The URL can be used to link to this page

Home My WebLink AboutSoil Testing Results - 594 BOXFORD STREET 7/30/1998 Town of North Andover, Massachusetts Form No. 1 01 6R ORTH BOARD OF HEALTH F qA ^^LEA / 'YO QL 19 Q _ m APPLICATION FOR SITE TESTING/INSPECTION ��SSA C HUS��y Applicant NAME ADDRESS TELEPHONE Site Location Engineer ;- NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg: Permit No. FORM 11 e SOIL EVALUATOR FORM Page 1 Date..... No. Commonwealth of MassaChUSettS Massachusetts Assessment oran-site Sew a e DisoWal Performed By: ..... ......... ............................... ......... Wimessed BY: ................ ........... ................................ ................... .............................. .......... ..................... ............................. ..................... ...................... o.."N.' wok%IN." ( L4eadon Address Or Address,AM Lot I Telephone New construction K Repair Office Review Yes Published Soil Survey Available: No Soil Map Unit ... Year Published llf...A- Publication scale Drainage Class WP.�.... Soil Limitations ....................................... ..................--....... . ......-.......................... ...... ...... Surficial Geologic Report Available: No Yes Year Published ................... Publication Scale Geologic Material (Map Unit) ... ........ .......-...--......................... ................................. Landform .....oorw. . A.... .................-............--........................... Flood Insurance Rate Map: Above 500 year flood boundary No El Yes El Within 500 year flood boundary No El Yes Within 100 year flood boundary No Yes Wetland Area: National Wetland Inventory Map (map unit) ,.. ........................................- ..................... ................ Wetlands Conservancy Program Map (map unit)....................:!7.................................................................. Current Water Resource Conditions (USGS): Month ...kv.S.vt'T Range Above Normal Normal Below Normal Other References Reviewed: FORM 11 ® SOIIu'EVALUATOR FORM: Page 2 On-site Review Dee Hole Number .....A........ Date:1.1jil?) Time:......:. b P�A Weather ...... 2..................... Location (identify on site plan) .......Wey.T......Tb........Gz4........ .. ......;a........-...UpT......V,...................... Land Use .... 0®:5........................ Slope (%) Surface Stones ..... ........................................................... Vegetation .....T2 .5......................._............................................................................................................................................................................................................... Landform .. ....tTuT ........�C .. 5 .................:................................................................ ................................................................................ Position on landscape (sketch on the back) ....... .. .P ...... ...................................... Distances from:= � A Open Water Body .- .. feet Drainage way........ ......... -- feet Possible Wet Area 73�; .. feet Property Line ...4d...... feet Drinking Water Well �.kl........ feet Other ......................................... DEEP OBSERVATION HOLE LOG Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (inches) (USDA) (Munsell) (Structure,Stones, Boulders, n _ Consistency, %_Grave! 0 — I-L11. !�. F.S a� tby YZ 312 ��otse 12`- z4 �M Parent Material (geologic) _.......................... ......................................................... ... Depth to Bedrock: ....C..t�.. Deoth to Groundwater: Standing Water in the Hole: o E. Weeping from Pit Face: A�'q.;J G Estimated Seasonal High Ground Water: ... ............ FORM 11 - SOLL EVALUATOR FORM Page 3 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 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 all areas observed throughout the area proposed for the soil absorption system? S If not, what is the depth of naturally occurring pervious material? Certification I certify that on Nab> 19�� (date) I have passed the 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. Signature Date FORM 12 - PERCOLATION TEST COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test Date: ` .. Time: ...... 2...`70.. '..PK Observation Hole # Depth of Perc tv0 %I Start Pre-soak - - 12 End Pre-soak DS Time at 12" Time at 9" Time at 6" Time (9"-6„) 1 Rate Min./Inch Site Passed �K Site Failed ❑ .............................................................................................................................................................. Performed By: Witnessed By: Comments: .................................................................................................................................................................................................... ........................ FORM 11 SOIL EVALUATOR FORM Page 1 Date..... No........ .......... Commonwealth of Massachusetts Massachusetts Soil sui—tabilia Assessment for ®n-site Sewa le Dis asad .............. Performed By: .......................... ........ .......... Witnessed BY: ................................... ................................I........................................................................................................................................................................................ Owner's Nurse. OP—TD t--) Locidon Address Or Address,W Lot I Telephone I 0 New construction Repair ❑ Office Review Published Soil Survey Available: No ❑ Yes Year Published lit?'.... Publication scale Soil Map Unit ... DrainageClass .... Soil Limitations .................................................................................................................. Surficial Geologic Report Available: No Yes ❑ Year Published ..........•••.•••.• Publication Scale ................. GeologicMaterial (Map Unit) ...................:...................................................................................................................... ........ Landform ...... .........I.......I................................................................. 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) .................................................................I............................................... Wetlands Conservancy Program Map (map unit)....................:!!n ..................I.: ........................................... Current Water Resource Conditions (USGS): Month ..;?�,T Range Above Normal ❑ Normal ❑ Below Normal Other References- Reviewed: FORM 11 - SOM;]EVALUATOR FORM Page 2 On-site- Review DeeL Hole Number .... ...... Date:.g9.� � Time:... �b Pn Weather 2-r..................... Location (identify on site plan) .......WET-:.......rt)........(62-4........ A ..... .......... . O.T.....'7.A.................... Land Use ....................... Slope (%) 3."'5.10 Surface Stones ..... .1,U........................................................... Vegetation ..... ? .,5.................................................................................................................................................................................................... Landform .......vvT v. St-........T IPYu 1....................................................................................