HomeMy WebLinkAboutSoil Testing Results - 149 MARIAN DRIVE 4/6/1998 (2) Town of North Andover, Massachusetts Form No. 1
NORTH,qA BOARD OF HEALTH
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APPLICATION FOR SITE TESTING/INSPECTION
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Applicant ADDRESS TELEPHONE
NAME
Site Location 14t-1
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Test/Inspection Date and Time
CHAIRMAN,BOARD OF HEALTH
Feed Test No.
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S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
NowTH
BOARD OF HEALTH
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30 SCHOOL STREET TEL. 688-9540
NORTH ANDOVER, MASS. 01845
APPLICATION FOR SOIL TESTS
DATE: z!® (0 °-2
LOCATION OF SOIL TESTS:
Assessor's map & parcel number: 10'16. 1
OWNER: DA 1 r—' cv TEL. NO.: �� � —
ADDRESS: I �� ► _i,cj _t f�
ENGINEER: ,4 � � TEL. NO.:
CERTIFIED SOIL EVALUATOR: I L k,. ,ED j��,k t "
Intended use of land: residential subdivision, single family home, commercial
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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 minimum two deep holes
and two percolation tests required for each disposal area. Fee of $75.00 per lot for
repairs or upgrades.
GENERAL INFORMATION
1. Only Certified Soil Evaluators may perform deep hole inspections.
2. Only Mass. Registered Sanitarians and Professional Engineers can design septic
plans.
3. At least two deep holes and two percolation tests are required for each septic system
disposal area.
4. Repairs require at least two deep holes and at least one percolation test, at the
discretion of the BOH representative.
5. Full payment will be required for all additional tests within two weeks of testing.
6. Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to
the Board of Health showing the location of all tests (including aborted tests).
7. Within 60 days of testing soil evaluation forms shall be submitted.
Location: I owner's Name: [2Aj l 0
Map/Parcel: 11A 101 Ci I�ast�i �� _ Address:--�ql HAVZ-Iko V 15
[nstaller- Tel#• &O'Of"701 New(siso) ai
Date: etlands,e Zone II Soil Symbol Soil 1Qame
�����7€�oil Class
Deep Observation Hole Logs
Elevation Depth Soil Horizon Soil Tenure Soil Color Soil Mottling % Gravel,Stones,etc:
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,7-70 Pry 10OU-6g H kW t4(,.tqe,
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Parent Material "rl LA" Depth to Bedrock °� Standing Water in the Hole: •Yeepin;from Pit Face_ktESHGNV:6
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Parent Material 0- Depth to Bedrock' Standing.Water in the Hole-_ from Pit Face_y�ESHGtiY:_�
Date Percolation Tests
Observation Hole R
Depth of Perc "
Start Pre-soak 0 t y$
Time at 12"
Time at 9" C415
Time at 6"
Time(9"-6")
Rate Nfin/Inch
Performed By: ��J_,__�� 1 Witnessed By:
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