HomeMy WebLinkAboutSoil Testing Results - 60 LONG PASTURE ROAD 4/29/1996 Town of North Andover, Massachusetts
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IN
'oE BOARD OF HEALTH Form No. 1
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2 /60
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APPLICATION FOR SITE TESTING/INSPECTION
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Applicantt� z � 1i
NAME ADDRESS
TELEPHONE
Site Location
Engineer
NAME ADDRESS
TELEPHONE
Test/Inspection Date and Time
CHAIRMAN,BOARD OF HEALTH
Test No.
S.S. Permit NO.-D.W.C. NO.
C.C. Date_ Plbg. Permit No.
Page 1 of 3
Date:
No.
Commonwealth of Massachusetts
/qo)ZTII qt4j)0()62 Massachusetts
� On-site Sew,a e Disposal
Soil Suitabili Assesstgmn(jo
Date: 6 ..............
Performed By .QC, rif,4E_-U...................................
............................
61W............................................................. .......
A.
Witnessed By* .
Owner's Nu„ . 7
Owner s
L_O/y( pj
Loly& PKSTwee
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LACUM Addl=—S C�t Addm%s,
T I phone
Lot I Telephone I
L4/ _r
C
130'4 FCD
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Co jStj air ❑
Location
construction Rep
office Review
Published Soil Survey Available: No Yes. .71 .........
cale Soil Map Unit
jV61...... Publication S
Year Published ............. ................................
.................................................... ............Wig
Soil Limitations S.
Drainage Class
Surficial Geologic Report Available: No Yes
Year Published :Publication Scale
....... .... ...................
...........................................
............................................ ..
Geologic Material (Map Unit)
........... ....................................................
...................................... .......................................
Laridform ..............................
Flood Insurance Rate Map:
Above 500 year.r flood boundary No ❑Yes
Within 500 year flood boundary No Yes ❑
Within too year flood boundary No ❑Yes ❑
Wetiand Area: ............................... .........................
National Wetland Inventory Map (map unit) .............................................. ..............................
Wetlands Conservancy Program Map (map unit)
Current Water Resource Conditions (USGS): Month
Range :Above Normal ❑Normal ElBeic-NNormal ❑
Other References Reviewed:
DEP APPROVED FORM 12107195
FORM 11 vn rvnni
Page 2 of 3
Location Address or Lot No. (.+,7 L.�✓G V
®n-site Review
Deep Hole Number 76-14- Date: SI I Time: Weather $14NN`1 70
Location (identify on site plan) - -
. .. .::.. .....::::.. ..
Land Use Slope M 3"8 Surface Stones
. (l1yZ
Vegetation Hl4K� -t ML
(it/....
Landform _ �R1�Mt-::. .
Position on landscape (sketch on the back)
Distances from: feet
Open Water Body feet Drainage way
feet Property Line S� ± feet
Possible Wet Area
Drinking Water Well
feet Other
DEEP OBSERVATION HOLE _OG+
Depth from Soil Horizon Soil Texture Soil Color Soil
Other
Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones,G avlel)rs, Consistency,
0- S- FSL_ Z,5.Li4Z,
_ _
`S 3Z gw - .
s-1&)3
3z-1L� FSc- Z. 4k� czi� (r(VM ►^) p�,4CC, aLOCK11 rA�
pew c-f S
faNGUlAVL SfbNrLS
X03 F 00"
MINIM L) ulspuSALA c N
—F/f I DepthtoBedrock: 7 t Z(o
Parent Material-(geologic)
Death to Groundwater: Standing Water in the Hole: 3o t f
Weeping from Pit Face:
Estimated Seasonal High Ground Water:
AEP APPROVED FORNS-12/07/95
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. lAr 4 (,D/UC, l�G4S?i nJ'
On-site Review
`Z
9�- I s : s�z¢ 7 Weather Sq v-,v`f 700
Deep Hole Number Date Time:.
Location (identify on site plan) ................
Land Use
Slope M) 0 _3 Surface Stones.
Vegetation
til,(T� WSI°�✓: I.CU�4�t AAkW -f,�. Y�(�/lz
Landform
Position on landscape (sketch on the back) • .-
Distances from: feet
Open Water Body feet Drainage way
Possible Wet Area
feet Property Line feet
... ..:
Drinking Water Well feet Other ,
-DEEP OBSERVATION HOLE :-OG'
Other -
Depth from Soil Horizon Soil Texture Soil Color Soil Gravel)
"
Surface (Inches) (USDA) 1Munselp Mottling (Structure, Stones, Boulders, Consistency, °ro
ct
i
C2-0
L to ,U
DepthtoBedrock* 7 /w
Parent material-(geologic) ---
•�
DPnth to Groundwater: Standing Water in the Hole: Weeping from Pit Face:t C —
Estimated Seasonal High Ground Water:
DEP APPROVED FORM-12/07/95
rUK1V1 11 - J"LL L' VA1JUAIUK PURM
Page 3 of 3
Location Address or Lot No. W N& Pr�SiLf�
De=nation for Seasonal Hieh Water Fable
Method Used:
• Depth observed standing in observation hole................... inches
• Depth weeping from side of observation hole ........... .... inches
® Depth to soil mottles ...:.�3 �: inches
❑. Ground water adjustment .................:. feet
Index Well Number .................. Reading Date .................. Index well level ............_.
Adjustment factor .................:. Adjusted ground water level .........................................:...._..:....
Death 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? q&S
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on 10 94� (date) I have passed the soil evaluator examination
approved by' he Department of Environmental Protection and that the above analysis
was performed by me consistent with the required training, expertise and experience
described in 31.0 CMR 15.017.
Signature Date
DEP APPROVED FORM-12/07/95
FORM 12 - PERCOLATION TEST
Location Address or Lot No. COT_ per,LW=E
COMMONWEALTH OF MASSACHUSETTS
it/62 HNSOuot , Massachusetts
Percolation Test*
Date: ... Time:.
Observation Hole #,
Depth of Perc
5�
Start Pre-soak
C/
End Pre-soak
Time -at 12" al D f
Time at 9" -
/O;d g ; Z7
Time at 6"
ivr3 � /0 ; IL
Time (9"-6") Z� S
Rate Min./Inch
t` d /it/
* Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed 2 Site Failed ❑
..........................:...................................................................:......................................_-................
.-
Performed By: CW(US 119ruS6u -4 SEr G( I rJC <
Witnessed By: /t11
Comments: :::.:,:. :.:::.:::::::::.:::::::::::::.:::..:::.:::::::.::::::.::::.:::.::::::..:::::::::.::::::::::.::::::::::::.:::::::::.::::.:::::.:.:._.:::
DEP APPROVED FORM-12/07/95