HomeMy WebLinkAboutSoil Testing Results - 50 ROCKY BROOK ROAD 9/9/1996 Town of North Andover, Massachusetts Form No. 1
NORTH BOARD OF HEALTH �) F
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�RA�RATEOE'PP\yc5* APPLICATION FOR SITE TESTING/INSPEC
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Applicant n ._
NAME ADDRESS TELEPHONE
Site Location /4- (2o C , l
Engineer, —�+„_L .....C'�
NAME ADDRESS TELEPHONE
Test/Inspection Date and Time '713vA�
115 ACC AIRMAN,BOARD OF HEALTH
Fee Test No. �� q
S.S. Permit No. D.W.C. No. . C.C. Date Plbg. Permit No.
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FORM II - SOIL EVALUATOR F'ORNI
Page I of 3
No.
Pate:
'I Commonwealth of Massachusetts ��
21() Mass ach
,fail Suitability Assessment or Ott-site Sewage Disposal
I
�l
�! Date' �
Performed Ely:
Witnessed By:
Lom,Iwn Aeerr.+s of
eW Construction I 1 Repair ❑
Office Review
Published Soil Survey Available: No ❑ Yest I
Year Published 1gjj Publication Scale / 11467 Soil Map Unit
Drainage Class
b✓r Soil Limitations
�
Surficial Geologic Report Available: No ❑ Yes ❑
Year Published Publicatic i Scale
Geologic Material (Map Unit)
Landform
Flood Insurance Rate Map:
Above 500 year flood boundary No l YYes
Within 500 year flood boundary No UYes ❑
Within 100 year flood boundary No R I Yes ❑
Wetland Area: ,
National Wetland Inventory Map (map unit) _..... ......
Wetlands Conservancy Program Map (map unit)
................................................................
Current Water Resource Ca ditions (USGS): Month
g
Ran a :Above Normal Normal ❑Below Normal ❑
Other }references Reviewed:
DE'P APPROVED FORM- 12/07195
FORM 11 SOIL EVALUATOR FOR'11
Page v of 3
Location Address or Lot ;Jo. 23
On-site Review
Deep Hole Number Date: 3® Y6 Time: 149 62611 Weather (-e 'Z'k
Location (identify on site plan)
Land Use ,Slope ( ,o) Surface Stones A4
Vegetation
Landform /�y�y(.�.�„•rte,
Position on landscape (sketch on the back) ..(���
Distances from:
Open Water Body ��o� feet. Drainage way,,'�/40 feet
Possible Wet Area feet Property Line feet
Drinking Water Wei feet Other
DEEP OBSERVATION HOLE LOG*
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surtace (Inches) I USDA) I (Munsell) Mottling I (Strucure, Stones, Boulders, Consistency, %
Gravel)
° 4� �? sZ. lOyg,/z - V,C:�a f
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Z� /-f V F� / .
17 L' lam' 2,SOILI 2 4c ' /I VIP-/ rozas-
MINIMUM OF 2 HULEb HF-QUrR=T EVERY PROPOSED DISPOSAL AREA
Parent Material (geologic) —'/ /L—L— DepthtoBedrock:
rr '7 cr
Depth to Groundwater: Standing Water in the Hole: 76 Weeping from Pit Face: 7G _
Estimated Seasonal High Ground Water:
DEP APPROVED FORM-12/07/95
i
FORM 11 SOIL EVALUATOR FORM
Page ? of 3
Location Address or Lot ivo. 23 o
On-site Review
Deep Hole Number ° Date: 30 xr Time: A oo Weather
Location (identify on site plan)
Land Use Slope (°,o) Surface Stones y�
Vegetation x6-1140 0 0
Landform
Position on landscape (sketch on the back)
Distances from:
Open Water Body feet Drainage way/ U feet
Possible Wet Area / VDU feet Property Line jCj feet
Drinking Water Well 1111A feet Other
DEEP OBSERVATION HOLE LOG'
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface (Inches) I (USDA) (Munsell) Mottling I (Structure, Stones, Boulders, Consistency,
Gravel)
MINIMUM OF 2 HOLES REQUIRED I EVERY PROPOSED AREA
Parent Material (geologic) 7—/4-z— DepthtoBedrock:
u y
Depth to Groundwater: Standing Water in the Hole: G Weeping from Pit Face:
r�
Estimated Seasonal High Ground Water:
DEP APPROVED FORM- 12107/95
FORM 1I.- SOIL EVALUATOR FORM
Page 3of3
Location Address or Lot No. 03 G 7
Deterfnination -for Seasonal High Water Table
Method Used:
Depth observed standing in observation hole ,inches
Depth weeping from side of observation hole 7G eg inches.
�Depth to soil mottles Z/,/-'(inches
❑ 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 p1l 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 11 (date) I have passed the soil, evaluator examination
approved by the Dep rtment 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.
Signature J, Date zz�
DEP APPROVED FORM- 12/07195
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