Loading...
HomeMy WebLinkAboutCorrespondence - 851 JOHNSON STREET 8/13/2004 o m b CD a ® 0 ° d f �� w Qot ti n Ln n.] O O O O Z y A oo 10 v, CD W N O N fD ul ul O � x 0'li b rTl p m n N°o c o o x ''� lid C CD o ° o a c. m c • a .y tro QQ 41 CD fD d c CO (IQ O O A � N A 00 b�A z C A A <o A tf° A A A co CD N O l�f, o CD 00 i o w o 0o n o ° g E. CA x _ LI) 3 5' n CC' CD Cenci c CD H. CD =° n, a y l as Q CD 11 -121 NO Co' w °- 0 a s o Cs x '. a o y.E,' # w y• G O w w w w o• .y O O O O R• X CD O A M ? A A A K a a•w p z _a O r. =s y w O O O O O p ti .'� O 'p 'i_00 Z 00 z 10 10 10 � � n 00 cc 00 00 ° _ O Y a a ° a O O �U z w ET CD N Z d Z N � O O A CD O C N VJ o CDN O y � r b' s CD D � m b ro N N O O A A O O � N N a � � O y N N O O O O 41 �• A m m � C7 C7 cr. I �'p c � O N N O O A A O O W W 00 � W 00 b a � a o "O fi Q CD Town of North Andover Of NORTH Office of the Health Department o? °4 Community Development and Services Division 4 400 OSGOOD STREET "," •' . ,a+" North Andover, Massachusetts 01845 1a3 c►+uge Susan Y. Sawyer, REHS/RS 978.688.9540-Phone Public Health Director 978.688.9542-Fax fW9W 7j"q E OT C09Y(''.GIAXCE As of 9V arch 16, 2005 This is to certify that the indivictuafsu6surface d4osa(system repaired(X) — FuffSystem by James 'ellett at 851 lohnson Street .North Andover, 9KA 01845 has been instalrfed in accordance with the provisions of 7itfe V of the State Sanitary Code and with the North Andover Board of Meafth regulations. The issuance of this certificate shall not 6e construed as a guarantee that the system wiff function satisfactorify. S T Sawyer B'u61rc Yfeafth Director BOARD OF APPEAI.S 688-9541 BUILDING 688-9545 CONSERVA'T'ION 688-9530 HEALI'14 688-9540 PLANNING 688-9535 North Andover Board of Health MEETING MINUTES DPW 384 Osgood Street Thursday—MARCH:25,2004 7:00 p.m. New Business Meeting Minutes Approval of February 26,2004 Board of Health Meeting presented for signature. Mr. Markey approved and Ms. Barczak seconded. All were in favor. . Mike Reilly of F.P. Reilly & Sons to meet with the Board of Health regarding 258 Bridges Lane, A presentation was given by Susan Sawyer regarding problems with the first excavation at which point the installer hit rock ledge. The engineer, Mr. Ben Osgood of New England Engineering called for a final inspection of the system. The Septic Consultant, Mr. Dan Ottenheimer, found some problems with the elevations in relation to the plan. Mr. Osgood changed a number on a pipe in the field, which did not match the plan. Two surveys were completed on this site: 1. Survey One was completed by an independent surveyor hired by the Town of North Andover; 2. Mr. Osgood also hired an engineer to have a survey done. The problem at hand for discussion is that the septic installer, Mr. Mike Reilly of F.P. Reilly & Sons should have immediately called the Health Department with any problems. It was stated that the field is too low at this site. A question was posed by Ms. Sawyer to the Board. members as to whether there is anything that Mr. Reilly should be responsible for in terms of consequences with regard to building according to the plan. Mr. Osgood states that when the problems with the elevations arose, the sill elevations did not correspond with the benchmark in back. The new system is located in the woods. The benchmark was not set at the time, so it was stated on the plan, with the intention of setting the benchmark. The labeled elevation was mis-labeled on original plan. A rod reading was taken in back, and there was a foot and a half mistake. Mr. Osgood takes responsibility for the error, as Mr. Reilly was merely following the plan changes. Mr. Reilly should have called the Health Department instead of calling the engineer. Mr. Osgood stated that in the past, the Health Department did not always work this way. There have been changes brought about in how the department works due to the transition of a new Health Director, and two different septic consultants. h1 addition, Mr. Osgood states that a new plan has been done. The second issue was that installer needs to attend a training when using a new infiltrator system, and not just watch a video. Mr. Reilly states that the issue at hand with this particular location was that the cufflinks could not be pushed into the ground. Title V requires training on this system. Mr. Reilly took the training two years ago. Mr. Markey asks if there