HomeMy WebLinkAboutSoil Testing Results - 1049 SALEM STREET 9/25/2013 TOWN 01i' NOR,11-1 ANI-)OV Ell I,
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1600 OS(,001) SUITE 203,,!;
NOPAI I AND(.)VC-11 , NIASSAC[iUSI-JTS 0184 5
S As an Y.Sawyer,RE I IS, [ts 978 68 9.95,40 Nlwle
�Inbfic Ifeafth Diredor 978.698.8476
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APPLICATION FOR SOIL TESTS
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DATE: —1 MAP&PARCEL: f1'f- -P
LOCATION OF SOIL TESTS:
OWNER: P, (tact 9:
to"-4�4�le�'
APPLICANT Contact
ADDRESS:S'0
ENGINEER: Contact#:
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CERTIFIED SOIL EVALUATOR: j2� -70)
Intended Use of Land: Resident I ial Subdivision Ingle Family Ho e Commercial
Is This: Repair Testing: Undeveloped Lot Testing:— Upgrade for Addition:_
In the Lake Cochichewick Watershed? Yes No
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
> Proof of land ownership(Tax bill,or letter from owner permitting test)
Location of Testinaklease indicate test pit sites on il 1_n
........ .....
➢ Fee of$1�25.00 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 BOR
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).
> Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval Date:
Signature o f Conservation Agent:
stamp in):
Date back to Health Department:
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Commonwealth Of Massachusetts
City/Town Of North Andover
Percolation Test
Form 12
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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: Site Information
When filling out A.
forms on the
computer, use 1049 Salem Street Realty Trust
only the tab key Owner Name
to move your 1049 Salem Street
cursor-do not _—.........
use the return
Street Address or Lot#
key. North Andover MA 01845
City/Town State Zip Code
rae c/o George Hughes, Jeffco, Corp. X978) 886-8408
-.-–
Contact Person(if different from Owner) Telephone Number
enan
B. Test Results
10-10-13 10am
Date Time Date Time
Observation Hole# P-1
78"
Depth of Perc _
Start Pre-Soak 9:57
End Pre-Soak 10:12
Time at 12° 10:12
Time at 9° 10:18
Time at 6" 10:28
Time (9"-6°) 10 --
Rate (Min./Inch) 4
Test Passed: ® Test Passed: ❑
Test Failed: ❑ Test Failed: ❑
Bill Dufresne SE#640
- ----- — - —
Test Performed By:
Susan Sawyer
Witnessed By:
Comments:
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