`............................................................................. Position on landscape (sketch on the back) ....... . G .....--7vZ PnF. AP4's1. .,.....1 4.t. ...................................... Distances from: Open Water Body 7.�-�'.°...- feet Drainage way..:��A'... feet Possible WetArea7300.. feet Property Line ... ...... feet Drinking Water Well .�.O........ feet Other ......................................... DEEP OBSERVATION HOLE LOG -Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (Inches) _ (USDA) (Munsell) - (Structure,Stones, Boulders, Consistency, %_GraveO— C , tip 1CJ�((L(44 34`` Lo t2, ISY Parent Material (geologic) `--�. `}'�. I -..... )............................... .... Depth to Bedrock: ......�r7� Depth to Groundwater. Standing Water in the Hole: Weeping from Pit Face: .. ,?i-?E u Estimated:Seasonal HigR Ground Water: ..3.��'. FORM 11 - SOIL EVALUATOR FORM Page 3 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 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 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 N°4) 19r14 (date) I have passed the 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. Date Signature FORM 12 ® PERCOLATION TEST COMMONWEALTH OF MASSACHUSETTS ° �e.�c✓L_, Massachusetts Percolation Test Date: .. .... ..... ` .. Time: ..................................... Observation Hole # Depth of Perc 60(0 Start Pre-soak 12: 4's - - End Pre-soak 00 Time at 12" `1 DO Time at 9" Time at 6" Time (9„_6„) 5 Rate Min./Inch Site Passed Site Failed ❑ ............................................................................................................................................. Performed By Witnessed By: Comments.: .......................................................................................................................... ..................................................................................................... .p k FORM 11 - SOIL ]EVALUATOR FORM Page 1 No....... ...... Date..... Commonwealth of Massachusetts Massachusetts 'I Suitability Assessment for On-site zy ............................ PerformedBy: .........I......................................................I............................................. Witnessed By: ................................................................................................................. ............................................ .............................................................................................. Low=Address or Lot I Address,AM &Z4 Telephone New Construction Repair ❑ Office Review Published Soil Survey Available: No ❑ Yes Publication Scale J Soil Map Unit ... Year Published . ... DrainageClass Soil Limitations .............................................................................................................................. Surficial Geologic Report Available: No EK Yes ❑ Year Published ................... Publication Scale ................. GeologicMaterial (Map Unit) ... ........ ......:............I............................. .............................................................................. Landform .... ................................................................................................................................................. 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: NationalWetland Inventory Map (map unit) ................................................................................................................ Wetlands Conservancy Program Map (map unit)............................................................... ............................. Current Water Resource Conditions (USGS): Month ';,T Range Above Normal ❑ Normal ❑ Below Normal Other References Reviewed: FORAM 11 -SOW EVALUATOR TORM Page Z On site Review DeeL%Hole Number ...........C. Date:1.1111(a Time:...C'.f3b Weather 2— Location (identify on site plan) .......WIC.:......T..{z>........G2,4.........LAX >1 .....�rT........-... T...... -................... Land Use .... -'e o:S........................ Slope M 3•`55110 Surface Stones ..............................I............................ Vegetation ..... ..............................................................................................................................................................................••................... Landform ......cwT v ........h�F u�......................................................................................`............................................................................. Position on landscape (sketch on the back) .......`4; ....... z; 12A. k.,.......^ ...................................... Distances from: � A Open Water Body30D.. feet 'Drainage way........ ......... feet Possible Wet Area">3P�?.. feet Property Line ... ! ...... feet Drinking Water Well 1.0........ feet Other ......................................... DEEP OBSERVATION HOLE LOG Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other _ (Inches) (USDA) (Munsell) - (Structure,Stones, Boulders, Consistency, %_Grav&F YP_ 1_14 C17- -10�(L4(0 Parent (Material (geologic) ..................F...S'. --......................................................... ..... Depth to Bedrock: ..........z.... ..... Depth to Groundwater: Standing Water in the Hole:... Weeping from Pit Face: ....1 ?!--` Estimated:Seasonal High Ground Water: ... .......... FORM 11 - SOIL EVALUATOR FORM Page 3 6 Determination ,tor Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole................... inches ❑ Depth weeping from side of observation hole................... inches LCk Depth to soil mottles inches ❑ Ground water adjustment feet Index Well Number................... Reading Date ................... Index well level ................... Adjustment factor .................. Adjusted ground water level ........................................................ - Depth of Naturally Occurring Pervious Materiar - - Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? �JE; S If not, what is the depth of naturally occurring pervious material? Certification I certify that on N°q, 19n4 (date) I have passed the 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. Signature Date FORM 12 -PERCOIATION TEST 1 COMM,oNWEALTH OF MASSACHUSETTS Massachusetts Percolation Test Date: ....... Time: ......2.'.....................P ..... ........ Observation Hole Depth of Perc Wo Start Pre-soak End Pre-soak Time at 12" \,Zl Time at 9 \ \0 Time at 6" Z� Time (9„-6„) 1� Rate. Min./Inch Site Passed Site Failed ❑ ............................................................................................................................... Performed. By: Witnessed. By: - ''E'� � PAL C�'A,S Comments: ......................................................................................................................................................................................................................... NORTH ANDOVE R BOARD OF HEALTH AUTHORIZATION FOR SOIL TESTS LOCATION ENGINEER TEL# PAID DATE TO PORT Boxford Street Mike Rosati/Marchionda 781-438-6121 Yes Faxed 8/31/98 NOTE: This is additional testing for this lot. Already tested unsuccessfully with Port. Please schedule as soon as possible. Thanks. 'past-lt"l brand fax transmittal rnerno #of pages at F Fro ro"n C C( —7 -77 (5, Ph. he ff D Fax It # "1u ter„ Al g o,YJ A f • n p� ' r- k�� 00 e V- 64% '4 y WJ --. !1 , . dyr e - � VI . „rte co c a CP .,i rt %•, " �"� 'lzp." P