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HomeMy WebLinkAbout- Soil Testing Results - 1015 FOREST STREET 2/13/2019 "I'OWN OF NORTH'l H AND OVER rt t"ouiniunity & Exononiic Development -IEAL'rH DEPARTMENT �. t 17.0 rti��tr Street NC:RTl-1 ANDOVER, MASSACTIt. SF,I"°'I'S 01845 t� � k" 978.688.9540 -Phone N �� "� � 78.688.954 -_I^"A 1 ltcaltli(lel)t*ioiwtl►an►;love►-tiia,gov www.northancloverma.gov APPLICATION FOR SO.11, TESTS DATE,:YNov. 29, 2018 MAP&PARCEL: Map 105© Parcel 56 LOCATION OF SOIL TESTS: � r� ��✓ �_�_� O WNI".'-W c/o Steve Cunha Contact j€: 617-823-4738 APPLICANT:_ � ()VA a __Contact 11 ADDRESS: 1015 Forest Street ENGINEER: Jack Sullivan Contact11: 781-854-8644 CI I TIFIED Soil.,EVALUATOR: Jack Sullivan (email:jacksul153@comcast.net) Intended Use of Land: Residential Subdivision Single Fa►uily l loupe Commercial Is uiis: Repair`Testing: X ._..... undeveloped Lot Testing: Upgrade for Addition:,___ In the Lake Cochichewick Watershed? Yes No X __....._..._ THE FOLLOWING MusT BE INCLUDED WITH Ti-Hs FORM Proof of land ownership(Tax bill,or lettc).11-0111 owner permitting test) � 8.51'x 1.1 1111ot plan&Location.,of% ink, Vease inriicate test )it it the plan Y bee of585.f10per lot for new construction. This savers t unirn►►n�t o deep holes and two percolation tests required for each disposal area, l7c f,$440A0 per of for repairs or upgrades. GENERAL INhf RMA'TIO Only Certified Soil I3valuators may perform deep liole insp ' s. Only Mass. Registered Sanitarians and Professio►►al Engincers can design septic plans. At least two deep holes and two Percolation tests are required for each septic system disposal area. 5* Repairs regnire at least two deep holes and at least one percolation test, at the discretion of the BOI-I ►epresenlative. Full payment will be required for all additional tests within two weeks of testing. Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the board of fleahh showing the location of all tests(including aborted tests). Within Gb days of testing soil evaluaticnx forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Can►n►ission 111)1moval Date:__...__ Signature gj'Conservatian Date back to Health Department: (lanip hi): Town of North Andover, MA November 29, 20I8 . . ,� __ ,, tas,Doasa � � r,l°rSII � l 105 D-0177 i�� 44,1011/0 1 /11 tas.t7 coat %/ A*ark s 40��� �j to .a-aa5e 1.OS.Daa57 , All V Vp u tas.c,.otaa 1a5.D Drat 1" = 120ft i Go Ik i MAC' FOR REFERENCE ONLY NOT A LEGAL.DOCUMENT � . Town of North Andover, MA makes no claims and no warranties,expressed or implied,concerning the validity or accuracy of the GIS data presented on this map. D a & 8X Geometry updated 10/31/2018 t �" Data updated 10/3112018 I i November 29, 2018 Stephen Cunha 101.5 Forest Street N. Andover, MA 01845 j Re: Permission for Soil Testing 1015 Forest Street,North Andover Board of Health, As owner of the above property I grant permission for soil testing for a future septic system, Sincerely, Stephen Cunha I A i %AORTN ti 9 Town of North Andover HEALTH DEPA11TMENT ps$ACW�St� CHECK#; "; ,<M 1(° " 1DA.lE: H/O .NAME: CONTRACTOR NAME: __. �X` Type of Pgmit or License: (Check box) q' k ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service - ❑ Funeral Directors $_ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic).Hauler $� ❑ Recreational Camp $ _ Sun tanning $ ❑ Swimming Pool $_ ❑ Tobacco $ ❑ Trash/Solid Waste hauler $ ❑ Well Construction $ SEPTIC stems: � Septic-Soil Testing ❑ Septic-Design approval $� ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Winks Installers(DKff) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other:(Indicate)_ H "Ith Agent Initials White-Applicant '. l ��Clozv m HeaIth Pink a Treasurer , wrAl _ t - --- dt t i ;jam j I� fat _ 11 J11 IN w _ k Al t _ Dt - J k t t L r / f -tj t E R -V _ Commonwe althof sacthAlws City/Town of W sessmen t f or On-Site Sewage Dis DEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but the information must qk check with your local Board of, the form th Before using this forrin Health to determine be substantially the same as provided here. Befo A. Facility Information Facility Information Steve Cunha Owner Name 1015 Forest Street Map/Lot: map 105D Lot 56 Street Address MA 01'845 North Andover State zip Code City/Town B. Site information 1. (Check one) New Construction F—I Upgrade Repair I available? vies D� No 'jN If yes: RCS Soil Nlap 422D 2. Published Soil Survey P avai Soil flap Unit Canton Fine Sandy Loam Soil limitations Soil Name 3. Surficial Geological Report available? y Ej,❑es No Il'yes: Year published Publication Scale Map Unit Geologic Material Landform 4. Flood Rate Insurance Map: Above the 500 year flood boundary? Yes ❑ No 71 Within the 1100 year flood boundary? Yes 71 No Z No Within the 500 year flood boundary? Y es 7 No Z Within a Velocity Zone? Yes El --------- ------- 5. Wetland Area: National Wetland lnven'Loryk4ap Map-unit Name------ Wetlands Conservancy Program Map Map Unit Name DEP Forim 11 Soil Suitability Assessment for On-Site Sewage Disposal- Page 1 of 7 Commonwealth City/Town� (� 'XIM ������� ��� �����^�� �������e 0�^s��os��l ������� v� � ����UU ��8�Q��i��oon�� »��^zv"�.� � ..~ On-Site Sewage , 6� Current Water R�soumeCond�ona (QS6G) Range: Above Normal �� Normal �� Below Normal i1 NonthiYear 7 other references reviewed: C. on-Site Review (minimum-of ftvo holes required at every proPOsed disposal area) 8�0O � rn� 4O dagnaes/o|eor Deep Observation Hole Number: 1 12/7/18 Tim� WeatherDate ^ 1. Location Ground Elevation at Surface of Hole 101.O_______ Location (identify on Plan) __See Sheet of 2, Land Use: Residential ProPe ------NonS_ -------- |neT�> � woodland, aghcuhvna|ma�.,aoont/c�eo.) -_-' - � Grass_ '' �n�io"" ----Position on landscape(attach sheet) Vegetation Lendfonn S Oiotancesfrom�� Open Water Body^2OU_ OnainageYVay>200 Possible Wet Area >150 feet feet = PmpanyLine15 Drinking Water Well 145 Other feet 4. ParentyWater|e|: Coarse Loamy over Sandy Me|toui_______-- Unsuitable Materials Present: YesL7 No-1-7 |fYeei DishurbedSoi|F-1 Fi|\ K8ateria|Z Impervious Layer(s) 17 VVecthered/FnacturedRockF BedpockFl 5 Groundwater Observed: Yes E] No [5� If Yes: Depth Weeping hnmPit n/ DepthSt�ndin� ater|nHole,___n/a______ Estimated Depth toHigh Groundvx--_ ---- VV (8m�um of Hole) Elevation: 91 Q DEP Form I I Soil Suitability Assessment for On-Site Sewage Disposal-Page 2 of 7 1�folig e Disposal orm�L\ Commonwealth of 5- ach 5V m I sssessment for On-Site Sewag Deep Observation Hale Number: 1 Boil Soil Matrix: edoximorphaic Futures 1 Soil Coarse Frac rraents Bail Strcicture Consistence Other mottles Texture %toy Volume les II Horizon/ Color-foist ( � I�SCA (foist) Depths unsell � ) (in.) Layer _ keptCrPercent , gavel Straw Cora. E j 1 -------------------- 0-42 FILL i j 1 FS nla 1 1 46-61 j lg f.5 6i n1a � I I _ 2.5 Y 5/4 n1a i_S 6 0 118 s Il I } I I Additional Notes DEP Form I Soil Suitability Assessment for On-Site Sewage Disposal-Page 3 of 7 ------- Commonweal"eat"h I city/—i own of On-Site Sewage DiSposal ssmenL Form 11 S lusi-cri f; C. On-Site Review (Cont.) � 121���8 9:� � 0 degrees/clear Deep Observation i umber. date Time Weather 1. Location Ground Elevation at Surface of Hole 100.4' Location (Identify on Plan ) See Sheet 7 of 7 none -3 2. Land Use: Residential surface Stones Slope(%I (e.g.woodiand, agricultural fief,vaunt lot,etc.) Grassed_ ground Moraine Positron on landscape;attach sheet) Vegetation Landfdform 3. Distances from: Open fluter Body>200 Drainage Way>200 Possible Wet Area >15e0t feel feet Property Line 12 Drinking Water