HomeMy WebLinkAboutSoil Testing Results - 60 ROCKY BROOK ROAD 1/30/1996 Town of North Andover, Massachusetts Form No. 1
NORTH AA.. BOARD OF HEALTH
3�O1�s�eo �
5� v) -19
O
APPLICATION FOR SITE TESTING/INSPECTION
SSACHUS��
Applicant 9
NAME ADDRESS TELEPHONE
Site Location M" T I At 41t,��r7
Engineers-C�
NAME ADDRESS TELEPHONE
Test/Inspection Date and Time
L CHAIRMAN,BOARD OF HEALTH
Fee. Test No. 190
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
FORM 11 - SOIL EV.-kLUATOR 11OR,%I
Page 1 of 3
0. M Date: 1w ia,
Commonwealth of 'Massachusetts
t.,AOV-fl) W(A)W--e- , Massachusevs
Sail Suitability Assessment for Ore-site Sewage Disoasal
Performed By: -... Dace -
Witnessed. By:
Location Add==or O.-r'%Hire,
Adds:.am .`C c 1l �l . \ li' �w i✓
New Consrrucrion C Regair ❑ I �-_�c .- (w, 1 -
Office Review,
Published Soil Survey Available: No ❑ Yes i
Year Published `C ... Publication Scale 1 4 Soil Map Unit
Drainage Class 1Ajft--LAX(N�"J Soil Limitations
Surficial Geologic Report Available: No Yes ❑
Year Published Publication Scale ___.........,
Geologic Material (Map Unit) ..................--...............................................................................,............................ ...........
.,
Landform ! tl :..:.........................................................................................................................................................
........... �.
Flood Insurance Rate Map:
Above 500 year flood boundary No []Yes
Within 500 year flood boundary No EKes ❑
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
Range :Above Normal ❑Normal 19"9elcw Normal ❑
Other References Reviewed:
kipEP APPROVED FORM• 11107/95
FORM 11 - SOIL EVALUATOR I+ORN1
Page 2 of 3
Location ,-address or Lot ivo. IN Val yc 7 -)2))A— v-C-0-0,
On-site Review
Deep Hole Number I Date:. �c Timer Weather f"-A-(tom-
Location (identify on site plan)
Land Use 1Q6,-,,rtt0(k-- Slope (%) 84� Surface Stones
Vegetation
Landform VA>ON ti'
Position on landscape (sketch on the back)
Distances from: �1
Open Water Body �' �/ feet Drainage way feet
Possible Wet Area k2&/ feet Property Line feet
Drinking Water Well Q)N feet Other
i
I
DEEP OBSERVATION HOLE LOG'
Depth from Soil Horizon Soil Texture Soil Color ! Soil Other
Surface (Inches) I (USDA) (Munsell) I Mottling (Structure, Stones, Boulders, Consistency, %
Gravel)
i
94
)
ti
UV.y
)
I
H tJ h CvLriy 11hu POSED L AREA
Parent Material (geologic) '- Z>4 DepthtoBedrock-
Depth to Groundwater: Standing Water in the Hale: Weeping from Pit Face: �Su
Estimated Seasonal High Ground Water:
>' t'
DEP APPROVED FORM-12/07/95
I
i
FOR11 11 - SOIL LVALUATOR FOR J
Page 3 of 3
Location Address or Lot No.
Determination for Seasonal High Water Table
Method Used:
ZL-t�epth observed standing in observation hole .._. �.. inches
❑ Depth weeping from side of observation hole ...... . inches
❑ Depth to soil mottles inches
❑ Ground water adjustment .................. feet
Index Well Number ....... ....... Reading Date ....... Index well level _
Adjustment factor _.._ ......... Adjusted ground water level .... . _ ...... .... .........
Depth of Naturallv Occurrina 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?
If not, what is the depth of naturally occurring pervious material?
Certification
I certify f l
y that on � (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
DEP APPROVED FOR.%t- 12/07195
03-21-1996 14:36 617 932 7616 CEP NORTHEAST REGICNAL P.02
FORM 12 - PERCOLATION TEST
Location Address or Lot No. �� ���1G�' ' ev,
COMMONWEALTH OF MASSACHUSETTS
Massachusetts
Percolation Test'
Date'. `� � �' Time:
Observation Hole K 1
Depth of Perc
Start Pre-soak
End Pre-soak '= \�y
Time at 12"
t
Time at 9" `
Time at 6" G'
Time (9"-6")
Rats Min./Inch
Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed 2"'� Site Failed ❑
Performed By:
Witnessed By ` �
Comments: �.. _...
nv worm MRM•w07191
FORM 11 - SOIL EVALUATOR FORM
Page 1 of 3
t"— r k Date:
No.
