE Waepine from Pit Face: Evirnated Seasonal High Ground Water: r1EP APPROVED FOM a IV0719$ pi � 1'"ORMt 11 - SOIL EVALUATOR F01Z N., Location Address or Lot No. _q!'/ JCrRAA}v1i- e IL �vr),jG, (�nwsze Re iew Deep Hole Number ..��.,��z Date:.-.. Weather ..: . �Vj Location (Idontify on Site plan) flr"v......—`-R'l,L:R Land Use TA R,f ; ..... .. o Slope {/o) 2 Surface Staves Vegetation ,. . .,. ,... Landform Q, . Position on landscape (sketch on the back} . Distances from: Open Water Body >i100 feet Drainage way 's 6� feet Possible Wet Area : Zaa, feet Property Line .. ,.,, feet Drinking Water Well ". .... feet Other DEEP OBSERVATION HOLE LoG=____Y Depth from Soil Horizon Soil Texture Soil Color �Sol( other Surface (inches) (USDA) (Munself) Mottling (Structure,Stones, Boulders, Consistency, 9°�I I 1 Parent Material(0oologic)„-.5ka 16 k, tip CK -J� �P�aSadrock: �S Mt a Groundw rr Standing Water in the Hole:v_ Wee in tram Pit Pace:_. 1y,2 _ Estimated Seasonal High Ground Water:_ Ael c)7 , �-�M(A/ .� DEP APPROVED MRM-12t0719S FORM 11 - .SOIL EVA.LUA,TOR ]ROOM . 1 Mm - . Page of 3 Location Address or Lot No, Sri-s y Re Yzew Deep Hole Number T ': Date: .l/%!�� Time:. /.l Weather s1) Location (identify on site plant Land Use . . !`�l . .. �. ..... .. Slope (%1 Surface ce Stones Vegetation ...,�� .ikr�.... . .,..... _ Landform .......... ..... Position on landscape (sketch on the back) . Distances from; Open Water Body `l'.'Y00 feet Drainage way7l �. feet Possible Wet Area feat Property Line .. feet Drinking Water Well ...!`'. ... feet Other !... .... .,.,... DEEP OBSERVATION MOLE LOG' Depth from Sail Horizon Soil Texture Sail Color :oil - — Other Surface ftnchdsl tUSDAf {MunSafq Marilfrig (Structure,Stones, Boulders, Consistency, % ..-^ -•-�--- - - - Gravel) �2S HOLES Parant Material(Qeologici -� ��i� C,�' Uepthtof3edroCkt_ penth to Groundwater Standing Water in the Hole: N N ---_..b2 Weeping from Pit Face:i N�� _ Estimated Seasonal High Ground Water:_^ �,��-- � ��^-�•-� .a Dk.P APPROVED FORM-MOMS FORM 11 • SOI.L EVALUATOR FORM Page 2 or Location Address or Lot No. A1• u . �rz.ws�te �v�ew Deep Hole Number 7::�Y (7ate:.7/ .. ,� j Time: Weather Location (identify on site plant �'t�`J •4 .,. t ?..(?. r`►rI+? ?1.:...:.!(-. ,. .... . n..v.,.. ............... Land Use .. .� ..: .:... Slope (/o} .�. . . . ..:. .. .� ° :�' Surfaces Stones Vegetation .,:....1x�2►9 Landform .... .. Position on Ianctscape (sketch on the back) „ ....:.:..:....:::..:;..,..., .,._. Distances from: Open Water Body 710- feet Drainage way feet Possible Wet Area �>2 feet Property Line feet Drinking Water Well - feet Other :.:.:..:,,.,.,w... DEEP OBSERVATIO N HOLE LOG Depth from Soil Horizon foil Texturo Soil Color Soil Oihur Surface (Inches) (USDA) (Muncell) Mottling (Structure,Stones, Boulders, Consistency, 9G Gr,�vel1 Ej — 7cr Fr /( -75 a �v rr Parent Material(gaoldpie} Gjj!jJek0 „ )V ock DapthtoSedrock:,,,r,,, ._../!A—_ -- — Clenth to Groundwater; Standing Water in the Hole: eVO sll _ Weeping from Pit face: /VtJ N _ Estimated Seasonal High Ground Water:_ O7___ Aka'APPROVED FORT-1•12107!49 ' FORM 11 - SOIL EVA.LUXrOR F(.lRm Page 2 of 3 Location Address or Lot No. _ + Gs ? n/+i�,�L�,_l�•U +��'-� Deep Mole Humber T1 C7atts;..J.r fC�t Time::. =,°. WeatherN� I c�=r�' Location (identify on site plant Land Use ...'