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HomeMy WebLinkAboutMiscellaneous - 190 GRANVILLE LANE 4/30/2018 190 GRANVILLE LANE 210/106.C-0077-0000.0 � 1 l Commonwealth of Massachusetts North Andover, Massachusetts System Pumping Record System Ow r & address: Brian Holasek 190 Grandville Lane North Andover, MA RECEIVED Location of system: Rear yard FEB 2 2 2005 Date of Pumping: January 05,2005 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Type of system: Septic Tank Gallons Pumped: 1000 Gallon(s) System pumped by: Service Pumping& Drain Co., Inc. License #: BHP-2004-0977 Contents transferred to: Greater Lawrence Sanitary District _i... ..JWN nu.. ...:::ID Uf .::::::::::::: . :.: t .: ..: ' h1r1���artaU� This is PROPRIETARY and CONFIDENTIAL information that may be used only by the Board of Health for regulatory purposes 4 RECEIVE® UA I0,51t)_5SYTTT,-i pomplfgQ RIE C, )}',*. SEP - 7 2005 TOWN OF NORTH ANDOVER HEALTH QEPARTMENT A7B OF _._....... .._.__._.w . . .. ..�5...__..... ...QUAN17Ty NA rUKB OK 9 Rvtc_�: Kali f Zhu 1\� / \ 1 Utia�R VA C`I(yAf3. d'OQDCC�NU11►UIv NUI_: DU t_'��� raY. KOM � 8 _. 8AFYG89 IN NLA/ ..c �+�C&98IY6 SOLIDS T. P�.ca0D8D �LlpCR�t,RYq AUYN'ER EXPLAIN Ajo o Address (?D G AMNU �-�,z k Title of File page of Date File Open: Date file closed: Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes action Document/ document/ Num. Action Department Board of Appeals - Board of Health - Planning Board - Conservation Commission - Building Department G FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments isdic have been obtained. This does not relieve thehappl' jurisdiction landowner from compliance with an PPlicant and/or regulations or requirements, y applicable local or state law, ****************Applicant fills out this seption* ** ******* **** APPLICANT: S 5�8 �'-7 - /0 X I g 3 Phone Sb U -.�J-1 Q b r7I LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) Street ( B1� G,CZA.�pv���E L.-) St. Number ��Q Official Use only************************ RECO ATIONS OF TOWN AGENTS: Cons ation Administrator Date Approved Date Rejected Comments ----�-1 ,� S � G Town Planner Date Approved Date Rejected Comments Food Inspe tor-Health Date Approved Date Rejected Se c I ector-He lth Date Approved d�/ Date Rejected z�y Comments o a Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date y L II ,RMW II-IMINA EMIR,Ii4:C in IiItW--w I4 LAI FG-izl IVY HIM,Itiall, -Mw Ap-wo -arm--II' son a Ong, IIIlow" Af I00 wo, no 1", qA4 Eli a-1 =w n" III %ARM V up;N Iif :MnNAV Icy I IIIto tiIt "Vol) IIwin W IIfIaft IIf qk iIIIIIiilk! 7 III-toy IIVol IIf %lion jwjj�,l IItatom tkA ow� no, .nv,"s Inge,bo IIlelm II .0 Ing ... ..........IIIIF tf IIIIIa IMW y r.Jt kr,T.iv • .Y .. 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Cement Pipe to Tank - Ca Both Sides of Tank 5. Distribution Box a. Covers & Box - No Cracks b. All Lines Flowing Equal Amounts c. No Back Flow a 6. Leach Field or Trench a. Dimensions b. Stone Depth c. Capped Fads d. Clean Double Washed Stone 7. Leach Pits a. : zensio, b. Stone epth C. Sp sh Pads d. s e. Cmment Pipe to Pit - Both Sides f. Clean Double Washed Stone 8. No garbage Disposal 9. Final Grading Inspection 10. Barricading Covered System r U. As Built Submitted a. Lot Location b. Dimensions of System c. Location with Regard-to Pere Test d. Elevations e: Water Table SUBSURFACE DISPOSAL SYSTEM CHECK LIST / c NORTH ANDOVER BOARD OF HEALTH APPROVED DATE PROVIDED DISAPPROVED DATE TIME REASON Title Reg. 2. 