should be any disciplinary action. Ms. Barczak inquires as to what has been done in the past. Ms. Sawyer and Mr. LaGrasse state that there were other March 25,2004 -North Andover Board of Health Meeting-Agenda Page 1 of 5 Board of Health Members:Cheryl Barezak,Clerk; Jonathan Markey,Chairman; Thomas Trowbridge,DDS,AID,Member; Health Department Staff-Susan Sawyer,Health Director; Brian LaGrasse,Heal&Inspector,Debra Rillahan,Puhlic Heallh Nurse; Pamela DelleChiaie,Health Department Assistant issues that have come to the attention of the Board in the past. Mr. Markey suggests a probationary period for Mr. Reilly for three installed systems to be reviewed upon installation and to be sure that they are all completed properly. With regard to 258 Bridges Lane, there were a lot of issues with the buyers and sellers. Mr. Osgood said that he would pay for the cost of the surveyor in the amount of$500 payable to the Town of North Andover. There will be a probationary period of three (3) septic installations for Mr. Reilly, and the probation will be, lifted after that time. The Board of Health accepts the offer of Mr. Osgood to pay for the additional survey that was paid for by the Health Department. Mr. Ben Osgood of New England Engineering presents the following requests for variances for Local SepticUpgrades on the following properties: r 551 Johnson Street I. A local bylaw variance to use a segmental block retaining wall and; 2. A reduction from the leachfield and the house from 20 feet to 18 feet. Two test pits were completed. A system was designed to accommodate the current three-bedroom house. A membrane was used as a barrier to reduce the slope. The bylaw requires a poured concrete wall that is very expensive at approximately $100 per lineal foot. Part of the problem is that the septic contractor does not pour the wall—a separate contractor has to pour it in. The segmental block walls are four (4) feet in height, and can be installed by the septic installer. The segmental wall is pointing toward the neighbor. The segmental block wall will prevent effluent from breaking the barrier, and the system should be serviceable for a long time. The size of the blocks specified are the ideal blocks to use. As long as there is a four (4) foot wall, blocks from any manufacturer can be used. Ms. Sawyer commented that the exposed rock is an issue during evaluation, as the consultant stated that there might be ledge. However, Mr. Osgood states that it is a large rock, and not ledge. Note: A certification form can be found online. The engineer will fax over a sheet, and plug in the values. We need this certification form before a permit will be issued. Mr. Markey stated that the exposed rock could be an issue. Mr. Osgood states that he thinks the rock will come right out. The rock in the back is probably very large, or bedrock. The system location is taken off of the As Built plan. Mr. Markey states that if the rock does not move, he can have the wall angled to make the grade. Ms. Sawyer inquired as to what the reserve area is in relation to the foundation. The soil tests were done at five (5) minutes per inch. Mr. Markey states that the topography is away from the foundation. Dr. Trowbridge asked if there was a barrier between the edge and the foundation. Mr. Osgood states that the installer goes down 10-15 feet to put in a barrier. Mr. Markey would rather not see a barrier around four(4) sides,just one. The porous soil would prevent risk to the foundation. Ms. Barezak made a motion to allow for reduction in the leachfield from 20 to 1.8 feet, and for segmental blocking. Dr. Trowbridge seconded the motion. All were in favor. March 25,2004 -Norlh Andover Board of Health Meeting-Agenda Page 2 of 5 Board ofHealth Members:Cheryl Barezak,Clerk; Jonathan Markey,Chairman; Thomas 7),olvbridge,DDS,AID,Member; Health Department Staff Susan Sawyer,Heahh Director; Brian LaGrasse,Health Inspector,Debra Rillahan,Public Health Move; Pamela DelleChiaie,Health Department Assistant Page 1 of 1 llhii , Pamela From: Dan Ottenheimer[info @millriverconsulting.com] Beat: Thursday, March 18, 2004 11:00 AM To: Susan Sawyer; Brian LaGrasse; 'Pamela Dellechiaie' Subject: two documents Sue, Brian and Pam, I have attached two documents for your review and use. First is an approval letter for 851 Johnson Street. I left an area of the letter blank so it can be filled in after