The URL can be used to link to this page

Home My WebLink AboutSoil Testing Results - 121 RALEIGH TAVERN LANE 8/24/2004 'BOARD OF HEAL"I. i NORTH ANDOVER, MASS. 01845 RF ED 978-688-9540 ' APPLICATION FOR SOIL, TESTS AUG 4 2004 r` OVER N OF NOR-r".PARDATE: MAP&PARCEL: p i LOCATION OF SOIL TESTS: OWNER V Y150n TEL.NO.:_ - I q q " GI c- ADDRESS: A"7 1 (;'wCY"n I (1 I� � �fl��' 'tJ� r ENGINEER: L.NO.: vi t 1 D CERTIFIED SOII UATOR UK W t fc C, O S CfMb ,�Qo Lxlaw-o Intended use of land: Residential Subdivision Single Family Home Commercial' Is This: Repair testing Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORMS 1. Proof of land ownership(Tax bill,deed,or letter from owner permitting tests) 2. Plot plan 3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of 1360.00 per lot for repairs or up ades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line yy pp F— Check ce. bYw , ..& ,77 ,N.A.Conservation Commission Approval:Date Received: ount: Check Date: RECEIVED SEP - 7 2.004 HEALTH DEPART ME�111 f, S `�a _f 4 �— x � 0 j � 4 V � by °.��c� � 03" Z i' �► p. 8�$ �e4�:1.�\ . � to yti� •o��` � V � � Z �.�,��c o 1V o *AL 00 0° Itp o � ti •L� ° w�.. e°_" o � ps Cb. O°• j t ,V Q '�l O�, 'am ON � -�' .rte r�3,� y �. h'`��y �•`� �� q 9� 0 �� p0 00 °o• � � �° 3' � �''�' 8• o t i f y � ar• �! K te7� IA-00 4r% 0 Alt u --.�t� ►`mod' �°�� h °`�`r� `Q9' � _ o n Lpr �. ,h • ,f 0 M� �t o� �o 6• =l x,61 �°� •��• �� frtzti vu zp� o a � Ci to k Al w h L fa 96, 14 40 lb qj 51 ell TOWN OF NORTH ANDOVER Th 4A Office of COMMUNITY D 0 EVELOPMENTAND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTf1 ANDOVER, MASSACI--IUSETTS 01845 Susan Y. Sawyer, REI-IS/RS 978.688.9540-Phone Public Health Director 978M8.9542 FAX January 21, 2005 Department of Environmental Protection Northeast Regional Office I Winter Street Boston, MA 02108 RE: in-situ state of Soils Address: 121 Raleigh Tavern Lane, North Andover, MA Soil Testing conducted on(date): 9/21/2004 North Andover Board of Health Representative: Andrew McBregty In accordance with Title 5 Alternative to Percolation Testing Policy for System Upgrades,the soils in the area of the proposed SAS were determined to be Uncompacted. Sincerely, C) Susan Y. Sawyer, REHS/R� Public Health Director 1/17/2004 22:16 17813340115 TANGARDR PAGE 01 FORM 11 SOIL EVALUATOR FORMM Page 1 of 3 No. Date: Commonwealth of Massachusetts /►/o. ��o�; , Massachusetts ol:'Z yiuitabi ' Assessment r On-sit Sewage Disposal C/ �� JG Date: Performed Thy: l�.....................,� Witnessed By; ...., ,� .1 - ......... ...,. .,.,,. Wnnon ndkdt a / / � �4� �`�✓C/ ��Y Owner's Name. , �`��•"-- rl�/ ��•V , TeEpho e,n,/e �o Tekptrx New Construction ❑ Repair Office Review Published Soil Survey Available: No Yes .. Publication Scale r/� Soil Ma Unit Year Published �� ................ �................ . p Drainage Class�X Soil Limitations � '� Surficial Geologic Report Available: No ® Yes El Year Published ...v..• Publication Scale A. Geologic Material (Map Unit) ..................-...-............ Landform .. . ..................................... ............... . F Flood insurance Rate Map: Above 500 year flood boundary No El Yes Within 500 year flood boundary No 0Yes 0 Within 100 year flood boundary No ❑Yes 0 Wetland Area: National Wetland Inventory Map (map unit) ........................................ „.................. Wetlands Conservancy Program Map (map unit) ........ ....................................... Current Water Resource Conditions(USGS): Month Lange :Above Normal OlNormal El Belvv Normal ❑ Other References Reviewed: - DEP APPROVED FORM-12/07/95 ill '_1/17/2004 22:16 17013340115 TANGARDR PAGE 02 FORM XI - SOIL EVALUATOR HORINI Page 2 of 3 Location Address or Lot Igo, an-site Re-view Deep Hole Number f Date:. /...0 Time; l. Q Weather �. C'.�T4-.. ..... . ...... Location (identify on site plan) 7��A,....,..,...v.. ...... .... . . ..�..�. ..... .... Land Use .�/l �cr�'(.�1� Slope (%) Surface Stones Vegetation Landform Position on landscape lvl' Distances from: Open Water Body:004-5 feet Drainage way 7Q feet Possible Wet Area W-37 feet Property Line �'� feet Drinking Water Well ,,," ./&'V feet Other DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders,Consistency, % Gravel) C e- V rnivcl" �Gr✓�jz� �%GL Parent Material(geologic) ,! De_ � pthtoBedrock; depth to Groundwater; Standing Water in the Hole: weeping from Pit FBoe: Estimated Seasonal High Ground Water:__ DEP APPROVED FORM-12/0705 11/17/2004 22:16 17813340115 TANGARDR PAGE 03 FORM 11 - SOIL EVALUATOR FORINI Page 2 of 3 Location Address or Lot No, 121 ,/��/ On-site Review e Deep Hole Number Date:. //�, Time: Weather �� Location (identify n site plan) ��6�/... . ✓�l..l� Land Use . . - Slope M Surface Stones , Vegetation �G Landform Position on landscape Distances from: Open Water Body feet Drainage way ` � feet Possible Wet Area feet Property Line �d.., feet Drinking Water WellISp feet Other :...... .:.." :......::: DEEP OBSERVATION'NOLE LOG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(inches) (USDA) (Munsall) Mottling (Structure,Stones,Boulders, Consistency, % Gravel Pool" Mee- Parent Material(geologic) _.__ _...__ DepthtoSedrock;_ Depth to Groundwater: Standing Water in the Hole; Weeping from Ph Face: Estimated Seasonal High Ground Water;-��__ DEP APPROVED FORM•tj/07/95 ?1/17/2004 22:16 17813340115 TANGARDR PAGE 04 FORM II - S011, EVALUATOR FORM Page 3 of 3 Location Address or Lot No.,6� Deter wination or• Seasonal i h Water Fable Method Used: ❑ Depth observed standing in observation hole......... inches ❑ Depth weeping from side of observation hole inches Depth to soil mottles . . `� . inches 19l- ❑ Ground water adjustment ................... feet -4&2 — Index Well Number .................. Reading Date ............... Index well level Adjustment factor Adjusted ground water level .......... .. Depth-of- Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in qII 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 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, Signatur `/ ate DEP APPROVPID FORM-12/07/95