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HomeMy WebLinkAboutSoil Testing Results - 1525 FOREST STREET EXT 6/28/2001 -BOARD OF A�.,H NORTH ANDOVER�'MASS. '0184�, 978-688-9840 2 6 � �.. APPLICATION Volisau.—T'Esa-S-1 l DATE: Tu ne- ZS ?_0y( IMAP cr+io,�� LOCATION OF SOIL TESTS: Lot Z, Forest Street OWNER: Scott Roth TEL. NO.: 978-887-9254 ADDRESS: 66 Stonecleave Road, Boxford, MA 01921 ENGINEER: Hancock Engineering Associates TEL.NO.: 978-777-3050 CERTIFIED SOIL EVALUATOR.: Charles R. Ogden Intended use of land: Residential Subdivision ingle Family Horne Commercial Is This; Repair testing Undeveloped lot testing Yes In the Lake Cochichewick Watershed? Yes No x (� THE FOLLOWING MUST BE INCLUDED WITH TINS FORM: 1. Proof of land ownership Tax bill, deed or letter from owner p ( ' permitting tests) 2. Plot plan 3. Fee of$275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of 575.00 per lot for repairs or up rg:ades. C, / GENERAL II`r'FORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass, Registered Sanitarian 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') shalt be submitted to the Board ci Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below- s Lin e ,. 1 — N.A. Conservatio n o miniss ion Approval Date Received: Check Amount: Check Datc; -- 6-11-1996 9:42PH FROM P. 2 p ass ' SWEaEA IM ,F 09 Aga NN AV BkdTVM 9 IT 1 � w .mow' v M — FUM Ames UM uvrw ' no Lod"..J P IJ Ar i spa a gy _°°•°q ° a � t � a,yv t J � v, •r� '! � t � °, I 1.� e s4 ip e7r7s fag umv oft M&C am tam �✓� ��� �" 'r^/�7P Y /` TONVE POND NOONAN & McDOWELL, INC. FIELD NOTES LAND SURVEYORS, CIVIL ENGINEERS 25 BRIDGE STREET, SUITE 6 BILLERICA, MA. 01821-1023 SHEET-OF TELEPHONE NO. (978)667-9736 FAX NO. (978)671-9565 /o PROJECT NO.: STREET: CREW: BILLING GROUP: TOWN: DATA FILE: DATE. TIME: WEATHER. TEMP.: --- ------------------ 7 -- -- ------ (7 J pq - HANCOCK D ���� �� �"[JJlO ��esu u �suu �/u- U ��/��u\J��uuuu U UMIL Engineering Associates 235 Newbury Street,Divilvers,MA 01923 (978)777-3050 Fix(97n)r74-7o|b nvvn.wxo|7O O |2Bonunn,dhS,oz/ O(26 Main*n*t JOB IIJO. omm^.Mx8zz|o (978)779-6767 T0 4V)0 i /NA {)|'64r WE ARE SENDING YOU O Attached O Under separate cover via the following items: � U Shop drawings U Prints U Plans O Samples O Specifications U Copy ofletter O Change order U COPIES DATE NO. DESCRIPTION � � � / � THESE ARE TRANSMITTED as checked below: � � O For approval O Approved assubmitted O Rexubmh-copies for approval � O For your use O Approved onnoted O Submit__-____-copies for distribution O As requested O Returned for corrections O Rwtum__-____oorr*cted prints � O Fnr review and comment D O FOR BIDS DUE O PRINTS RETURNED AFTER LOAN TOUS � RE�ARKS �....�� C0PYTO S|GNED: �� - -- --- if e"^/a*uxewane not as,nmue4wndlymmw'31vs at Once. e-11-19y6 y:a pm PROM P. 1 —140CW.71 A XT f- Survey Assoyd ttesg Inc. FACSIMILE LETTER 235 Newbury at., Danvers, MA 01923 DATE f 1 10 1 PROJECT NO. �2'7 ATTENTION: FAX NUMBER: (� FROM' SUBJECT: Lod- Z TOTAL PAGES INCLUDING THIS COVER- DISPOSITION / REQUESTED ACTION: Original to follow by mail C3 As requested For your use Please review / comment C1 Please call me q - -. ATTACHMENTS: COPY TO: Please call us if this fax is not clear and complete: Voice (973) 777 3050 Fax (973) 774 7616 The information contained in this communication is confidential and is intended only for the use of the addressee. Unauthorized use, disclosure or copying is strictly prohibited. 11197 HANCOCK Engineering Associates 235 Newbury Street,Danvers,MA 01923 (978)777-3050 Fax(978)774-7816 ft)..l................... --------------------- ;E 0 12 Farnsworth Street 11626 Main Street D Boston,MA 02210 Bolton,MA 01740 ...................V.-...... ............................... (617)350-7906 (978)779-6767 ATTENTIO�l _. _____............................................. _..w._... ....................................... TO R E: AML V%, (Aw ll&� ......... ....................... .............................____.................. .................. .......... WE ARE SENDING YOU E.1 Aftached El Urider separak c;e>ur,r via________........._......_..__...__......__....._.__..................-_lhe followirig fterrls:. 1:1 Shop drawir-Qs 11 Prfirrts El Plans Cl Sarriples E] Specificatioris ❑ Copy of letter 11 Change order El ............... ..................... _------- ....... (P e_........... -—------------------------- Vl) ............._�.)................................................. .............................___­........................... ........... ..........— o( ........................... ............ . ...... ............... .................. ......................... ............ ..................... ......................................................................................... ................................... .......................................... .................................................­­- ..............­ ........................................................_­__.............. ...............................................­­­­­................­.............................­................................... .....................­................................­--l-I ..................... ------................................................ ............. _........... ................... ...................... ............... ...... ...........................................................__...........__ ____......... ............. .......................... ................­­­�.................. ..........................._­­-------­­_­.____­__­.. __ ...... ..................... ---------------------............................... ­............­ ___....................... ....................................