the Board of Health meeting (assuming they approve the variance request and local upgrade approval request). Second is a document we have written which describes how Boards of Health should look to review variances and local upgrade approvals. The subject is somewhat dry so we put together an explanation at the beginning, and then put in appropriate sections of Title 5. The Title 5 sections are divided into two categories: factors to consider when reviewing a variance or LUA, and procedures to be followed with a variance or LUA. This is not in the same numerical order as in Title 5, but I think is more easily understood this way. We also described what each section of Title 5 was before giving the actual text. Hope this is of use to the Board members. Feel free to share it with them in whatever format you see fit (paper or electronic). Dan Daniel Ottenheimer,President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 WWW.rnitla°�����'�°��:w 4/6/2004 .._ .. ........ ....... __ ...... February 24, 2004 ,.:. , 6-: o-:RirHAN'uu Susan Sawyer kG,O : :�� ��.°�� u �� .ro North Andover Board of Health 27 Charles Street E B 2 4 91 North Andover, MA 01845 Re: 851 Johnson Street,North Andover, Septic system design Dear Susan: Please accept this letter as a request that the Board consider the following local upgrades and variances included on the septic system design for the above referenced property. They are as follows: Local upgrade approval. 1. Reduction in the distance between a leach field and a foundation wall from 20 feet required by Title 5 section 15.211(1)to 18 feet. Local variances required 1. Allow the use of a segmental block retaining wall in lieu of a poured concrete wall as required by North Andover Regulation 9.02 If you have any comments or questions please do not hesitate to contact this office. I will plan on attending your next regularly scheduled Board of Health meeting to address this matter. Sincerely, Benjamin C. Osgood, Jr., LIT President 00 F,-'. :CHwOOD DRIVE-NOV't'1li ANDOVEIR, Mph 01 X 45,.(078)686..1768-(088)359-7645 . FAX(978)C5R'5.40„0 Town of North Andover HEALTH DEPARTMENT 27 Charles Street North Andover,MA 01845 978.688.9540 healtlidepWmynofnorthandover.com SEPTIC PLAN SUBMITTAL FORM DATE OF SUBMISSION: SITE LOCATION: 8,5 l v E t w TI ENGINEER: 1J NEW PLANS: YES $225.00/Plan Check#: (Includes Ist(NE' P and one Re-Review Only) REVISED PLANS: YES ,x $75.00/Plan IV Check#: SITE EVALUATION FORMS INCLUDED: YES NO LOCAL UPGRADE FORM INCLUDED: YES NO Telephone#: `/ '7 �3� i 7 G Fax#: l 8-- >` -r 9 y E-mail: �t/c;LS L n� /� �? L c-—\ HOMEOWNER NAME: P1 -(-✓-}0 k7 A) Pr w P o c i� OFFICE USE ONLY When the submission is complete(including check): 1. Date stamp plans and letter 2 Complete and attach Receipt 3. Copy File; Forward to Consultant 4. Enter on Log Sheet and Database ««.......,,..:...,ii .,iiii ...i...i...i...i.i. .i...ii. .i.i.. . NEW m ENGINEERING ..o..o....o.....i .mm . iii.a .i.i.W..�. R i C nn xn �.,...,...i...... ...� .i.�...�... �........v«• .......� INC ...... �....i uuuuu�.uuuw w uwuu iww.weu............... ...uwu w.uuuuu u yy � u�n» nu �Y February 24, 2004 Susan Sawyer North Andover Board of Health 27 Charles Street North Andover, MA 01845 Re: 851 Johnson Street, Septic system design Dear Susan: Enclosed are 5 sets of revised septic system design plans for the above referenced property. The changes made address the comments in a letter fi•orn Mr. LeGrasse dated February 4, 2004. 1. The design has been modified to be for three bedrooms. 2. Construction note 4 has been modified to include removal of the first 6"of"C" layer 3. All setback distances have been added to the plans.. 4. General note 6 has been revised to indicate that the dwelling does not have a foundation drain. 5. The distribution box detail as well as the system profile detail have been modified to indicate that all outlets are at the same elevation. 6. The septic calculations are for a three bedroom home which is what is now designed on the plan. 7. Form 12 is enclosed, 8. The walls have been revised as part of the reduced leach area size however the walls are still segmental block walls. A local bylaw variance has been noted as being required on the plans. 9. The septic tank loading has been specified. 