Commonwealth of Massachusetts
Na'"�A , Massachusetts
Soil Suitability Assessment or On-site Sewaa e Disposal
Performed
Bv: �L-� J ��t ®. ....... Date:
... .. .... ..
l
Witnessed By: . .....
I.ocauon Address or
`/ ,/Jrn 1y, address.Ina
P '� �'V4-�f"'�" V71(_l'.x- Vio 1'� Telcporc/
New Construction EV Repair ❑
Office Review
Published Soil Survey Available: No ❑ Yes t
>i �1� v�-Z'O Soil Ma Unit(f bC'
Year Published
................ Publication Scale ...... ........ P
YL^U1`�EO�'t�1r� .�. .17Y7��2 -•� ,- ..`�...
A i,i ��
Drainage Class WrY�I�S�e•• Soil Limitations
Surficial Geologic Report Available: No l� Yes ❑
Year Published Publication Scale ---
GeologicMaterial (Map Unit) ..............................................................................................................................._. .........
Landform
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑Yes
Within 500 year flood boundary No [3///yes ❑
Within 100 year flood boundary No Ll Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit)
.............................. ..............................................................
Wetlands Conservancy Program Map (map unit)
...................
Current Water Resource Conditions (USGS): Month
Range :Above Normal ❑Normal elcw Normal ❑
Other References Reviewed:
DEP APPROVED FOMM. 12107195
FOR.11 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location .address or Lot ,vo.
On-site Review
Deep Hole Number Date:. l�1 j Time: WeatherlA l YZ
Location (identify on site plan) _�`
Land Use °� zj( ���t Slope (%) g--i1 Surface Stones
Vegetation �k/1j v6/'9
Landform rR
Position on landscape (sketch on the back)
Distances from: yy//
Open Water Body )i01-7 feet Drainage way �—\(1 feet
Possible Wet Area 10'>V°-feet Property Line l"2- -Y--feet
Drinking Water Well P A feet Other
DEEP OBSERVATION HOLE 'OG'
Deoth from Soil Horizon Soil Texture Soil Color Soil Other
Surface (Inches) I (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, %
Gravel)
MINIMUM OF 2 i
{
I
I
I
HOLES R r 17 EVERY c AL
Parent Material (geologic) �G
� t W�}f � DepthtoSedrock:
�Y
Deoth to Groundwater: Standing Water in the Hole: 222 Weeping from Pit Face:
i(
Estimated Seasonal High Ground Water:
DEP APPROVED FOFLM-12/07/95
FORM 11 - SOIL LVALUATOR FOR-NI
Page 3 of 3
Location Address or Lot No. Gib ��1l1DUYL_ 8 �
Determination for Seasonal High Water Table
Method Used:
lam" Depth observed standing n observation hole...��.�.
9 inches
❑ Depth weeping from side of observation hole ;.:.:. inches
❑ Depth to soil mottles inches
❑ Ground water adjustment .................. feet
Index Well Number .... . ....... Reading Date ...... . Index well level
Adjustment factor .... .......... Adjusted ground water level
Deoth 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- =
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on (date) I have passed the soil evaluator examination
approved by the Depa tment 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
DEP APPROVED FORUM- 12/07195
03-21-1996 14:36 6i7 932 7615 CEP NCRTHEAST REGICNaL P.02
FOR.N1 12 - PERCOLATION TEST
Location Address or Lot No.
COMMONWEALTH OF MASSACHUSETTS
Massachusetts
Percolation Test'
Date: V2� Time: >
Observation Hole # V VA
Depth of Perc M :3t
Start Pre-soak ` 1�
End Pre-soak rZl
Time at 12" ¢
Time at 9" 2
Time at 6"
Time (9"-6") �(
Rats Min./Inch
Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed L! Site Failed ❑
Performed By:
Witnessed By`.
Comments: : _...... . ..... -.. _....
DIP Amoy=TDRM•U1p71!!