__­__­­l­­ ­­...................................................................................... ............................................................... -------------------------------..........................--l"I'll,"ll..",............................................................. I FIESE ARETRANSIVIl"TTED as checked bcAow: ❑ For approval El Approved as sul,)initled Fesubmi[ ............................ copies for approval 11111 For your use I Approved as nol:ed LJ Subinit copies for distribution I I As requested 17 Returried for corrections [ I Peturii --cortectedprints II F'or review,,,u-id conm,ient 1-1 ...............................___............................. I FOR 13117S E)UF I I Pf"Off,,, RFJUR,1140.) AF-n ir I.OAN TO US .. ......................... RUVIARKS .......... ----------___--___-------- .................................................. ......... ............... .................... ............... .... ........ ...... .. ..... COPY m4 as lwhul, kill(fly rlc4ifV t1s,"'I'l(me"'O, HANCOCK n Engineering Associates J L V11 MV L&I 235 Newbury Street,Danvers,MA 01923 (978)777-3050 Fax(978)774-7816 ❑ 12 Farnsworth Street ❑626 Main Street DArE JOB No. , Boston,MA 02210 Bolton,MAO 1740 ATTENiIOiV ` (978)779-6767 +CJ' [� _ TO % RE V t%J7C.f J (/T fH� �✓ , WE ARE SENDING YOU Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION Fool', 15011— THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval (WFor your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS - 9° ?� /l�r�G� 42/ Y 1 COPY TO SI - - If enclosures are not as noted,kind/ Znot'jus at one . Engineering Associates [_00­11 MR R-1 235 Newbury Street,Wrivers,MA 01923 (978)777-3050 Fax(978)774-7816 --- -- — --. D/\T� JOIi N(), lU 12 1"'trrnsworth Streit U 626 Main Street — Boston,MA 02210 Bolton,MA 01740 (978)779-6767 t v�(ire TO RE: x gg .;M WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via .-the following items: 5 ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ _ COPIES DATE CVO. DESCRIPTION THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval CI For your use [J Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: � . If enclosures are not as noted,kindly notify us at once. f� DETACH HERE. . • . . DETACH HERE - - - - - DETACH HERE - DETACH HERE . . . . . DETACH HERE - - - - - DETACH HERE- SEE REVERSE SIDE FOR IMPORTANT INFORMATION � Interest at the rate of 14Y per annum will 7349 RE . accrue on overdue payments from the due Yfl date until P a Yme nt is made. #�.€......... ... . ... ... .....:. +��:�<,. iil�,�F.; �:i•✓MY�s:y�YY!i:S.:J �:`ti�:Ti�':'i4.}iti: :::i:... :"•"'>���1::�.... .::.S.::i::.is ii:::...:i:yii:::i.��:: A� - s;:.., >> ROTH, SCOTT D - I �I���I��I���I�I��I��I�I�iI��� Loc: 0 FOREST STREET Parcel Id: 105.8 0002 0000.0 This form approved by the Commissioner of Revenue 2000 QUARTERLY REAL ESTATE MAKE PAYMENTS TO THE COMMONWEALTH OF MASSACHUSETTS 7349 RE TOWN OF NORTH ANDOVER NORTH ANDOVER LOC:BU"�F ���fREET P. 0. BOX 124 OFFICE OF THE COLLECTOR OF TAXES Id: 105.B 0002 0000.0 NO. ANDOVER, MA 01845 Your Preliminary Tax for the Fiscal Year 2000 Deed/Legal : 04072 0033 M-F 8:30-4:30;11/1 TO 7:30PM beginning July 01 1999 and ending June 30 2000 Land Area: 2.86 (ac) TAX 688-9550/ASSR 688-9566 on the property described is as follows: First Amount Interest Second AmnAmt Interest EGEP VQ�1tER I-TAX 21.02 0.00 2-TAX 21.02 0 . i�f4INAiY, M. 7 -72- INI ZI t? Al1Q(1N 0-f.W 02 ROTH, SCOTT D T , MARY L ROTH Nt £...... f1 00 66 STONECLEAVE ROADsT ' BOXFORD MA 01921 FORM 11 - SOIL EVALUATOR FOR]t•I Page 1 of 3 No. Date: Commonwealth of Massachusetts No,-4) Avljovar- , Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed By: _Ckac`es pn4.er - 1-cwccv, hW�'Aj AssocicLf-s Date: Ehcloi Witnessed By: O�'"' 1\Jo°n�� ®H Andover° 13oacd of Nc�.l L=tron Ad&css of Loy, �°"€�'J`'�a'L✓, Cv 4ye,&,+ Pxner't Nune, .5e_0 �Q` ) La t Address,tud 6�(U EaV1�G IAA �4 Tekphotn 1 ®Y.4,ra, MA ew Construction Repair ❑ a7a) 957 Office Review Published.Soil Survey Available: No ❑ Yes Year Published — 1IS l Publication Scale 1' 15;,s4o Soil Map Unit Drainage Class weAt d'ra'' A Soil Limitations 54-ovie.1;, Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) Landfonn Flood Insurance Rate Map: ootOL3 Above 500 year flood boundary No ❑Yes 1Z zoo Within 500 year flood boundary No Yes ❑ Within 100 year flood boundary No EYes ❑ Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions(USGS): Month Range :Above Normal ❑Normal ❑Below Normal ❑ Other References Reviewed: DEP APPROVED FORM-12/07/95 FORM - SOIL EVALUATOR hOltNI Page 2 of 3 Lot iqo. 'On-site Review Deep Hole Number ® I M01 Date:. 30 o) Time:,1130'L�11 * Weather La��, dear Location (identify f on site plan) .Land Use fZeyi deoAA..l Slope M lzlb% Surface Stones Vegetation Oal� yD1`K e-5, MotpleS Landform Position on landscape (sketch•on the back) Distances from: Open Water Body•> 120 feet Drainage way. feet Possible Wet Area �t 100 feet Property Line .. , 2.Zo filet Drinking Water Well y o.v feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texturev- Soil Color Soil .Other Surface (Inches) (USDA). (Munsell) Mottling (Structure,Stones;Boulders, Consistency, % Gravel) -7157Yks I ktle h coo- Mom,vP_ ve. rlAl; 2(Q 1 Z- SL Z. 5Y14 N1a sS;de, ri rt4 REQUI Parent Material(geologic) ;a VA-1 , iwy— ��� DepthtoBedrock: ✓1o✓1e o�S, Depth io Groundwater: Standing Water in the Hole: 6oYke Weeping from Pit Face: no✓Y- Estimated Seasonal High Ground Water: k KEY DEP APPROVED FORM-12107195 L S L 5L 5a r;dy.l. a rtic.d l v,� 5�L 5ili- Loam FORM - SOIL EVALUATOR Folol Page 2 of 3 �eeat err Aid Lot loo. _ 1='ere Ski ►J�rI�. �a� - On-site Review - Deep Hole Number -—Z-21 Date:. 30 0l Time:-L,' -3 no ,- Weather Lc, dear Location (identifyt on site plan) ,l 2e5 and Use ,d �i�e l Slope (%) -IO% Surface Stones- �kent / Vegetation 0111o�- Landform o+�� Position on landscape (sketch'on.the back) Distances from: . Open Water Body.