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Home My WebLink AboutSoil Testing Results - 67 VEST WAY 7/28/1999 BOARD OF HEALTH NORTH ANDOVER, 5. APPLICATION SOIL TESTS DATE: "7 2. LOCATION OF SOIL TESTS: 4a:?- ye-✓"' Assessor's map & parcel number:L� , _ OWiJER: Jol Q ec t7mg. TEL. NO.: 6:7 - ADDRESS: ( ] V -5 ENGINEER: r 1 - TEL. NO.: CERTIFIED SOIL EVALUATOR: i ors I Intend se of nd: residential subdivision, single family home, commercial Rep it sting Undeveloped lot testing N. Con w at Commission Approval: THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1, Proof of land ownership (Tax 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 SOH 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. SINE. A �� PA C Lor 36A 0 o ) —! N P p � m ry)_ v Z- Bray r �.o T 38 /V 0 � �7 J ► MA7'CM sc�,L. , 1 = 110E-r. CA)IEROH BISHOP EHGMCERlHG CORP. 125 MAIN ST, STONEHAM MA ozlao _ e — 51 D a 3 o. /? S —f8 �5 ^ —...-- r4ORM It - SOIL EVALUATOR FORNI page I Date......f No. .................................. Commonwealth of C husetts • Meseachusettra ......................... performed By: ...... .................................................................................................... ............ ...................... .......... Witnessed By: ...................... ....................................................... ......................... .............I..................................... ................................ Omw's Nw. —4110,A) A"Vu.wA &--?- Tekpkm I x)0, / & Now construction El Repair Published Soil Survey Available: No D Yes Year Published Jft.. Publication Scale .j.,!X.5 Soil Map Unit ...... —........................ Drainage Class ........ Soil Limitations ...................................... .................... Surficial Geologic Report Available: No Yes Year Published ................... Publication Scale ................. GeologicMaterial (Map Unit) ......................................................-............................................................................................... Landform .............................................................................................-.................................................... .................................................. Flood Insurance Rate Map: Above 500 year flood boundary No El Yes El/ Within 600 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)............................ ................................................................. Current Water Resource Conditioni (USGS): Month ... Range Above Normal El Normal E] Below Normal [3 Other References Reviewed: FORM It ® SOIL EVALUAYOR VORM Page Z nn-sfite P,view • Deep Hole Number._1.:�_.» Data:..... Time:_.�/...�� Weather Location lldendfy on alto plan) • Land Use »�. ice„ � » »»_ ». Slope 116) � 6urfece Stones ......124 ........_..... Vagetatlen » » .........r.. ..» .... ...» ».. .......... ».w»..... »»»»» »».......»» wdform .»._ » » ......._._ »....»_..»» »..._ »» posltion on landscape(sketch on the back) »»»__ .......... Distances from: ' Open Water Body ... feet Oralnege waV.,>...1m_. feet, Possible Wot Area feet Property Una » feet Drinking Water Wed 7. . feat Other................................»... Qow pepth Irom Gurkas Goa Hahon Boa Testate 6Pa GoWt Sol MAtow relruoar�� . llnatael Wfil1A) lNkinteltl SiltaA�pere, r be �0 Parent Mstetlal(geologic( __»_.»__1..�G L. _...._.._ ._.»._..._».._..»._................_............. Depth to Bedrock: » nwnth t Or undwetar,, 11611.Standing Water In the Hole: •-••• �• Weeping from Pit Face: Estimated Seasonal High Ground Water: ....... Ryti11 ® SOIL EVALUATOR ]FORM Page 3 Detemination fa Water RAathnd Used: ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of-observation hole inches- l1 Depth to soil mottles ... . Inches ❑ Ground water adjustment feet Index Well Number ._................ Reading,Date Index well level Adjustment factor Adjusted ground water level _......... Denth of Naturally Occurring Per u Material T 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? certify that on (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 experlence described in 310 CMR 16.017. Signature L Date FORM 1 m PERCOLATION T COMMONWEALTH 'OF MASSACHUSETTS Me88 echusetts Percolation Test Date: :. Tfin �.� Observation Hole # Depth of Pero K Start Pre-souk end Pre-soak j Time at 12" , Time at 8" Time at 6" Time W-6«1 Rate Min./Inch Site Passed Site Failed ❑ Performed By: 7 Witnessed By: /2v 1`r& Comments: ........................... r r ❑r, �. LOCATION� / o t m.. l° EC NE E A'D _ r PE .CC!",TICN T= T .. a � � r T I T I NI'--- IN E . f I�IE 117 t I II �� II / I II - I 1 j I I i A I iv7�5 r n - 1 I i � I Town of North Andover, Massachusetts Form No. 1 01 NORTH qq BOARD OF HEALTH 0 ,P� 5' ry;r oA � 19 r n APPLICATION FOR SITE TESTING/INSPECTION DRFTEDEPpPy�S �SSACHUSE� Applicant_ 1 6; NAME / ADDRESS TELEPHONE Site Location ) Engineer .-'. NAME ADDRESS TELEPHONE Test/Inspection Date and Time—At 6� Fee CHAIRMAN, BOARD OF HEALTH `�� Test No. S.S. Permit No. C.'q D.W.C. No. C.C. Date Plbg. Permit No.