HomeMy WebLinkAboutSoil Testing Results - 40 OXBOW CIRCLE 2/24/1992 Town of North Andover, Massachusetts Form No. 1
p1ORTH BOARD OF HEALTH
01
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APPLICATION FOR SITE TESTING/INSPECTION
ADRATED PPP �(5
�SSACHUS��
Applicant
NAME ADDRESS TELEPHONE
Site Location-- l � W C �4 �;�a�-�t���
Engineer
NAME ADDRESS TELEPHONE
Test/Inspection Date and Time
`41 CHAIRMAN,BOARD OF HEALTH
Fee Test No.
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No
Town of N th ndover, Massachusetts Form No. 1
NORTH •A'� A OF HEALTH
16 C
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APPLICATION FOR SITE TESTING/INSPECTION
7Q DRATEDE APay RS
�SSACHUS'-
Applicant__ &-u—
NAME ADDRESS TELEPHONE
Site Location L =-tk- ��r c1�'�__t :�u �� VVL_ I C�'x100�'j C.y_d'-t
Engineer -�
NAME 8 ADDRESS TELEPHONE
Test/Inspection Date and Time
CHAIRMAN,BOARD OF HEALTH
Fee Test No. 17 3 ?
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No
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FORM 11 - SOIL EVALUATOR FORM
Page 1
Date.... .-Z. .. ........
Commonwealth of Massachusetts
Nof-TK A►. wvap., Massachusetts
foil Suitability Assessment for On-site Sewage Disposal
Performed By: ....W...a.Li.A.l` .......................
Witnessed By: :..: '.L1S:F:t�,) ... QR. .. ........
.................................................................................................................................
Location Address or Owtser's Name, A.C, gV�LtaE2S 11�►L'
Lot N Address,and '33 W n�k�� QO A
/�
Telephone rl L
No(Z—rj4 / t zove2, HA.
DI gNS
d D E251AVSS
New construction Repair ❑
Office Review
i
Published Soil Survey Available: No ❑ Yes
f.`. ►Sgyv Soil Ma Unit ...��.Q... GR.
Year Published .�.�[ �... Publication Scale . �p«c ')LrC-iz'P f Ct+�4t�o7t�ti(�
Drainage Class ........ Soil Limitations ..... EvE. ................................................................................
1....r���t�s
Surficial Geologic Report Available: No ❑ Yes ❑
Year Published ............... Publication Scale ..................
GeologicMaterial (Map Unit) ......... .....................................................................................................................................
Landform .......................... .........................................................................................................................................................................
Flood Insurance Rate Map: -H 71-S-00 lie 00 to P5 6–is- 01
Above 500 year flood boundary No ❑ Yes U
Within 500 year flood boundary No Yes ❑
Within 100 year flood boundary No lVJ Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit) ..............C2.u..... ..........p. +.. A ❑.0..! 1......
Wetlands Conservancy Program Map (map unit) .................-.................................................................
Current Water Resource Conditions (USGS): MonthvL`�
Range : Above Normal ❑ Normal D"'� Below Normal ❑
HSS�r�cp
Other References Reviewed: V S 6
FORM It - SOIL EVALUATOR FORM
Page 2
On-site Review
Deep Hole Number A,.2...... Date:.6-2.y-.9 Time: Weather C..C..x..,A.Y..,... .v........
Location (identify on site plan) ......FAO..I.FI'...Ydl.&—P...................................................................................................................................
Land Use .. !.!!.la,...trNM...H.5. .:..... Slope (% ... ........ Surface Stones .....r!l�.l,(.y..........................................................
Vegetation .......G AR L?....... > ,P.G..1=.... uSl .................................................................................................................................................
Landform ........NJA ...................................................................................................................................................................................................................
Position on landscape (sketch on the back) ....... ..................................................................................................................
Distances from:
Open Water Body .... feet Drainage way...2.51 - feet
Possible Wet Area .APP.t. feet Property Line ....1.U.. -.. feet
Drinking Water Well .loo. .... 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, % Gravel)
A, wq 1z z1z
tlo"-2s" C, 6RAV. CaA tv'40- SC r,u4.
S iA uD t•wrt�S
Z5'-3b" 'r2 HaD, 5A)JD 2•Sy sly 2,Sy(-i-SJy M < F
f t
3l� -58 L3 &RA V. L.S, 2•sy��y MfF
gj3- ey wAMy sAj�ro I-5\1 Z MSF
to r API=
talt R S1 A'
Ilo"- q0- C V. eARAV'' tuvs s�,�
d0A. `eAA1D 4 GR
`fib"-12�'' G2 GRav c.•S. 2.sY Sly r� s P.wTS 'Tb Rio"
2•S`tR 2�s�w
Parent Material (geologic) ....6 C.I.A.L........rLlet .................... Depth to Bedrock: ....WA...........
Depth to Groundwater: Standing Water in the Hole: ........... Weeping from Pit Face: . ..(.�.Z�'
Estimated Seasonal High Ground Water: .3• /�(®
FORM 11 - SOB, EVALUATOR FORM
Page 3
Determination for Seasonal Higji Water Table
Method Used:
❑ Depth observed standing in observation hole..... inches
❑ Depth weeping from side of observation hole ..�.......: .... inches
k3 Depth to soil mottles 32�'./..qO"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? 5 � – —
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on G' (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 Lejjt ate
FORI\7 12 - PERCOLATION TEST
COMMONWEALTH OF MASSACHUSETTS
I•toM AJsWVf 2 , Massachusetts
Percolation Test
Date: ..... .'g.7... Time: ..P.1' .....................
Observation Hole #
Depth of Perc
t 2,011
Start Pre-soak
End Pre-soak 2-,IDS
1 : 3`1
Time at 12" �
2 &AL . 2� GAL .
Time at 9"
Time at 6"
Time (9"-6")
Rate Min./Inch
Site Passed LJ Site Failed ❑
0 ` �� t "
Performed By: ki
Witnessed By: SL) SA Q 12-D
Comments: .. __. ... ..... . ................ .. . ...... . .........