5 Fail OK The submitted plan must show as a minumum: he lot to be served (area,dimensions,lot #,abutters) (Planning Board files) location and log of deep observation holes-distance to ties location and results of percolation tests-distance to ties esign calculations & calculations showing required leaching area ocation and dimensions sf system (including reserve area) existing and proposed contours ocation of any wet areas within 100' of the sewage disposal system or- disclaimer (check wetlands mapping) surface and subsurface drains within 100' of sewage disposal system ordisclaimer location of any drainage easements within 100' of sewage disposal system or disclaimer (planning board files) known sources of water supply within 200' of sewage disposal system or disclaimer location of any proposed well to serve the lot (100' from leaching facility) location of water lines on property (10' from. leaching facilities) m location of benchmark driveways garbage disposers no PVC is to be used in construction a profile of the system (elevations of basement, plumber pipe septic tank, distribution box inlets and outlets, distribution field piping and any other elevations) -maximum ground water elevation in area of sewage dispose s stem plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Septic Tanks Reg. 6 a) Capacities - 150% of flow, water table, tees, depth of tees , access, pumping, b) Cleanout 10' from cellar wall or inground swimming pool 25' from subsurface drains Norte Andover Subsurface disposal system check list - Page 2 Pail OK Distribution Boxes Reg.10.2Slope greater than 0.08 Reg;10.411�b` ) Sump Leaching Pits Leaching pits are preferred where the installation is possible Reg.11 .2 (a) Calculations of leaching area (minimum 500 S.F. ) Reg.11 .4 (b) Spacing Reg.11 .1 (c Surface drainage 2% Reg.11 .11 d) Cover material feeo¢e.io Leaching Fields Reg.15.1 (a) R2Greater than 20 minutes/inch Reg.15.1 (b) Area (minimum 900 S.F.) Reg.15.4 (c) Construction of field Reg.15.8 (d) Surface drainage 2% Reg. 3.7 (e) 20' from- cellar wall or inground swimming pool Leaching Trenches Reg.14.1 ) Calculations of leaching area (min. 500 S.F.) Reg.14. 3 ) Spacing (4 ft. min. 6 ft. with reserve between) Reg.14.4 Dimensions 14.5 Reg.14.6 Construction Reg.14.7 ) Stone Reg.14.1 —Surface drainage 2% Downhill Slope ( Slope y/x = (to be shown) y/x X 150 = (to be shown) Pumps j Reg. 9.1 (a) Approval Reg. 9.6 (b) Stand-by power • SOIL PROFILE & PERCOLATION TEST DATA Board of Health-North Andover, Mass. Street F 6 Lot No. 33 Subdivision' Owner Investigator ,, Observer U ` SOIL PROFILES 1 . Date 2. Date 3. Date 4. Date Elev. Elev. Elev. Elev.. Feet Inches 0 0 Ties to Test Pits 1 . . 1 12 2. 2 24 3. 3 36 4. 4 48 5. 5 60 72 7 84 3 96 3 108 10 120 Note: Top & subsoil depth; depths of other soil types; depth of water table; depth of refusal. PERCOLATION TESTS Date 6-12-7$ Date Date Date Date Pit Number 1 2 3 4 5 Start Saturation 3:1 Soak-Mins. 21 Start Test-Time :yo Drop of 3"-Time :cro Drop of 6"-Time PL Mins. 1st 3" Drop Mins. 2nd 3" DroD Z Rate Min. In. J K SOIL PROFILE & PERCOLATION TEST DATA Town/City No.&Street C_�-�-C.�-i�C�. ��G Lot No. S3 \J Loc./Subdiv. ,'9 -, ;4C/Z Plan Owner_74 - . Investigator,/�?O_.,-Ae G- -C.// Observer , SOIL PROFILES-DATE 1. E1 v. 2. Elev.� 3. Elev. 4'Elev. ,} o 'Sa� 77 0 0 0 1 1 1 1 2 2 2 2 3 3 3 3 4 4 4 4 �5 5 5 5 6 6 6 b �7 0. 