> 100 feet Drainage way. feet Possible Wet Area oo feet Property Line ..?.Z•o filet Drinking Water Well > oil feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texturev- Soil Color Soil Other Surface(Inches) (USDA). (Munsell) Mottling (Structure,Stones Boulders, Consistency, % Gravel) 0- 7 A i v-*-� '7,SYee 5iS SL tom 410 N om l v-e q e t Ft-t'°,t�d 5L Z. 5Y54 has;;,o—J 1::71,rf MIN Parent Material(geologic) DepthtoBedrock: ✓tO✓1E O�S, Depth io Groundwater: Standing Water in the Hole: AQeye, Weeping from Pit Face: n'd Estimated Seasonal High Ground Water: LP KEY DF.PAPPROVEDFORM- 12107r9S LS 5and 'S L` Sandy L+xw�. Goa-r5� S L Sill-''Laary FORM .. - SOIL EVALUATOR pOlt1\4 rate 2 of 3 Lot No. On-site Review - Deep Hole Number T°3 m•01 Date:. 30 01 Time:..11J0-;w0 t Weather War•,, je_qr Location (identifyt on site plan) Land Use Slope (%) --IO% Surface Stones— wept Vegetation te•S Landform Position on landscape (sketch'on the back) Distances from: • Open Water Body..> 120 feet Drainage way. feet Possible Wet Area -L oo feet Property Line .. �.?�.. fret Drinking Water Well y o o feet Other DEEP OBSERVATION HOLE LOG' Depth from Soi(Horizon Soil Texture- Soil Color Soil Other Surface (Inches) (USDA). (Munsell) Mottling -(Structure,Stones Boulders, Consistency, % Gravel) 0- 5 A s log 3 E Up" ..,- Mass , Qn Frtw" $° Z_00 e) P S L° to'vR 41(- N1as5�ve 1 �xft q-tca ke tol G ! SL Z,5`P 4 bass;,- ri rr4 I + r v�'�aw-�• coo�,�s��� ��v�e�2� E Parent Material(geologic) w/}1161 DepthtoBedrock: ✓0,)o Depth to Groundwater: Standing Water in the Hole: wq Weeping from Pit Face: Estimated Seasonal High Ground Water: KEY S Sand DEP APPROVED FORM- 121.0719S LS- LOo^3 50i118 say Lam, ' M�dI 5 t, 5.l Silt `=LoAwi FORM , - SOIL EVALUATOR f(OltN1 Page 2 of 3 Lot iqo. --2 �� s Skc�e�- ►.J©rte. 13haa�.er° - 'On-site Review Deep Hole Number T�' -o) Date:.9 30 0l Time:vll�o'��?� 17 Weather Location (identify on site plan) .. . __Land Use R�Si d�pia,l Slope M �—f0% Surface Stones Vegetation M"I&O, Landform Position on landscape (sketch*on.the back) Distances from: Open Water Body.> oo feet Drainage way. feet Possible Wet Area ? 10 o feet Property Line ..M M Met Drinking Water Well }- 00 feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Textured Soii Color Soil Other Surface (inches) (USDA), (Munsell) Mottling (Structure,Stones Boulders, Consistency, % Gravel) l_ 6" V-")v'_ v l C 5L 5Y 14 �Aasc.'/ve.a rirt4 una6ulc ay.� ro�,�_L�� Parent Material(geologic) 5��� 'dock �, DepthtoBedrock: no Depth i.o Groundwater: Standing Water in the Hole: ►7oo''_- Weeping from Pit Face: d*p✓ Estimated Seasonal High Ground Water: ZO" '• KEY S Sanj DEP APPROVED FORM• 12107145 L•S Loa^� 5anr� r✓1 -5L Sn�,dy L:iztr�, �te.�lvr� C G oartS��. S L Silt- Loarvi FORM - SOIL EVALUATOR 11ORM Page 2 of 3 Lot 00- - On-site Review - Deep Hole Number Date:. 30 0l Time:.1110"100 * Weather Location (identifyl on site plan) Land Use IUhi devtfa,� Slope (%J lob- Surface Stones—vent Vegetation Landform Position on landscape (sketch'on the back) Distances from: Open Water Body.> 00 feet Drainage way. feet Possible Wet Area ? 00 feet Property Line .. 2 LP filet Drinking Water Well > ov 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) �— Lo L 1o`ip�3 Z�'pt. 5 L. 10`M 411 M1as5,,re � qvt q4e t'- Z�� G SL 2,5Y5 Nlass;vo,� F rf4 wt6 anqula� fOc 1�y Coblakq, al 130)`ik rS Parent Material (geologic)- 54H AL(4 {vet (I DepthtoBedrock: 60ne, pj,;, Depth io Groundwater: Standing Water in the Hole: +'�wc— Weeping from Pit Face: ytovj-e— _ Estimated Seasonal High Ground Water: ZV1 �k KEY DEP APPROVED FORM-121.0719S L S L.00^+) 5and m ; '5L 5and� Ln1 trt�lw� 5;L Silt- Loarvi i } FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Lot No. 4\9we'T. Determination for Seasonal High Water Table Method Used: Depth observed standing in observation hole inches Z.,-'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 J Depth of-Naturally Occurring Pervious Material ::Does at least four feet tiof.,naturally.-occurring. .pervious.material. exist .in all areas observed throughout.the:area proposed for:the-soil absorption system?.. ` s5 If not, what is the depth of naturally occurring pervious material? Certification I certify that on Oc+- Ro, MIS (date) I have passed the soil evaluator 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 10 kp lot DEP APPROVED FORM-12/07195 1, 'J FORM 12 - PERCOLATION TEST -Ad,*- Lot No. � . COMMONWEALTH OF MASSACHUSETTS Onr n�oQer , Massachusetts Percolation Test* Date:—'; Time:, Observation Hole # � l Depth of Perc Start Pre-soak End Pre-soak 1 � Time at 12" I(53 Time at 9" �•�� Time at 6" , 7 Time =Rate n./Inch Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ ...........................................................................................:............................................_..... _ Performed By: Chas-1ie,6 0�den �e5 Witnessed By: 7o�)n Noona�vt M. Ar4ove.r� goara ,,C Comments: DEP APPROVED FORM-LV0719s i 1.ORNI 11 boIL EVALUATOR FORM Paget or Location Address or Lot 14o. I On-site Review _ Deep Hole Number � r� Date: ".� °'� Time: Weather Location (identify on site plan) Land Use K-10(2 V,1' Slope (%) Surface Stones Vegetation i Landform Position on landscape (sketch on the back) Distances from: Open Water Body' feet Drainage way " ` feet Possible Wet Area feet Property Line "'' `' feet Drinking Water Well /-5' ' ''feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Sol Texture Sol Color Soil Other Surface{inches) (USDA) tMunsell) Mottling (Structure,Stones.Boulders,Consistency. 