HomeMy WebLinkAboutSoil Testing Results - 58 OAKES DRIVE 11/8/2002 BOA1W OF HEAL,TLI
NORTH ANDONE R, MA 01845 DSO/"`
975-6$8-9540
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APPL,ICATIOJN FOR SOIL TESTS
DATE: I I I d o; . MAP &PARCEL: (0.
LOCATION OF SOIL TESTS: I
OWNER: l TEL. NO.;
ADDRESS: a r I P r4 E_ A) . y ,.
ENGINEER; TEL. NO.: l ( r3( l I
CERTIFIED SOIL EVALUATOR:
Intended Use of Land: Residential Subdivision Single Family Home Commercial
Is This:
Repair Testing: _ A Undeveloped lot testing:
In the Lake Cochichewick Watershed? Yes No
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
1. Proof of land ownership (Tax bill, or letter from owner permitting test)
2. Plot plan & Location of Testing
3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and
two percolation tests required for each disposal area. Fee of$200.00 per lot for repairs or
upgrades. (If time is-not critical, fee for repairs-is $75.00)
GENERAL INFORMATION
1. Only Certified Soil Evaluators may perform deep hole inspections.
2. Only Mass.Registered-Sanitarians and Professional Engineers can design septic plans.
3. At least two deep holes and two percolation tests are required for each septic system disposal area.
4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the
BOH representative.
5. Full payment will be required for all additional tests within two weeks of testing.
6. Within 45 days of testing, a scaled plan(no smaller than 1"-100') shall be submitted to the Board
of Health showing the location of all tests (including aborted tests).
7. Within 60 days of testing soil evaluation farms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Comnissi, n Approval:
Date Received: Check Amount:, ,, ,� Check Date r�
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SCALE 400 FEET = 1 INC 64
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I+OP01 11 - SOIL EVALUATOR FOIt11
Page 2 of 3
Location Address or lot ldo. '
On-site Review _
Deep Hole Number Date: ���`�', ` Time: Weather
Location (identify on site plan)
Land Use Slope (°.b) Surface Stones
Vegetation
Landform
Position on landscape (sketch on the back)
Distances from:
Open Water Body " feet Drainage way feel
Possible Wet Area "feet Property Line feet
Drinking Water Well - feel Other
1
DEEP OBSERVATION HOLE LOGS
t
Depth from Soil Horizon Sol Texture Sol Color Soil Other
Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency, %
Graven
III
'1
I
Parent Material(geologic) Oa�thco6adrock:
Depth to Groundwater; Standing Water in the Hole: Weeping from Pit Face:
Estimated Seasonal High Ground Water-
VV 5 12 6y
E X L'11 VA --rO i:7- ;
DET APPRON'ED FORM-12/07193
I
FORM 11 - SOIL EVALUATOR FojI .%1
Page 2 of 3
Location Address or Lot iJo.
On-site Review _
i
Deep Hole Number Dam._>3 .... Time: Weather
Location (identify on site plan) m
Land Use Slope Surface Stones
Vegetation
Landform
Position on landscape (sketch on the back(
Distances from:
Open Water Body `'" feet Drainage wayr} feet
Possible Wet Area ',,,/ "`' feet Property Line '_ feet
Drinking Water Well feet Other
I
DEEP OBSERVATION HOLE LOG`
i
i
Depth from Soil Horizon Sol Texture Sol Color Soil Other
Surface (inches) (USDA) (Munsell) Mottling (Structure,Stores,Boulders, Consistency, %
Gravel)
J
I
Parent Material(geologic) OepCRflBedrodc;
Depth to Groundwater; Standing Water inthe Hole: Weeping from Pit face:
Estimated Seasonal High Ground Water;
t
sa r='t ��9en
W`�%'�!"�55�D 6Y
DEF APPRON-ID FORM-12107l95
FORM 12 - PERCOLATION TEST
Location Address or Lot No.
COMMONWEALTH OF MASSACHUSETTS
Massachusetts
Percolation Test*
Date: Time:,
Observation Hole #
Depth of Perc
Start Pre-soak
End Pre-soak
Time at 12"
Time at..9,.
Time at 6"
Time (9"-6")
Rate Min./Inch
F Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed ❑ Site Failed ❑
..............................................................................................:......................................._...._.....----......._.
Performed By
Witnessed By: �
Comments: .
DEP APPROVED FORM-12/07/95
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