7 - 7 7 8 8 8 8 9 9 9 9 10 10 10 10 Benchmark Location Elevation Datum Percolation Tests-Date Pit Number 1 2 3 4 5 Start Saturation Soak-Mins. Start Test-Time Drop of 3"-Time Drop of 6"-Time Mins. lst 3"Dro Mins. 2nd 3"Dro Notes & Sketches on Back Frank C. Gelinas & Associates, North And. FILE# a 96 107 Forest St. Middleton,MA 01949 SID (508)774-2772 7 i it AA J Y' I + •M TOWN , F NFR1,t i { Ftp 2 1996 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PROPERTY OWNER'S NAME: i r Q / PROPERTY ADDRESS: /� rt^n �/ � l.,�tr�� N• �j?p�pe/�r_�/ �: 6 f ADDRESS OF OWNER: S�!ti-Qi fF I` 1 (if different) DATE OF INSPECTION: c;2 - i 3 . } NAME OF INSPECTOR: �, k u 5643 m b F i, s. •THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY• i FILE# ;2,94 4 Iq "{ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM # PART A CERTIFICATION /90 G'.tr.�v��,LQy,r�U, An�o'.f!ifi/4 Property Address: Address of Owner: Date of Inspection: F'cb .Z, � (if different) Name of Inspector: 7)cw, G. l�iscrsrr,d.� Company Name,Address and Telephone Number: Currier Septic& Drain Service, Inc. 107 Forest Street, Middleton, MA 01949 (508) 774-2772 CERTIFICATION STATEMENT - I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority } Fails Inspector's Signature: Date: F-e 6r4td`y The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Chec�B, C, or D: A) SYSTEM PASSES: _ I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. 3i B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the l replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of termination in all instances. If"not determined", explain why pot Ii Ll/ The septic tank is metal, cracked structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 8/15/95) 1 4 FILE# r ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (conriNuEd) B) SYSTEM CONDITIONALLY PASSES(continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: I I Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLl`S� THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONidENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply t well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply / well. /V The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. i D) SYSTEM FAILS: have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. (revised 8/15/95) 2 FILE# SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) D) SYSTEM FAILS(continued) ) Static liquid level in the distribution box above oulet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. 1 Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. i Any portion of a cesspool or privy is within a Zone I of a public well Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: ._.�r The following criteria apply to large systems in addition to the criteria above: The des -of..�jystem is 10,000 gpd or greater(Large System) and the system is a signifi'Int threat to public I health and safety and the•L vironment because one or more of the following conditions-exis the system is within 400 feet ora surface drinking water supply the system is within 200 feet of a tributary o-a;surface drinking water supply the system is located in a nitrogen sensitive area (Int ire ire m°Wellhead Protection Area (IWPA)or a mapped Zone 11 of a public watei:supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program require n.