76 Graveq Parent Material(geologic) Oap�ROf3adrodc: - Depth to Groundwater: Standing Water inthe Hole: Weeping from Pit Face: Estimated Seasonal High Laround water: DE?APPRONla)FORM-WOW% FOR.N1 11 EVALUATOR FOIL'\i Page 2 of 3 Location Address or Lot tdo. i On-site Review _ Deep Hole Number ; p Date: Time: Weather Location (identify on site plan) ( Land Use Slope Surface Stones Vegetation Landform j Position on landscape (sketch on the back) Distances from Open Water Body feet Drainage way,'' `�' ' feet Possible Wet Area /`' feet Property Line �' feet ' Drinking Water Well f` feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Sol Texture Sol Color Sol Other Surface (Inches) (USDA) tMunsell) Mottling (Structure,Stones,B)ulders,Consistency, % Graven / d ji REQUIRED AT EVLRY FRUPUbti) a d rat Parent Material(geologic) pap&vtog*drtx*- Depth to Groundwater; Standing Water in the Hole: Weeping fiom Pit Face: Estimated Seasonal High Ground Water:" DEP APPRONIM FORM_1210719S FORM 11 - ,,,.IIL EVALUATOR FORM Page 2 of 3 Location Address or 1.at IJo. � i i On-site Review _ Deep Hole Number Date: t Time. Weather Location (identify on site plan) Land Use LL O'{' ' Slope (%) Surface Stones Vegetation Landform Position on landscape (sketch on the back) __.. Distances from: Open Water Body '" feet Drainage way feet Possible Wet Area feet Property Liner.,, , feet Drinking Water Well feet 'Otter DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Sol Texture Sol Color Sol Other Surface(Inches) (USDA) (Munsell) Mottling (Structure.Stones,Boulders. Consistency. % Graven Q 1 � 1 P - J� (z Parent Material(geologic) peveltosed roc*: / /,; �r Depth to Groundwater; Standing Water in the Hole: / e5;1 Weeping from Pit face: /0 ,- Estimated Seasonal High Ground Water: W�a DEF APPROVID FORM-12107115 FORM II ..-/IL EVALUATOR FOR NI Page 2of3 1 )7 0/e Location Address or Lot i4o. On-site Review 4p. Deep Hole Number 'LL.' (L- " Date: °�.... « Time: t 't Weather ,. Location (identify on site plan) Land Use _ �b �a 1„`�.° Slope M �` � Surface Stones &A,/ Vegetation Landform ! Position on landscape (sketch on the back) . ,,... Distances from: Open Water Body feet Drainage ways feet Possible Wet Area-' 2!° feet Property Line feet Drinking Water Well "` `' feet -Other _. DEEP OBSERVATION HOLE LOG® Depth from Soil Horizon Soil Texture Sol Color Soil Other Surface (inches) (USDA) tMunsell) Mottling (Structure,Stones,Boulders,Consistency, % Gravel) MIN-Iwc� HOLES REQUIRED AT EVERY PRUPOSED DISPC6AL AREA t .=r x v o Parent Material(geologic) DepthwBedvok: o . Depth to Groundwater; Standing Water in the Hole: Weeping lrorn Pit Face: Estimated Seasonal High Ground Water: DEF APPRON7M FORM-12/07195 I FORM 11 - -1L EVALUATOR FORM Page 2 or i Location Address or trot 14o- i On-site Review _ Deep Hole Number '> y_ �' Date:- 21..' '�' l Time: Weather r '�c 0 Location (identify on site plan) — Land Use Slope M '- Surface Stones js r 9 : Vegetation Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way ��'`'} feet Possible Wet Area feet Property Line feet Drinking Water Well feet -Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texture Sol Color Soil Other I "! Surface (Inches) (USDA) (Munseln Mottling (Structure,Stones,Boulders, Consistency, % Graven F _ 6-1 � �, ! I s - t i i Parent Material(geologic) Dep0=13drock mss" Depth toGroundwat__r: Standing Water intheHole: Weeping liom Pit Face: it Estimated Seasonal High Ground Water: OF?"PRON•ID FORM_12107195 F'OR�'tl 12 - PERCOLATION 1 TEST Location Address or Lot No. �`� � , •,; a COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test* Date: r=` E - 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 Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ .............................................................._.................... Performed Witnessed By y Comments: DEP APPROVED FORM-12/07/95 FORM 11 - SOIL EVALUATOR FORAI Page I of 3 No. b�r57 Date: 9 IZ5 Icy,-) Commonwealth of Massachusetts Uor� An ,orer , Massachusetts Soil ► uitability Assessment for On-site Seivage,. Disposal Performed By. Ckos-te-S. 5 A.e v) c�w_-L4.�,h W, _4 es Date: 7*Lk0__ Witnessed By: 9,0,,A Q,Af4oA(' &O0,(-1A 0 L=jtwn A6& j or A w 8 Ad&as,&M Tekoo �ew.Construction L2Repair * ❑ m 00Z I Office Review Published Soil Survey A\ ilable: No ❑ Yes Year Published Publication Scale 11 IS,442_ Soil Map Unit CC-b Drainage Class—\.}ek\ Jv,m,,c_A Soil Limitations Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) Land form Flood Insurance Rate Map: Z 500'�"b- 00 t o TJ gob 3 Above 500 year flood boundary No ❑El Yes -z-0 c' Within 500 year flood boundary No Eryes ❑ Within 100 year flood boundary No 21yes ❑ Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Non-nal F]BelowNormal ❑ Other References Reviewed: DEP APPROVED FORM-12/01/95 FORM 11 - SOIL EVALUATOR 1 ORM rage 2 of 3 r Location Address or Lot No. —A COTQCe- On-site Review - Deep Hole Number -T__._9 _ Date:. 2404 Time:.. Weather kwt\ D cl�­? Location (identify on site plan) Land Use Qe I,Ae, Q Slope (%) Surface Stones— Gow�movy Vegetation WkWA Landform , V^v)0 r-O l0& Position on landscape (sketch*on the back) Distances from: Open Water Body, >102 feet Drainage way. feet Possible Wet Area ?I oV feet Property Line ..--_Sb_filet Drinking Water Well 151D feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Textured Soil Color Soil Other Surface (Inches) (USDA) . (Munsetl) Mottling (Structure,Stones,Boulders, Consistency, % Gravel) SL W4,312- Massive. r-rvv...6 Sig +t�s� ;r ,A Plat 'K W �G rtse. �O.r 1��✓ry 2 goo-�s •4-0 !12" Parent Material (geologic) DepthtoBedrock: ✓)OV Depth to Groundwater: Standing Water in the Hole: /1 OVIC. Weeping from Pit Face: yt p y'C_ Estimated Seasonal High Ground Water:_ eS' , o? (Z r1 �- KEY S Sand ,� �-,ne- VEPAPPROYMFORht-12/07!95 LS Lmr­� 50lnd 5L 5andy Loam C G 0 ax5� 5;L 5ilf Loam FORM 11 - SOIL EVALUATOR pORNI "'age 2 Of 3 Location Address or Lot No. _A ' 6., na uzeeT- e-c e ,gall -. On-site .Review - Deep Hole Number T-10 Date:. 