10. Mmm 11. The leach trenches have been moved down hill in to the area that was previously used as the reserve areas. This enabled the barrier to be placed in a location that would accommodate both the primary and the reserve areas. It also enabled the septic tank to be lowered so the system could more easily be serviced by gravity. The upper reserve area will need a pump to enable future use. A note has been added to the plans reflecting this requirement. It is not possible to modify the interior plumbing to accommodate the upper reserve area trench being serviced by gravity. 60 BE ECsEd17tJC.)OD DRIVE-NORTH ANDOVER, MA 01845..( -78)686-1766. (88 8)359-7645- FAX(975)685-109 12. The outcrops have been noted, however it is not the belief of this office that the outcrop adjacent to the proposed system is bedrock. It appears to be a large exposed rock. 13. This office does not agree with having to do an additional test pit prior to approval of the plans. The leach field is within 25 feet of the test pits that were excavated as part of the on site testing. A more appropriate method of insuring that there will not be a problem is to excavate a test pit at the south end of the system just prior to construction to confirm the presence of 4 feet of naturally occurring soil. These plans are being submitted for approval. A separate letter requesting that the board approve the local variance and local upgrades is enclosed. If you have any questions please do not hesitate to contact this office. Sincerely, Benjamin C. Osgood, Jr., EIT President Page I of I DelleChiaie, Pamela .......... From: Dan Oftenheirner[info@rnillriverconsuffing.corn] Sent: Thursday, February 05,2004 8:45 AM To: Heidi Griffin; Brian LaGrasse; pdellechiaie@townofnorthandover.com Subject: 851 Johnson Street Atfacf-ied please find the plan review letter for 851 Jotinson Street. You will see that the design failed to depict the bedrock outcrop which appears to be locafed in or near the soil absorption system. The two test its are also located very close to one end of f he [each trenches and with the shallow deptl,�) to ledge at this site, we feel it prudent o have additional test holes dUg of the other end of the proposed le('ich tre,riches. This will avoid problerns like what we had at 258 Bridges Lane, Dan Daniel 0f elmer, President Mill River Consulting Septic System Mc7nagernent Services 2 Blackburn Center Gloucester, MA 0 1930-2259 978-282-0014 or 1 800-377-3044, fax: 9 78-282-00 12 www irnrllNu' Corn 2/5/2004 TOWN f' NORTH ANDOVER Office of COMM UNIT`S DEVELOPMENT AND SERVICES at . . . o HESL D s- � M N l .R,.. ....- ... a � F 27 CHARLES STREET utM1iOY ApPy 5 NORTH ANDOVER, MASSAC1-ft.JSETTS 01845 �ss.,CHUS��� Susan Y. Sawyer, REI-1S/R.S 978.688.9540 -Phone Public Health. Director 918.688.9542 - FAX April 5, 2004 Mary Ann& Richard Nawrocki 851 Johnson Street North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan for 851 Johnson Street, Map 107A, Lot 62, North Andover, Massachusetts Dear Mr. &Mrs. Nawrocki, The North Andover Board of Health has completed review of the septic system design plans for the above referenced property submitted on your behalf by New England Engineering Services dated February 23, 2004. The design plan was technically complete and the requested variances to state and local design standards were reviewed and approved at the Board of Health meeting of March 25, 2004 with regard to reducing the leachfield from 20 to 18 feet, and allowing the segmental block wall. The design has been approved for use in the construction of a replacement onsite septic system. This approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. The time period for which this plan is valid is reduced to two.years from the date of a septic system inspection which did not meet the acceptable criteria in the state regulations. The time period for which this plan is valid may be reduced by the North Andover Board of Health in the event an imminent health problem such as sewage backup into the dwelling is occurring. This approval is subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit (3 10 CMR 15.020(1)). 2. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board,Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. 3. During the time of construction, confirmation of the availability of suitable soil on the Southern edge of the soil absorption system will need to occur. If soil conditions are found to be different as provided for on the design plan, work shall cease and the construction permit shall be void. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincerely�' Sus Y. Sawyer, REHS/RL� Pu lic Health Director encl: List of licensed septic system installers cc: file New England Engineering Services Page I of I DelleChiaie, Pamela From: Dan (Ottenheirner[info@millriverconsulting.com] Sent: Thursday, February 05, 2004 8:45 AM To: Heidi Griffin; Brian LaGrasse; pdellechiaie@townofnorthandover.com Subject: 851 Johnson Street AHacf'ied please fird the plan teview letter fu 851 Johr'isor) Stree-L Y(:)u wiH see that the desip-� faile(J Io depicf fhe bech(�)ck oulcror) which al1')peais to be loca ir- or fhe soil absoq'..')fic)r"i systeryi, 'H-ie two test pils are also loc'x fled very CIOSE' fo one end of 1he leach fireriches ap d wiih the shallow de[DH'I 9O ledge at ffiis sile, we feEfl i9 l,-)r-(.,)denl (�:> haVE (Aditional lesi holes dug of the ofh& erid of the proposed leac:h frenches, R-Os will avoid p�)roblerns like whac e l m ad at 258 Bridges Lane, Darilel Ofietihehner, hesident ll ---------- -- -—------ Mill River, Consulfirig yet--Yfic, Sy!.;fe n Managern(-,A t S(-,rvices 2 Blackloup r rp Cl'ei-iler ("I ouc,(,-ester, MA 01930-2259 978-282 00 14 or 1 800-377-3044 fax.- 978-282-00 l 2 www,L 3/30/2004 TOWN ()F NO ICI TI ANDOV�[ilt, 0, tl Office 1111KVEL0PMF',NTAN11 SF111tV'l('1 ES 1( HEA131-1 DEPARTMENT 27 CHARLES S"IRFET NOR'H I ANDOVER, N4ASSA(,11LJSF11'TS (H845 �eidi Griffiln 978,6W9540 Phone Acting, ficalth Director 978 688,9542 17AX February 4, 2004 Richard Tangard, P.E. New England Engineering Services 60 Beechwood Drive North Andover, MA 01845 RE: 851 Johnson Street, Map 107A, Parcel 62 Dear Mr. Tangard, The proposed septic system design plans for the above site dated January 2, 2004 and received on January 20, 2004 have been reviewed. Unfortunately, the plans cannot be approved as submitted. The following items are in need of attention prior to approval: 1. The proposed design flow is for a 4 bedroom house while the existing dwelling has 3 bedrooms, The additional flow desired requires that the design meet new construction standards in state and local regulations. The use of the Infiltrator system requires the designer to demonstrate that a standard soil absorption system can be placed in the same location with a conventional primary and reserve area(See: DEP Infiltrator Modified Certification for General Use dated February 21, 2003: Section IV. Conditions Applicable to the System Owner, Paragraph 2). 2. Please indicate that removal of soil horizons A&B shall extend at least 6" into the suitable soil of the C horizon or request a variance from this regulation. (NA 9.02) 3. Please provide setback distances on the site plan such as the septic tank& SAS to the dwelling& property lines. (NA 8.03) 4. Please provide a note regarding whether a foundation drain does or does not exist within the setback standards indicated in the regulations. (NA 8.02) 5. Please specify that all distribution box outlets are to be at the same elevation. (3 10 CMR 15.232) 6. The calculations for the septic tank size do not reflect the design flow of 440 gallons per day. 7. Please provide the percolation test results on DEP Form 12. 8. The retaining wall indicated on the design plan must be reinforced poured concrete. (NA 9.02) 9. Please specify the septic tank loading. 10. Please clarify the notation for the elevation of C,found in Test Pit#2. 11. The proposed impermeable barrier installation will compromise the integrity of the reserve area soils. Please amend the location or configuration of either the barrier or reserve area to assure they do not coincide in location, 12. Please indicate the bedrock outcrops on the property in the vicinity of the proposed soil absorption system. 13. The parcel has shallow depth to bedrock present and the design of the soil absorption system is located a considerable distance from demonstrated suitable soils. In order to avoid costly problems during the construction phase, please arrange for additional. soil testing to be performed to confirm the suitability of soils in the vicinity of the southern end of the proposed soil absorption system. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincerely, Y, Brian LaGrasse Health Inspector cc: Homeowner CD&S Dir. File NEW ENGLAND ENGINEERING SERVICES January 15, 2004 Brian LaGrasse T �i OF N0 M�"" North Andover Board of Health BOAFM OF I1FALTH. 