FORM 11 - SOIL EV.-,,LUATOR FORM
Page 1 of 3
Date: )o A 1c�
Commonwealth of !Massachusetts
Nb,10 P�NgL; Massachusetts
Soil Suitability Assessment or On-site SewaZe Dis oral
`
Performed Bv: v `� 19 .......... Date:
� � U
Witnessed By: ..�..
. ... ...........Qmr's 42M.
t„pCi(tdfl Addiui« `/ y��/r�7` / y,✓ A6drui.im ,rte
Lot ' 1� G,�1clL�Vl�6.�K--l`a�'JV ...ralrcnom
onst ruction repair
Office Review. _
Published Soil Survev Available: No ❑ Yes l✓ �
196 Soil Map Unit Cb�
�..... Publication Scale
Year Published �c'.� ...
y�t� 2A-t � Limitations 1c� L:�1.J� ....�....C� '.. .......1 ........
Drainage Class wCA- Sxpk�►v
Soil �—, /
Surfcial Geologic Report Available: No L/ Yes ❑
Year Published -
_.... Publication Scale -
GeologicMaterial (Map Unit) .............................................................................................................................._. ............. .._
Landform .................................................................................................
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑Yes
Within 500 year flood boundary No
[91yes ❑ _
Within 100 year flood boundary No L9Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map (map unit)
....................................................................
Current Water Resource Conditions (U�SGS-S): Month
Range :Above Normal ❑Normal —Belcw Normal ❑
Other References Reviewed:
DEP APPROVED FORAM_ 11!07195
FOR 111 - SOIL EVALUATOR I+'ORN1
Page ? of 3
Locction ,address or Lot iqo.
On-site Review
Deep Hole Number Date:. 1 Time: PVC Weather
Location (identify on site plan) l2 ?-
Land Use --4":Stb6tQ,-1ClArC- Slope M 6-0;- Surface Stones
Vegetation
Landform �r?5rti�
Position on landscape (sketch on the back) ��2C. q (
Distances from:
Open Water Body feet Drainage way "A- feet
Possible Wet Area 113+/--feet Property Line 35N—feet
Drinking Water Well W A- feet Other
DEEP OBSERVATION HOLE LOG*
Oeoth from Soil Horizon Soil Texture Soil Color Soil Other
Surface (Inches) I (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, %
Gravel)
i
I
I
MINIMUM-7 HUL=S n cVERY PR DISPOSALAREA
Parent Material (geologic) 6 K-0 (vl�- l t"�� OeptMoSedrock:
Oeoth ro Groundwater: Standing Water in the Hole: >/�iy' Weeping from Pit Face: t r
�l
Estimated Seasonal High Ground Water: 21
DEP APPROVED FORM-12/07/95
i
FORM 11 - SOIL LVALUATOR FORM
Pae 3 of 3
Location Address or Lot No.
Determination for Seasonal High Water Table
Method Used:
lam' Depth observed standing in observation hole .....J '. inches
❑ Depth weeping from side of observation hole ...... inches
❑ Depth to soil mottles inches
❑ Ground water adjustment .................. feet
Index Well Number ....... ........ Reading Date .... .. Index well level
Adjustment factor .................. Adjusted ground water level _. . ........... .... _.......
Deoth of Naturally Occurrina Pervious Material
Does at least four feet of naturally occurring pervious material exist in al areas
observed throughout the area proposed for the soil absorption system? r
If not, what is the depth of naturally occurring pervious material?
Certification
I certify
y that on (date) I have passed the soil evaluator examination j
approved by the Depar ment 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 �% ry" Date
DEP APPROVED FOR.11- 12/07/95
03-21-1996 14:36 617 932 7615 CEP NCRTHEAST REGICNAL P.02
FORA 12 - PERCOLATION TEST
Location Address or Lot No.
CO MONWEALTH OF MASSACHUSETT
Massachusetts
P colation Test'
Date: Time:
Observation Hole K
Depth of Perc
Start Pre-soak
End Pre-soak
Time at 12"
Time at 9"
Time at 6"
Time (9"-6")
Rats Min./inch
` Minimum of percolation test must be performe\in th the primary area AND
reserve are .
Site Passed ❑ Site Failed ❑
Performed By:
Witnessed By:\•
Comments: :_ ..... . ...._ _...
DLr XMOrm roRM•U/Vlnf