26 04 Time:.. Weather lArn p, c!o:.) Location (identify on site plan) Land Use Slope (%) 5 Surface Stones Vegetation A Landform , &M 0 e-N�rte.. Position on landscape (sketch'on the back) Distances from: Open Water Body.? FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 'r Location Address or Lot iJo. Caen,x cy-ve-eeT " ;on On-site Review - Deep Hole Number T-4)._ Date:. 21# o4 Time:., Weather Worn Location (identify on site plan) Land Use - ReS Apra Slope M 5 Surface Stones- Go�nn ovl Vegetation Landform Position on landscape (sketch*on the back) Distances from: Open Water Body, > 0-0 feet Drainage way. feet Possible Wet Area _? I oy feet Property Line .. ]Sb. fdet Drinking Water Well 1512 feet Other DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texturev- Soil Color Soil Other Surface (Inches) - (USDA) . (Munsell) Mottling (Structure,Stones,Boulders, Consistency, % Gravel) 0-31 ` 3J-4o fib SL WO/2. MGSSivr_ C_r11_6 An 5() 5 L 101 4 4 ,.�C ) Pr i s I C- 5-0 �2� , S�. 2�SY S/ SSttL`Sr�f�rQir 5Y ''/2 ver+� t U V �� 54-av,y SA J Parent Material(geologic) DepthtoUdrock: Depth to Groundwater: Standing Water in the Hole: �f" I O V Weeping from Pit Face: i p Estimated Seasonal High Ground Water: # KEY S Sand ,F Into DEP APPRO VIED FORM-12107/9s L S L oo rN j Sand NI 5L 5andy Loam N1G��tN� 5�,L Sill- Loom i FORM 11 - SOIL LVALUATOR FORM Page 3 of 3 Location Address or Lot No. A FOr t, , 1J Anc6j,'✓ Determination for Seasonal High Water Table Method Used: ❑� Depth observed standing in observation hole 122 inches ® Depth weeping from side of observation hole �106 inches 2/Depth to soil mottles_a.__ 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? �eS If not, what is the depth of naturally occurring pervious material? Certification I certify that on OG+. Ito, 1995 (date) I have passed the soil evaluator 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 &J, C "°' Date � — DEP APPROVED FORM-12/07195 1, FORM 12 - PERCOLATION TEST Location Address or Lot No. A fk-cort c-/--C,6or. COMMONWEALTH OF MASSACHUSETTS Cdr Ate Av ove_r , Massachusetts Percolation Test* Date: 212, Time:, Observation Hole # Depth of Perc 3,gu 4- 5+ + �rr Start Pre-soak End Pre-soak t lo % 41 Time at 12" 10 4 l 1 Z4 Time at 9" . Time at 6" 01 1 1 5 Time (9"-6") Rate Min./Inch Aqi Q Minimum or 1 percolation test must be performed in both the primary area AND reserve area. Site Passed ❑ Site Failed ❑ f `; �•r-, Performed By: Engineer IIM Asso��a�es Witnessed By: C. f Ron ,-n U A14,er- goo-ri mc Comments: .. z nEP a»ovm FORM-UM19S FORM 12 - PERCOLATION TEST Location Address or Lot No. Fore--%J Cilen6or. COMMONWEALTH OF MASSACHUSETTS An over , Massachusetts Percolation Test* Date: Z'�'4�'� Time:, Observation Hole # Depth of Perc Tiro � 4L%, m i n Start Pre-soak End Pre-soak Time at 12" Time at 9" . Time at 6" Time (9"-6") Rate Min./Inch Minimum or 1 percoiation test must be performed in both the primary area AND reserve area. Site Passed ❑ Site Failed ❑ ........................................................................................................................ _..�....._....._ Performed By: { gn-- ,ck_ EnginwtI'm Asso 'A�C5 Witnessed By: (Zv y �•A� �e�'gvQ�a ©� 1-�es�� e,�� Comments: .�.......�..... .. DEP APPROVED FORM•12107195 ' FORM 12 - PERCOL,ATION TEST 'r Location Address or Lot No. A 166reiJ COMMONWEALTH OF MASSACHUSETTS �Jdr-4, A,44v�cr , Massachusetts Percolation Test Date: ._ o ed Time:, Observation Hole # n Depth of Perc �Z�� + Ibl, Start Pre-soak End Pre-soak Time at 12" q ;wb Time at 9" Time at 6" Cl ; S' Time (9"-6") 2Uirn Rate Min./Inch C( M� Nliniinum or i percoiation test must be performed in both the primary area AND reserve area. Site Passed Site Failed El ..............................................................................................:............................................_....._ Performed By: Gh�sles d��err NC"C'cK. Engine�a'��n� Asso��a�e5 Witnessed By: �""dA v — rJ. A.dover gpard mC e,�,\Vn 'T Comments: DEP APPROVED FORM•1=19S Col�71 \ \ v k J W J Wp \ � � o � r � o N _ 610 Qr Z \ Q � \ oQz QI h ul CL Q \ N LAJ \ LQ � ad W FORM 11 - SOIL EVALUATOR FORM Page I of 3 No. Date. Commonwealth of Massachusetts Mass-ac " useus Soil Stlitabili Assessment for On—site--�e�va�e . zs osez� Performed By: — Ck 0-6 e-S 05�en- kan(or-V-,N Date: ....... J;:�ee-,r Witnessed By: (0,6 Aon jr w -NAV�Aovp-r &Cmcc� L,5)4- A Cwncr'%Num. La i Ad&ut,xM Te4how I mA 0192 I �ew construction Repair ❑ 88-�- 9ES4 Office Review Published Soil Survey Available: No ❑ Yes EK Year Published -- Publication Scale Soil Map Unit Drainage Class WCO Soil Limitations c 1,0DC- Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) Landform Flood Insurance Rate Map: Above 500 year flood boundary No E]Yes ❑ Within 500 year flood boundary No ❑yes ❑ Within 100 year flood boundary No Dyes ❑ Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Normal F]BeloNvNormal ❑ fi Other References Reviewed: DEP APPROVED FORM•12/07195 FORM I I - SOIL EVALUATOR I Olzn� Page 2 of 3 Lot i4o. A On-site Review - Deep Hole Number T Date:. 00 Time:.: Weather cool p,c h­, . Location (identify on site plan) - Land Use Slope Surface Stones— Vegetation cwjV) Landform , M^5KT Position on landscape (sketch'on the back) Distances from: Open Water Body..