27 Charles Street North Andover, MA 01845 i Re: 851 Johnson Street, Septic system design Dear Brian: Enclosed are the following documents concerning the above referenced property 1. 5 sets of septic system design plans. 2. Copy of Form 11 soil evaluator sheets. 3. Application for approval. 4. Check to cover the review fee. These plans are being submitted for approval. If you have any questions please do not hesitate to contact this office. Sincerely, Benjamin C. Osgoo"d, Jr., EIT President 60 BE[-.0 MOOD DRIVE -Nd€;')Pd rIl ANDOVER, MA 01845-(978)686-'1768.. (888)359-7645- FAX(975)685-1099 SEPTIC PLAN SUBMITTALS LOCATION: l °) i > -�./Z �-% Map &Parcel NEW PLANS: ' $225.00/Plan Check#: (, 7 . REVISED PLANS: YES $ 60.00/Plan Check#: SITE EVALUATION FORMS INCLUDED: YES NO LOCAL UPGRADE FORM INCLUDED: YES CNLoj DATE: ' o v DATE TO CONSULTANT: DESIGN ENGINEER: k ) E A-�(,-t-A t Telephone#: i ��✓ � 0, 11 When the submission is complete (including check),date stamp plans, COPY for Conservation,and place in existing file with green Design Approval form. FORM 11 SOIL EVALUATOR FORM Page I of 3 No. Date: Commonwealth of Massachusetts /VO A4VV , Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed By: ........... P.....Cr Date: ���/4 3 Witnessed By: P/) - ..................r3.................................................... .................. ....... ........ .......... .. L=afion Address or Lot I A"01,and A/0. Tclephone I 7._ • A/0. r4ew Construction ❑ Repair 17 L_ .Office Review i Published Soil Survey Available: No ❑ Yes Z Year Published /? , :........... Publication Scale "ew.... . Soil Map Unit Drainage Class ....477"......... Soil Limitations .................................. Surficial Geologic Report Available: No K Yes ❑ Year Published Publication Scale GeologicMaterial (Map Unit) ....I..............I..................... ............................................................. Landform .......................................I................................................................................................................................ Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes EZ 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 eel-0,9472- Range :Above Normal ❑Normal QBelcwNorrnal ❑ Other References Reviewed: DEPkPPROVED FORM'-12/07/95 FORM. 11 • SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. ��� ���!'��/ JT �• ��d�.� _On-site Revie Deep Hole Number J w. Date:�//V1'0 Time:. T. Weather Location (identify on site plan) Land Use / �r/ � Slope (%) . , Surface Stones Vegetation ' Landform : ��� �5 .. . r/�'lGl!v. ........ , ... Position on landscape .Distances from: Open Water Body feet Drainage way 4 feet Possible Wet Area ��� feet Property Line ...2r feet Drinking Water. Well • feet Other .. DEEP O$SERVATION'HOLE LOG' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches),: (VSDA) (Munseii) Mottling (Structure, Stones, Boulders, Consistency. s: Gravel) Y r, Dl Nv I ��e �G�-- DepthtoBedrock: Parent Material (geologic) -- 0opth to Oroundweter: Standing Water in the Hole:, _ Weeping from Pit Face: Eslimated Seasonal High (around Water DE►APPROVED FORM 11107I9S FORM 11 - SOIL EVALUATOR FORM Page 2of3 Location Address or Lot No. �✓ L- On-site Review Deep Hole Number .2 Date:.:. /�?/�3 Timer /-�� Weather plan) �� Location (identif on site Ian) :.v...::..,::. .::.. Land Use Slope (%) Surface Stones Vegetation .. Landform Position on landscape --:�rjc Distances from: Open Water Body � feet Drainage way feet Possible Wet Area �0i4-96. feet Property Line feet Drinking Water Well,/,'f-O. 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) Lc Parent Material (geologic) DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: — Weeping from Pit Face: Estimated Seasonal High Ground Water._ DEP APPROVED FORM, 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. �-�� G�`-��/�J,� �T� RO.'Al--)49 Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole................... inches ❑ Depth weeping from side of observation hole ............ ..... inches © Depth to soil mottles .:,::.:K� inches v ❑ Ground water adjustment ................... feet2 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 all 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 ep ment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 31.0 CMR 15.017. Signature-p, Date Y DEP APPROVED FORM•12/07/95