-,its of 314 Clv]R 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 8/15/95) 3 FILE# g.9619 1 i , ! l i ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B i } CHECKLIST Check if thef ollowinghave been done: information was request�2a of the owner, occupant, and Board of Health ,LNone of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. ZAs built plans have been obtained and examined. Note if they are not available with N/A. _✓The facility or dwelling was inspected for signs of sewage back-up. 3 i ZThe system does not receive non-sanitary or industrial waste flow. l � I i LI/The site was inspected for signs of breakout. i ZAll system components, excluding the Soil Absorption System, have been located on the site. //The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of tna Soil:;:sorption System on the site has been determined based on existing information or approxiniated by nuii-intrusive methods. L/The facility owner(and occupants, ;f different from owner)were provided with information on the proper maintenance of Subsurface Disposal System. (revised 8/15/95) 4 I FILE# I 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION a i i, 'I FLOW CONDITIONS RESIDENTIAL: Design flow: J140 gallons Number of bedrooms:_ Number of current residents: 1 Garbage grinder(yesyr no):�S Laundry connected1d system, or no): Seasonal use(yes ol(n'i : G, /� i Water meter readings, if available: 61/0 e?"IF ' �C�'%�s. �rT '"; i`u�•- t::d:l �'}iY l�.i/'t�,"tl,^..°.r Last date of occupancy: I, !' Type o sta ishmDen�TRiAL• Design flow: alloias/d y Grease trap present: (yes or not)'--- j Industrial Waste Holding Tank pre sentys or.no} Non-sanitary waste discbaryed-to the Title 5 system: (yes nro o): Water er_readii-s if avialbie:_ Last date of occupancy:_ OTHER: (Describe) Last date of occupancy: CC-NER«L INFORMATION PUMPING RECORDS and source of informati'n: System pumped as part of inspection: (yes �or no) If yes, volume pumped: 4. Z) gall cisJ Reason for pumping: i.~ TYPE SYSTEM Septic tank/distribution box/soil absorption system Single cesspool i Overflow cesspool Privy { Shared system (yes or no) (if yes, attach previous inspection records, if any) Other(explain) APPROXIMATE AGE of Lill co;inpoments, date installed (if known) and source of information: Q 79 i Sewage odors detected when arriving at the site: (yes or j'q (revised 8/15/95) , i F ,� FILE# 1 : SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C i ¢ j'E t 1 SYSTEM INFORMATION (continued) f� SEPTIC TANK-A!<, (locate on sit Depth below grader t i ! aterial of construction:: cLrete_!Metal FRP other(explain) /1 H,* � L 3 ` ` t-<:i t" C G'T�i p1^d)I Q I'° I , ^ Q� ✓�+ f Dimensions: ' tie k 5 L� . ' " v+,', r'r� p Baffle De th Below Outlet Invert: G Sudge depth: > 3" distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: t I Distance from top of scum to top of outlet tee or baffle: ' /� ,Distance from bottom of scum to bottom of outlet tee or baffler_ It i ty Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert 'structural integrity, evidence of leaks e,etc. ` v�7�ii'" Mftr, ' iE " 1 A ter.. aij.+ 0"I ,� /,;,, rZ r-tr�lrli;.' c'� <,'S �/t':a !" �' r. .'s<, t:� !'.� � F �J /�.J6 �"1.•[�[v`✓"iv't' cs� C! /P'4�lf �RN'1�♦ EEq�! i GREASIE-TI;`AP: (locate on sife-o p) i Depth below grade: Material of construction: concrete metal_FRP other(explain) Dimensions: _ —`Baffle Depth Below Outlet Invert: Scum thickness: Distance from top of scum to top of outle ee o�baffle: Distance from bottom of scum tg..bottom of outlet tee or baffle: } t ;R, Comments: "(recorTimen ad t o for pumping, condition of inlet and outlet tees or baffles, depth o iq id level in relation'to outlet invert, structural integrity, evidence of leakage, etc.) li . 1 } if , 1 t .. 