� 1102 feet Drainage way. feet Possible Wet Area _> too feet Property Line 40t:- fdet Drinking Water Well 2 I SO feet Other 4 1 DEEP OBSERVATION HOLE LOG' O- S e, �,le -- A. e Aa dQ Depth from - Soil Horizon Soil Textured Soil Color Soil Surface (Inches) Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency, Gravel) Parent Material (geologic) `xtvl�e �p -T(��_ DepthtoBedrock: tjD1 Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: N0,%C Estimated Seasonal High Ground Water: R dA-e, 4-0 Iar-y bowl" f sRC --- Y, KEY S Sand Fee- DEP APPROVED FORM- 12/07 19S L S L•00.My Sand 5L Sad Lcnr✓, rtc�i�,�: 5 L Silt Loar•� C Goa�S� FORM 11 - SOIL EVALUATOR f;O1`M P29C 2 of 3 Lot No. A +70re_'b� -VYr_L4-• On-site Review - Deep Hole Number )`Z Date:. vo Time:.: Weather C001 ,cAn„Jl Location (identify on site plan) - Land Use Rts' e✓AO Slope (%} 5 Surface Stones— CoMr�ov� Vegetation _ �awlrl Landform Position on landscape (sketch'on the back) Distances from: Open Water Body. }oo feet Drainage way. feet Possible Wet Area > loo_ feet Property Line _50t. fdet Drinking Water Well ( 0 feet Other DEEP OBSERVATION HOLE LOGO e-V\ r 0.f` SN4C,-0,-111 lv)� V1 C>�(d Depth from Soil Horizon Soil Textured Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency, 4'. Gravel) 5 312 M0.SS1V2) Sq sL ►o�� 4/� amass U� ����bl� S�1° I � SL 2,5Y 5/4 MINIMUM 01­- 2 HOLES REQUIRED Parent Material (geologic)_ C',�L') �oSG _rj I_L DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: 1��0 Weeping from Pit Face: Estimated Seasonal High Ground Water: KEY S Sand .� �-”')e- DEP APPROVED FORPt• 12r070S LS L,oo. % �jcinc� o 5;L Silt Loc�r� C G ��5 C FORM 11 - SOIL EVALUATOR Page 2 of 3 1 eea dfess-ea;Lot No. On-site Review - Deep Hole Number _T 3. Date:.—S Time:.. Weather Cool Location (identify on site plan) - Land Use ReS'%e"AVta Slope (°io) _ Surface Stones— Vegetation Landform M r,R Position on landscape (sketch on the back) Distances from: Open Water Body. � )00 feet Drainage way. feet Possible Wet Area > loo feet Property Line .. ._ filet Drinking Water Well 2 IL feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texture V- Soil Color Soil Other Surface(Inches) (USDA) (Munselq Mottling (Structure,Stones, Boulders, Consistency, Gravel} 0®1b A V 36-(O� C MINIMUM OF 2 HOLES REQUIFt Parent Material (geologic) .� �� �i�_�__ Depthto%drock:_ �Or Ct2,�Cr r- 1r2 n Depth to Groundwater: Standing Water in the Hole: O r'e)L Weeping from Pit Face: ►JOwf'_ --- Estimated Seasonal High Ground Water: Re�v�c.� -�o boti�c;erS / S, 'z.Q -- Y, KEY — S Scnd -F �-,1 )& DU"PROVED FO"I• 12/07/95 L S Loom_) �I L, Sancly� Lcar� 'M f"tt..a i 5 5�,L 5 i 11- L oc v) FORM I I - SOIL EVALUATOR rage 2 of 3 Lot No. A On-site Review Deep Hole Number -T- 4. Date:_51doo Time::. Weather Cool, Location (identify on site plan) - Land Use R�Siclen• k° Slope (%) Surface Stones— Co^^1110 Vegetation awVl Landform Position on landscape (sketch'on the back) Distances from: Open Water Body. � )00 feet Drainage way. feet Possible Wet Area _> loo feet Property Line Met Drinking Water Well 215-0 feet Other DEEP OBSERVATION HOLE LOG' a Na�� :JM66ttling , Depth from • Soil Horizon Soil Texture' Soil Color Other Surface (Inches) (USDA) (Munsell) ( ,Boulders, Ccnsistency, Gravel) Parent Material (geologic)__ 0 s T(1 DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: fJ tide-, Weeping from Pit Face: Estimated Seasonal High Ground Water: Rem KEY UEP APPRO VFW FORM• 12/07r95 L S L o0.r �7anr� 5 L. Sarx)v3 G 5,L 5ilfi Loam FORM 11 - SOIL EVALUATOR Pagc 2 of 3 Lot N o. - . On-site Review - Deep Hole Number Date:.-_cc Time::. Weather Cool Location (identify on site plan) Land Use R2S;e�e��ItA� Slope M 3,5 _ Surface Stones— C0(v-1Y1 0n Vegetation Landform , ManQ Position on landscape (sketch'on the back) Distances from: Open Water Body. )00 feet Drainage way. feet Possible Wet Area _> 100 feet Property Line .. 30�- filet Drinking Water Well 2 15-0 feet Other t. DEEP OBSERVATION HOLE LOG' Nod a S'k' ��I e - �u6 40 elm 4k,) Depth from • Soil Horizon Soil Texture4- Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency, S Gravel) 0-41 rI LL -- 4�--45 A r SL_ 1 o`{P.12 M0.SSiV2) io-yp- I/t.7 �ass �uct ���0,bt �. -I®°° �� �' SL_ 2,5 YS�a, MIN t Parent Material (geologic) r1 took Tj DepthtoBedrock: Nn} �o�Vw frt' Depth to Groundwater: Standing Water in the Hole: 00,j Weeping from Pit Face: Noti Estimated Seasonal High Ground Water: KEY DEP APPROVED FOP-',I- 12/07/95 L S L-ma `,anc) 5 L 5;L 5111- Loam C Goc�rSC� FORM 11 - SOIL EVALUATOR I O1ZM Pagc 2 of 3 <�4yr_t - On-site Review - Deep Hole Number T` b Date:._5k I vo Time:.: Weather Goo Location (identify on site plan) Land Use —P,eSiele�AVhAj Slope Surface Stones— Vegetation __ Io tjn Landform , M5K:rj^,Z, Position on landscape (sketch'on the back) Distances from: Open Water Body._? 100 feet Drainage way. feet Possible Wet Area > loD feet Property Line _10t filet Drinking Water Well ,2 1 512 feet Other 4. 1 DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture' Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, °5 Gravel) lO 3/2_ N�rxSSiV2) Fri aWe. 32 ('� S L to f-e J 2,5Y 5/3 Z5Y 7/Z MINIMUM OF 2 HOLES-REQUI Parent Material (geologic) G"4, Cpp "�i -� Depthtotiedrock: NOS dQ4CI,. `reJ _ Depth to Groundwater: Standing Water in the Hole: "Of-1 C_ Weeping from Pit Face: NO Estimated Seasonal High Ground Water: 43tt KEY S Sind .F ��ne. DEP APPROVED FORM• 12I07r9S LS Loom_) 5aP)d 5L C G oa�5c_ 5 L Silt- Lcar� , FORM 11 - SOIL EVALUATOR I O1:M Pagc 2 of 3 t ,: � f-Lot No. A On-site Review - Deep Hole Number T 7-7. Date:. ICO Time:.: Weather cool p ' ,c 1-�1_�., Location (identify on site plan) - Land Use —(�eSie�e��lta� Slope (%) _ Surface Stones— Vegetation yl Landform , nn —.- Position on landscape (sketch'on the back) Distances from: Open Water Body._ )oo feet Drainage way. feet Possible Wet Area ? 100 feet Property Line .. ''®!' filet Drinking Water Well 2 ( SO feet Other ii DEEP OBSERVATION HOLE LOG` N o� a Nom Depth from Soil Horizon Soil Textured Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Ccnsistency, Gravel) �--7� Parent Material (geologic) ✓ DepthtoBedrock:_ Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face:_ NOn,2� ----- Estimatee/d Seasonal High Ground Water: \ S RCYV��I Gl� 40 'nvc E b0�1 A-'P-rS / �ZQ KEY S 5"nd F �-;ne- DEP"PRO VIED FOR,N1• 1210719S L S L omr-,\u 5a)d rYl 5L 5ar)8y 5; L 54 Loar,) FORM 11 - SOIL EVALUATOR Page 2 of 3 Lot No. o. On-site Review - Deep Hole Number T-6. Date:. 