HomeMy WebLinkAboutSoil Testing Results - 20 ROCKY BROOK ROAD 9/9/1996 Town of North Andover, Massachusetts Form No. 1
NoRTN � BOARD OF HEALTH b ` f/
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^c° * APPLICATION FOR SITE TESTING/INSPECTIO
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Applicants � � TELEPHONE
NAME ADDRESS
Site Location CF's.
Engineer C� � ��h {�� 1d�
g NAME /� /ADDRESS G TELEPHONE
Test/Inspection Date and Time q/��JO�e
AIRMAN,BOARD OF HEALTH
Fee Test No. 9 (0
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
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CHRISTIANSEN S, i
PROFESSIONAL ENGINEERS AND LAND SURVEYORS
160 SUMMER STREET HAVERHILL, MASSACHUSETTS 01830 (508),373-0310 FAX: (508) 372-3960
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FORM 11 - SOII, E`'A1,UATOR F'O"I
Page 1 of 3
Rio. Date:
Commonwealth of Massachusetts
c> (j/.,,c, , Massachusetts
,Soil Suitability Al.ssessinertt for° On-site ,Sewage 1st
Performed By:
Date:
Witnessed By: `
Lmxiwn Address or owmi't Name.
ACW and
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ew construction M
Office Review
Published Soil Survey Available: No ❑ Yes
Year Published /rrU=` Publication Scale
/ 'I l � Soil Map Unit
Drainage Class ° ' Soil Limitations _ _... _...
Surficial Geologic Report Available: No ❑ Yes ❑
Year Published Publicatic 1 Scale
Geologic Material (Map Unit) ............................................... _.........................
i
Lanorrn .......... ......._..... .. ................
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 ErNonnal ❑Below Normal ❑
Other References Reviewed:
UEY APPROVED FORM- 12/01195
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FORM 11 SOIL EVALUATOR FOR,NI
Page ? of 3
Location Address or Lot lJo.
On-site Review
Deep Hole Number /� ®r Date: Time: Weather
Location (identify on site plan) 6 '-
Land Use Slope (°%) Surface Stones
Vegetation D
Landform CIC.�iiit�
Position on landscape (sketch on the back)
Distances from:
Open Water Body feet Drainage way;�/CJo feet
Possible Wet Area �h0 feet Property Line feet
Drinking Water Well IVIA feet Other
DEEP OBSERVATION HOLE LOG'
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface (Inches) (USDA) I (Munsell) Mottling I (Structure, Stones, Boulders, Consistency, %
Gravel)
Ll
57-5 ,
PROPOSED AREA
Parent Material (geologic) )LC— DepthtoSedrock:
Depth to Groundwater: Standing Water in the Hole: ° Weeping from Pit Face:
Estimated Seasonal High Ground Water:
DEP APPROVED FORM- 12/07/95
03-21-1996 14:36 617 932 7615 OEP NORTHEAST REGIONAL P.02
FORM 13 - PERCOLATION TEST
Location Address or
Lot No.
COMMONWEALTH OF MASSACHUSETTS
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14 � Massachusetts
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Percolation Test'
Date; Time:
Observation Hole # ��
Depth of Perc
Start Pre-soak
l� a�
Ertid Pre-soak
Time at 12"
Time at 9"
Time at 6 <
Time (9"-6")
Rate Min.11nch j
* Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed 5 Site Failed ❑ ......... ........................................................
Performed By, !�
Witnessed By:�,_ `
comments: _.. .. . -:. .... �. :
orr Am()vlm roars-u/07193
_ 1
-FOR—M 11 SOIL EVALUATOR FORM
Page ? of 3
�LocaLlon Add�r'ess or Lot ,vo.
On-site Review
Deep Hole Number Date: Time: Weather
Location (identify on site plan) �Ivezlj-'L.
Land Use Siooe ("o) Surface Stones
Vegetation
L andform
'Position on landscape (sketch on the back)
Distances from: -
Open Water. Body P fee*. Drainage way /U0 feet
Possible Wet Area feet Property Line j<D leer.
Drinking Water Well /�1A feet Other
I
DEEP OBSERVATION HOLE LOG'
Deoth from Sod Horizon Soil Texture Soli Color Soil I Other
Surtace (Inches) (USDA) (Munsell) Mottling I (Structure, Stones, Boulders, Consis iency, "o
Gravel)
Z/— G f �/-�Gt� L® ®yam yl j r // ®� g
y
r-s L -
HOLES I EVE KUPZ73cu DISPOSAL AREA
Parent Material (geologic) —/—/ L—r -- DepttttoBedrock:
G7 �r S
Death to Groundwater. Standing Water in the Hole: l® Weeping from Pit Face: _
Estimated Seasonal High Ground Water: —
DE?APPROVED FO"I- 12107195
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No. G �
Determination for Seasonal High Water Table
Method Used:
e� p th observed standing in observation hole inches �� � �` yo
pth weeping from side of observation hole- inches. 4/T"
Depth to soil mottles .3& inches
3U j
❑ Ground water adjustment feet
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 al ar as
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 Er-Mironmental Protection and that the above analysis
was performed by me consistent with the required training, expertise and experience
described in 310 CMR 15.017.
Signature J, Date
DEP APPROVED PORN- 12!07!95
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