?A� slope ow .1001w Surface $tones �9 ... Vegetation .. .a pe.e Landform ..... Vii,.+##? .t T:b. a.-c-0/20tJ4 Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way Apo feet Possible Wet Area feet property Line -3.0. feet Drinking Water Well '"'... feet Other DEED OBSERVATION WOLF LOG' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surtece (Inrhas) (USDA) (Munsalq Mottling (Structure, Stones, moulders, Consistency, / Gravel) 3D Z y � 02& 5q 8Uj Z L- , 2.5 J©.y/z 6/s /o°/d I I i OF Y Parent Materiel(geologic) 1, _k_. ect Doo to(gadrock: _ _ Depthto Gto-unwret r. Standing Water in the Nola: __N h+ ." Weeping from Pit Fate: A/ Estimated Seasonal High ground -- DER APPROVED FOXN1-/2147/95 M « SU%I F4AL ) LT �R�O M f Y Parle Z of i Location Address or Lot No, I )aJV'71['— �`'f'� A`—h^J-- b 1I Times /.L�:�. Weather J�'.A� ...C +- Deep Hole (dumber Date..:... r Location (identify ar► site plan) ..h,..� .!tE' J+ t ./Z.. Land Use .y�A.[�.i�.. Slope (%) /ads Surface Stones Vegetation ( u N r ...:. _ ,. . . .... .. .... ... ,.. ,.... Landform Position on landscape (sketch on the back) _. ...... .. .. ....:. . .. ..:.. ..:. Distances from Open Water Body �Lf�• feet Drainage way 7 l�? feel Passible Wet Area . �? feet Property Line .. feet Drinking Water Weil ...._ . .:... feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horiznnr�~ Sail Texiurd Snit Color �Soil -aiher Surface(Inches) (USDA) tMunsell) Mottling (Structure,stones,Boulders, Consistency, ` Di 57 ,,yt q s 51 ,E G Parent Material (geologic) --- p th to.Greur dwater: Standing Water in the Bole: PAd li� Weeping(earn Pit Face: /✓�'V — Estinnoted Seasonal High Ground Water: )r•:p ApplROVFD>:OM%-12107/9,1 FORM X t - SOIL h VALUATOR FORNv Location Address or Lot No. ��'/ �a"('�A������,nl. �A �oc�,�rL. er rt cxtivn fi2r Bomar .T igh Water Table Method ,Used: ❑ Depth observed standing in observation hole inches Depth weeping from side of observation s observation hole inches (_ Depth to soil mottles7i05Y,b. inches ���" i P "i y' [1 Ground water adjustment ...•........I".." feet Index Well Number ._ .......... Reading Date ............ ... Index well level Adjustment factor Adjusted ground water level p_qpth of Ngturglly,per grrin Egrvious 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? —ZZ If not, what is the depth of naturally occurring pervious material? Certification I certify that on Nov 1125 (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 1AP APPROVED FORM•12/0705 TOTHL P.09 --- _.,, .,...:.�..r...i-+..n.«.,n ..n.r` p. _ _. ._ .. .. ...r:. .nr .� n.,. ., ..,. - .. •,, - - - ... . . ..nnr n. ,.�n_n.: _._..._ __: ...__ _ _.... _ .. - ll � LOCATION: EN ENE 0L T ION T EE 0 TT 0Ni T 0r C T-E ST. c� IN1E IN'1E , .. TIME CAS 1MG T C, T ME T _ C� d ol T INIE , J II I j I I ily I � I I I -t i I I I i I I I i i 5I, L* N i✓f2. ,�. - y s 1 Lsa«r k ,/ I F W .:fF ^F�• 5✓� +l' ;< r ,a v s tt f �1 f r � MN a a a� �l