15 cc Time:.: Weather Gool Location (identify on site plan) - Land Use - RP_ ;A�y'Aa Slope (%) _ Surface Stones— C01K'^0n Vegetation — la�'n _ Landform Position on landscape (sketch on the back) Distances from: Open Water Body._ )OD feet Drainage way. feet Possible Wet Area _> loo feet Property Line .. 15} filet Drinking Water Well 2_I5-1? feet Other DEEP OBSERVATION HOLE LOG` Depth from Soil Horizon Soil Texturev- Soil Color Soil Surface (Inches) (USDA) (Munselq Mottling ther ng (Structure,Stones,Boulders, Ccnsistency, Gravel) • ,1 0° �9 SL lo' 9_1/2_ Massive ) �na��e 3 1 S L i o`�� /f� amass ter✓ ` �� b1 e� 31--1S_ SL_ 2,5Y5/4 mINIMUM Ut- .4 HOLES Parent Material (geologic) tame 10e,'� 7'1�L _ DepthtoBedrock: TJOI- cl� rw fnC Ci Depth to Groundwater: Standing Water in the Hole: Q0 tic- Weeping from Pit Face: rJpnJ{' _ Estimated Seasonal High Ground Water: 4-0 eor,lo � KEY rt S �jand T dine DEP"PROVED FORhl- 12/oN9S L S L ooxr Sand 5 L Sandy Loam '�''� Mc cl i w-; C G oCti�SC� 5 L Silt Lcc�r� i 1 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 -L- r Lot No. Determination ,Lor° Seasonal High Water Table Method Used: ZDepth observed standing in observation hole 13(sa inches ❑ Depth weeping from side of observation hole inches Depth to soil mottles- inches ❑ Ground water adjustment feet r Index Well Number Reading Date Index well level Adjustment factor Adjusted ground water level - i Depth of Naturally Occurrinq 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, rwhat is the depth of naturally occurring pervious material? Certification certify that on Oc, , ILo, HIS (date) I have passed the soil evaluator 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 ° DEP APPRONID FORM-12/07/95 ,,r FORM 12 - PERCOLATION 'PEST Lot No. YN T�oCe_ k COMMONWEALTH OF MASSACHUSETTS A-\r�over' , Massachusetts Percolation Test* Date: 2�0'00 Time:, Observation Hole # �� I Depth of Perc „ 5�Nk Start Pre-soak 3; I End Pre-soak 3 2-9 Time at 12" Time at 9" Time at 6" Time (9"-6") Rate Min./Inch S MPt Minimum or 1 percolation test must be performed in both the primary area AND reserve area. Site Passed LI Site Failed ❑ ...................................................................................................................................._....._..... _ Performed By: Ghasle5 p��eri �ur :, _ Engine��r� RSS�ua�es Witnessed By: Carl-kon 'P ro 'r) //?0(4 Ehgine.err.ts�� ' 0 A,)A.ogr BOH A<14 a Comments: :.. M..::.w.:. ..,. .w.�M_..._......:._..�.�.....:..::..:::..:...� _ ..M :.: ::-M�... ....:.:...M� .�. �... . �M...:...,:....._ nFP APPROVED FORM-12107ros HIANCOCK JOB b l C7 ( '1041 Engineering Associates SHEET NO. OF 235 Newbury Street,Danvers,MA 01923 (978)777-3050 Fax(978)774-7816 I 1112 Farnsworth Street CALCULATED BY G� DATE L�a ❑626 Main Street Boston,NIA 02210 Bolton,MA 01740 CHECKED BY DATE (617)350-7906 (978)779-6767 1` P SCALE �3 -'D SIC A)— Tee v Or t> D a° o� B .- ___ 6TY? ° 06 ID IOT- Iiia � r Tj ° a� T7 o _fv� _ ... STO;rJEGtrE,+,v� �So�CFoRD, PRODUCT204-1(Sifq!e Sheets)205-1(Padded) -DETACH HERE- DETACH HERE - DETACH HERE - - - - - DETACH HERE . . . . . DETACH HERE - - - - - DETACH HERE- SEE REVERSE SIDE FOR IMPORTANT INFORMATION Interest at the rate of 14t per annum will 7349 RE accrue on overdue payments from the due �`�� � MATE date until payment is made. IQTAk� pflttllk SAX X12 08 �IN1'like-l�,�II1�1�9� 4�1� 4 ROTH, SCOTT D l �l�lllllll il�ll II�III�INIII�I�III�Nlllllf�lllllllll IIII�II Loc: 0 FOREST STREET Parcel Id: 105.0 0002 0000.0 This form approved by the Commissioner of Revenue 2000 QUARTERLY REAL ESTATE MADE PAYMENTS TO THE COMMONWEALTH OF MASSACHUSETTS 7349 RE TOWN OF NORTH ANDOVER NORTH ANDOVER Loc:11dify-STREET P. 0. BOX 124 OFFICE OF THE COLLECTOR OF TAXES Id: 105.8 0002 0000.0 NO. ANDOVER, MA 01845 Your Preliminary Tax for the Fiscal Year 2000 Deed/Legal: 04072 0033 M-F 8:30-4:30:11/1 TO 7:30PM beginning July Ol 1999 and ending June 30 2000 Land Area: 2.86 (ac) TAX 688-9550/ASSR 688-9566 on the property described is as follows: First Amount Interest Second Amrn1nt Inte ETPT V40 1-TAX 21.02 0.00 2-TAX 21.02 0 TAB i?fkdl#kAil" SAX 42 kCa ROTH, SCOTT D ? .:. MARY L ROTH tJI�T W . '! 66 STONECLEAVE ROADS °t BOXFORD MA 01921 NT lltt i1 AId 'Vi 02 zii li � Ullllllll�lifl��lll�lll� ICIIIIII�IB�Inlli�l IIII BOARD OF HEALTH NORTH ANDOVER, MASS. 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: March 13, 2000 IM-AP & PARCEL: Map 1058, Lot 2 LOCATION OF SOU_ TESTS: Lot 2, Forest Street OWNER: Scott -Roth TEL. NO.: 978-887-9254 ADDRESS: 66 Stonecleave Road, Boxford, MA 01921 ENGINEER: Hancock Engineering Associates TEL.NO.: 978-777-3050 CERTIFIED SOIL EVALUATOR: Charles R. Ogden Intended use of land: Residential Subdivision ingle Family Home Commercial Is This: Repair testing Undeveloped lot testing Yes In the Lake Cochichewick Watershed? Yes NO x THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership (T&-< bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of 275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75.00 per lot for repairs or upgrades, 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 l"-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 forms shall be submitted. Please Do Not Write Below This Line Q N.A. Conservation Commission Approval: CZ, 2 Date Rec8ved-. Check Amount'. Check Date: 1 i 1IMM I i Mcm ME �6.ctll i �tu� i!'js:':i Di i1•� �� � Rj1 • : ,�i i!y ani M EI N ME all MW IN ii l• iiME m IN= ELI pXV. i��i i fir: am MR. IN= ME III OmaVllMlI iRlww� 1 ���� : • ii� iR't4:�.� iii %iii ��cl�i� ►iii �, �; iii r��l�lwiii■�■�,�a�.rr� � s�i�w �. c��ll!