9 t y (revised 8/15/95) 6 r Fp J, FILE# I t SUBSURFACE SEWACE DISPOSAL SYSTEM INSPECTION FORM }F} PART C SYSTEM INFORMATION (continued) :TIQHT OR HOLDING TANK: (locaWon site plan) —" r E kl Depth below gr d .Material of constructio concrete_metal FRP�other(explain) t 1' i . E imensions: Ca aci allons ,, Design flow: gallons/day `:> Alarm level: Comments ` (condition of inlet tee, conditign-o6larm and float switches, etc.) ! i§ I .,-'... 1, -4"1ry DISTRIBUTION BOX: ye (locate on site plan) Depth below grade: j 21." r4 ,Depth of liquid level above outlet invert: Ferre) 1 .Dimensions of D-Box: q"x 1-1 'Depth of Sump: Comments: '(note if level and distribution is equal, evidence of solids carryover, eviden a of leakage into r out of box, etc.) Roy- •r5 4 KJi ("0J t")re� -',V.�.... Irl•y�,, aE..(^J�'7 f.�'.�' �y /i I, C^ t 7h" ` {``Y a"2 "4`CI /✓}—finA: ! t-?j'r a-7-4 SL! Q r� Ic .5 C/L'".i i- k �s•I!,..tf Ii' .s'� �'y c:t" l�.l "f/.f,•, yy „•,I ,�. ;ty i-. E , I PUMP CHAMBER: IVU �. (locate on site planes f Depthbel g grade:---. Pumps in working order:(yes rrito) Comments: „ (note conditions of pump chamber, condition of pumps dpp rteenances etc.) � s F r' (revised 8/15/95) 7 t` Ir C' I 9[. t` �.. 1 1z FILE# t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART CA. .I SION (continued) t SOIL ABSORPTION SYSTEM (SAS): e�°=> ) (locate on site plan, if possible excava ion not required, but may be approximately by non-intrusive methods) . r4 h' Depth to bottom of SAS: (Stone or Pit) Aepr,r, fiIfF not determined to be present, exp lain:�r ;��P'v x1r ',(eI sir j t Type: 7 C,./4" J �c��t,i�tiirr� !/'jld ,+9 aZ3 _ leaching pits, number: F a ' !!' leaching chambers, number: f leaching galleries, number: ', 7 j9 it leaching trenches, number, length: leaching fields, number, dimensions: I t`,z I-X Comments (note condition o soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc..) �i � r^�?� /s �✓s'Y'e"ef v� C 4%/ "�r'�At,..�' Gt�,��r"Gt . n�,.'n� � �`C4'(ti:f` .'}+�r•:L .)C` .�iAt."r`�Jf G3Y' �� !.(, /"r.r �� :s• r' •fit.c� r �" r �""Y's� it� "i"1ct � ��.' �" ' CESSPOOLS: E,a (locat on site p an) Depth below grad ' Number and configuration: . F Depth-top of liquid to inlet invert: Depth of solids layer. -� ` Depth of scum layer: ' Dimensions of cesspool: l t Materials of construction: i i � N ' ' Indication of groundwater: inflow(cesspool must be pumped s part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, j (locate on site plan) } i 5 Materials of construction: Dimension s: + Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of-pop ding,o dition of vegetation, etc.) i � it � e � j•. F (revised 8/15/95) $ s -�. FILE# 0202 !��/�i >. .. {i SUBSURFACE SEWACE DISPOIAL SYSTEM INSPECTION FORM a . PART C 4 SYSTEM INFOI21 ATIONcon inued gy Y � ) A.SKETCH OF SEWAGE DISPOSAL SYSTEM: . _ include ties to at least two permanent references landmarks or b nchmarks locate all wells within 100' � E.¢ , { 1 i t 4 / d y rl € `.� .� ! .,.._...«.._. -.._......_.._._.....�t'f:5iit ,SiYyµi�t.,..i.i...-_._......_._.___.._._.._. - •{S ja.�,� �,. y t DEPTH OF CROUNDWATEst i }' Depth to groundwater: feet { method of determination_or approximation: t:it l`/'t /%�� r ,•r,f �,4.�4-; *r 7a�i t,✓CLf ' t r l l ' ' t 4 {� t,1 t ��c;' �-��1 c'` l�,�'1 �.�)G'3fCI C/';�✓°` �t;: � ��� �� ` ....+.��. «.-..•.-.........�....,......r..............................+................._.....a..,_+s...w,w........,....+..n.._...+.r.rw....�...._....w,......�.....•.... IE .y tFs"� Ys '(revised 8/15/95 9 t ..