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Home My WebLink AboutSoil Testing Results - 26 LONG PASTURE ROAD 5/18/2000 Sort, b> :G Ma'j-18--00 08:57 from 9783723960>508 688 95 42 page 2/ 2 Rote i ved M<jy_-12 -00 14: 17 f role 500 688 9542 4 G �<r,9 r, May--12-00 14.08 No--'th Y"1C°:1oN14§Y' Cant- Dev.. BOB 688 9542 P102' JJOARD OF HE ALTH NOWM 78-688-9540 MAP & PARCEL; _ /�1 (�� _...w_ �� ✓ d� DATE: � 1 LOCATION OF Slat,TESTS: _ 0 -R.: r 110.: . 0 CERT"IFIED SOEL EVALUATOR: Imended Use of Land- Residential Subdivision n angle Family Home Cornttnercial Is This- Repair Tvstiatg: , Undevelopcd lot testing: - - - in the Laite Coelaichewick Watershed? Yes — No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land owner9hip (Tax bill, or letter from owner permitting test) 2. plot plats & Location o.f estireg 3, F of ?5.00 per lot for w cottistructiort. This covers the minimums two deep holes d two percolation tests required for caoh disposal area. Fee of 1,71.00 per lot for fiE E INr- RMA TION J. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only glass.Registered Sanitaxianr and Professional Engineers can design septic plans, 3. At least two deep holes and two.percolation tests are required for each septic system disposal area. d. Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. 5. Futl payment will be required fox all additional tests within two weeks of testing, 6. Within 45 days of testing, a scaled plea(no smaller than 1"-100')shall be submitted to the Board of 14ealth showing tire. location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation form shall be submitted. Please Do Not Write Below This Lime N.A.Conservation Commission Approval; -7E�97T \-1-1 `) � Date Received:. _w. _ Check Amount: Check Tate: _,.... _ Town of North Andover, Massachusetts Form No. 1 NORTH A BOARD OF HEALTH APPLICATION FOR SITE TESTING/INSPECTION 7�A�RATEO PPa,��y SSACHUS� Applicant NAME ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts Farm No. 1 NORTH BOARD OF HEALTH f� O5 OO< 19 R <°<LAKE,<k ^> APPLICATION FOR SITE TESTING/INSPECTION AERATED SSACHUS� L ; Applicants NAME ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF HEALTH Fee ' Test No. 74�, S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. P ► �� Li z Vol w v r �. fr 1 FORM 11 SOIL EVALUATOR FORM Page 1 of 3 Date: LLLA 60 No. Commonwealth of Massachusetts IV04T,4 /qjU60b/0,' , Massachusetts Soil Suitabili Assessment or On-site Sewagg Disposal Performed By: .......Di9 ti 1. ........ ..................................... Date: �.(........ ...................... Witnessed By: ......... ...... STUKI MT, 000,� owner's Nuns. LoAJG P0 uOulon Atkkas of T Address,and Address Lot I T 12—� Telephom 1 0,0 . 3O1C 343 ew Construction A AJO OU61t '14 Repair ❑ Office Review Published Soil Survey Available: No ❑ Yes n .......... ..... Publication Scale Soil Map U' it Year Published Drainage Class C,15%S ► Soil Limitations ...................................................................................................... DRAIIV60 [D/ Surficial Geologic*Report Available: No Yes Publication Scale Year Published .. .............................. Geologic Material (Map Unit) ....................................................... ................................... .. .....................-....... Landform .............................................................................................................. ..... Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes Within 500 year flood boundary No ❑Yes ❑ 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 ❑Be1c,.,1 Normal ❑ Other References Reviewed: DEP APPROVED FORINI• 12/07195 �; .�..... _ Page m of J cation Address or Lot 110- ®n-site Review Time:. 3 `.30 Weather to- sep Hole Number Date:. ..: .. on site plan) "'o� Surface Stones cation (identify Slope M) and Use egetation andform 'osition on landscape (sketch on the back) )istances from: feet feet Drainage.-waY Open Water Body Line feet feet Prop. Possible Wet Area feet Other Drinking Water Well DEEP P OBSERVATION HOLE 1-OG� other Soil Color Soil Soil Horizon Soil Texture (Munselll Mottling :Structure• Stones.Gravlellrs. Consistency._°.o Depth from (USDA) Surface (Inches) C? P-P �vr1hSS i'Y''r Y 4-1+ S-� �O ( 0 Y'4'� ✓ hr�1 �"'rits I. inn ✓IfJJ/ 6 dK��U�Lf L' S GN /'-I c Dept=Bedtock: � Parent Material (geologic) S Weeping from Pit Face: Oe th to Groundwater: Standing Water in the Hole: I Estimated Seasonal High Ground Water: t)EP APPROVED FORM- 12/07/95 Lion Address or Lot t�o. L � L-DYI.0 On-site Review -`� Date:, 42-319-11 Time:. 3 S� Weather oep Hole Number - )cation (identify on site plant Surface Stones and Use _ Slope M) egetation -....... andform osition on landscape (sketch on the )istances from: Drainage..way feet Open Water Body feet feet Possible Wet Area feet Property Line Drinking Water Well feet Other DEEP OBSERVATION HOLE I-OG� Soil Other Soil Horizon Soil Texture Soil Cotor ;Structure, Stones, Boulders, Consistency, Depth from (Munselll Mottling Gravel) Surface IInchesl (USDA) . -2, AI 1vy ws70 C'' 7, -0 4 i L CJ Depthto8edrock: parent Material (geologic) U Weeping from Pit Face: Depth to Groundwater. Standing Water in the Hole: � estimated Seasonal High Ground Water: pgp AppROVED FORM- 12107195 FORM II - SOIL, L VALUATOR FORM Page 3 of 3 Location Address or Lot No. LO T Determination for Seasonal High 'Water Fable Method Used: ❑ Depth observed standing in observation hole................... inches ❑ Depth weeping from side of observation hole ........... .... inches Depth to soil mottles ...:..22..: inches ❑ Ground water adjustment ................... feet Index Well Number .................. Reading Date .................. Index well level ... .:... . .. Adjustment factor ......... ........ Adjusted ground water level .......................:............... .......... IDe th of Naturally Occurring Pervious Material Does =at least four feet of naturally occurring 'pervious material exist in all areas I observed throughout the area proposed for the soil absorption system? _ If not, what is_the depth of naturally occurring pervious material? Certification I certify that on lo ¢ (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. _ Date /o Z� `� Signature DEP APPROVED FORM- 12107/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS No AAA'(X'ti , Massachusetts Percolation Vest* Date: ...V I SI Time:, ......... Observation Hole # Depth of Perc Start"Pre-soak End Pre-soak G I r✓ Time-at 12" Time at 9" Time at 6" 37 Time (9"-6") Rate Min./Inch r�171 l,hc�- ,��dr► e� / ►�L.�i * Minimum of 1 percolation test must bo perform i ed in both� the primary area AND reserve area. Site Passed a Site Failed ❑ V/ ....................................................................................................................................._ . .._........_....... U Performed By: JDAlq 0a ycr k o�i S Witnessed By: Comments: .:.:.::.::. DEP APPROVED FORM-12/07/95