�.ea •r�l�w� �� w�ii■■ wry ,�■ A w y Al 4 r "I Jill a� r R ,.1 "1 L • Ems, ti4 ----- r ► o<�_; t i . • • s • • I If f _ + May-01-00 04 : 12P Paul D. Tui-bide , PE/PL S 978-465-0313 P .01 Facsimile Cover Sheet To: SANDRA STARR Company: NORTH ANDOVER BOH Phone: 978-688-9540 Fax: 978-688-9542 From: Carlton A. Brown Company.- Port Engineering Associates, Inc. Phone: (978) 465-8594 Fax.- (978) 465-0313 Date May 1, 2000 Pages Including This Cover Page: 5 Comments: Sandy, Enclosed are the results of the perc test done by Hancock Survey at Lot A Forest Street (by 66 Stonecleave Road, Boxford), The area by the horse barn was tested first. There was extensive fill in this area, and interlocked boulders kept the backhoe from going down into the C horizon to the required depth. A second area by the house was next tested. Only one deep test pit (T6) had an adequate depth of C horizon and only one perc test was performed next to Test Pit T6. it is my opinion that this area will probably be adequate, but a mid-size to large excavator must be used to get down through the boulders. (The backhoe just did not have enough power.) I would like to charge for three (3) extra test pits ($150.00) for a total of $400.00, 1 believe that Hancock Survey will be scheduling another day to finish the testing. I would like to have a total of at least 3 test pits in the area of the leaching bed and another perc test. I imagine that our fee would be another $250,00 for the future testing. Thanks, Carlton I 1 .<j �c,-. ilo�� ', _5,E �G C O L"i 10 N i= rI - �.. I . i INI� l_.' �v�.�. _ ._ '`°'� (^-.t C�C' TiPVIE j i � EEv- i iNl= I „ J ,OARD OF HEALTH NORTH ANDOVER9 MA 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: 7 MAP & PARCEL: LOCATION OF SOIL TESTS: 60 F lq- r-'0 OWNER: S C-0—Ir TEL. NO.: ? ADDRESS: C16 n± IA-uk- /�' QAPI,z Z HAO GO Q-K 'DAJjvr(A) ENGINEER: C-"(CV" Coe ' Ge crag(r-L)L -TEL. NO.: CERTIFIED SOIL EVALUATOR: Intended Use of Land: Residential Subdivision Cf�mgleFamil Commercial Is This: I Repair Testing: Undeveloped lot testing- In the Lake Cochichewick Watershed? Yes No K 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$275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarian 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 forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval: Date Received: Check Amount: Check Date: 1 NORTH 1 own Of/Yo! 1,h Andove F?o ao a 1 0 William. Scott Community Development & Services • a 27 Charles Street Director ° (978) 688-9531 North Andover, Massachusetts 01845 4SS^CHUSt< Fax 978-688-9542 Board of May 2, 2000 Appeals (978) 688-9541 Building Charles Ogden Department Hancock Survey Associates (978) 688-9545 235 Newbury Street Danvers, MA 01923 Conservation Department (978) 688-9530 Re: Lot A Forest Street Health Department Dear Mr. Ogden: (978)688-9540 Three additional test pits needed to be performed on Lot A Forest Street. There is Public Health a charge of one hundred and fifty dollars ($150) for each additional test pit for a Nurse total of four hundred dollars ($400). (978) 688-9543 Please send a check made out to the Town of North Andover and mail it to Board Planning of Health, 27 Charles Street, No. Andover, MA 01845. Department (978) 688-9535 If you have any questions, please do not hesitate to contact this office. Sincerely, Sandra Starr,R.S., C.H.O. Health Director HANCOCK Engineering Associates m3EM1113MMMMM 235 Newbury Street,Danvers,MA 01923 (978)777-3050 Fax(978)774-7816 0 12 Farnsworth Street E)626 Main Street -DA----- .... .................. .........- Boston,MA 02210 Bolton,MA 01740 - ---------------- (617)350-7906 (978)779-6767 AT TION ............................. TO �C�,x is .........._........... ............. ............... .............. WE ARE SENDING YOU 0 Attached 0 Under separate cover vita..........._.._..._.___..-..... __..__......_the following items: I I Shop drawings El Prints E.] Plans EJ Samples El Specifications E] Copy of letter El Change order U ................... ....... ....................................................................... ......... ......... .......... ................... ............ ........... ................................... ............... .......... ...............­­­­11..................... ................................ ----------------- .......... ........... ........ .......... ----------.............. ........................... ................ .................. ............................... .............. ...................................... .......... ................ .................................................... .......... .............. .....................- .....---------......... ..... ........ ............................. ............. .......... ................................--------.........­h ----------- ............ ................... ............ ............................ ..........------------ ................. ---------------- ...... .._. ........­----------------------- ................... ............................... ......... ........................ .................................. -------- --------------- ...................... THESE ARE.)RANSM11 1"EDas checked below: I For approval E] Approved as sutm,fltl.ed I I InOSLlblflit copie-s for approval -] For your rise p Approved as noted I'] StAbinit .. ......_copies for disiribution Ll A�,, requested F I F eturned for corrections El Return cc)rrected prints I-I For review and conwrient, LJ L I FOF� BIDS DLJF 17 FIRIN p S KI-(H flV 1".)/T U H I 0AN FO (),l) i::lElViAlF,H(S -- --------- - ---------- ....... ....... ----- — - -------- .............. .......... ................. .............. ......... —--___- ................. ("OFly To If enc)osurosam nor iisnotod, kindly notily tnia nt onc,,o,