Well 135 Other feet feet Unsuitable materials Present: Yes ] No 4. Parent material: Coarse Loamy over Sandy meltcut If Yes: Disturbed Soili 7 Fill MateriaC Impervious Layers;CI'I, Weathered/Fractured Rock[] BedrockE] 5. Groundwater Observed: Yes ❑ No 71 If Yes: Depth Weeping from Pit nla Depth Standing!Water in Hale_n/a Estimated Depth to Nigh Groundwater: 1161, g0.7 inches elevation DBP Form 14. Soil Suitability Assessment for On-Site Sewage Disposal-Page 4 of 7 Commonwealth 0 M � it yITI own ofAabMility Lssmentfor iteOn-S Sewage Disposal Y 4 � Deep Observation Hole umber: 2 so€� Soil Coarse Fragrnes is Soil Snit I Sail Matrix: Redoxi orphic Features I Structure Cosisteca�e Other Texture ( la volume {Moist} Horizon/ Coior- €gist 1 (Mottles) � {�lS�A? Depth ;ayer (MUnsell) i Gravel Cobbles I (in.) � r [ _P'h Color Perce�� &Stones I ii FLS j 0-3 A i 10 R 13 Ala I 8-30 B 10"R 518 nla I I 1 C1 2.56I4 I i LS j 30-�8 '� � 1 I 4$-1 i6 C2 2.5 v 5/4 LS t 1 F 1 1 Additional Notes D P Form 14 Soil Suitability Assessment for On-Site Sewage disposal s Page 5 of 7 Commonwealth of, S!5'1 �� |�n �� ���00��� ��� �����~�� ������� ��^������� ����rK�| 11 ~ ����K8 ��o�ot�uxxx*�� ^-«��� ~ '- - _ D. Determination of High Groundwater Elevation 1. Me'hod used: Depth observed standing waterin observation hole A. 118 1 1c, (Bottom of Hole) inches inches El Depth weeping lrom side of observation hole A._ &_ inches inches � Depth to soi| redmjmorphic features (mottles) A.inches &mmes -- Groundwater adjustment(US8G methodology) A, u, �_ inches inches 2. Index Well Number Reading Date |ndexVVa|| Leve| Adjustment Factor Adjusted Groundwater Level Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material � Does a�least four feotuf tu U 000urring pervious material exist in all! areas observed throughout the area proposed forthe [� - soil absorption Yon�� No �� b, |f yes, at what depth was itobserved? Upper boundary: 3U��____ Lower boundary: �11Ginch _______ F. Certification tor examination*approved by the Depadmannches tof Environmental Protection and that the above ohbedin31O (�NlR15.U17, ' ---' - - ' mmgexpe,uue and ep== " ". Sullivan ^'' P.E.- ^Date n[Soil Evaluator Exam Typed or Printed Name of Soil Evaluator Consultant m huTownovNo� Aouove, ,inm�nne Board ofHealth TNarneof Board of*eeuoWitness Note: This form must be Submitted to the approving authoritywiMh Percolation Test Form 12 DEP Form i1 Soi\Suitability Assessment fnr On-Site Sewage Disposal` Page Oox7 Commonwealth of Mapsachu sel 6-ty K� j ment for On-Site Sewage Disposal l EX v I `DEC{{ aj io Use this sheet for - 4,. Ex. 4 BEDROOM � �n .�JOI. C�cond moor O,/"r arr 1CC' WELL PROTECTION RADIUS I _7/__ -10 24 _ /I zr 14 S 7C°1 4'2 E �- : c0 °�6;02"E - �3" i 06.2 ; �.79 - __D_=or 1 Soil Suiiabilicy Assessment for Can-Site Sewage Disposal a Page 7 of 7 Comrronw alth caf s setts t� City/Town of Percolation T ° Form 12 Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DE:.P has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the Ideal Board of Health to determine the form they case. __ .._.,_.,.... . ..,,.__ .....__-, _. ..._._ _..__..._ ........_... Site Information When fitlling out A. forms on the computer,use Steve Cunha only the tab key Owner Name to move your 1015 Forest Street cursor-do not _ .. ..-..--- -.._.... use the return Street Address or Lot## key. North Andover MA 01845 UW Git /Town State Lid Code to Y d�lrr, Contact Person(if different from Owner Telep hon Number —- B. Test Results 12/7/18 9:00 a.m. Date Time Date Time Observation Hole#x PT 1 Depth of Perc 40"-58" Start Pre-Soak 9:07 End Pre-Soak 9:22 Time at 12" 9:22 _....._... ._.__._.__. — Time at 9" 9:24 Time at 6" 9:26 Time (9"_6") 2 min 2 Nl P I Rate(Min./Inch ---...__. .,. .. Test Passed: Test Passed: (� Test Failed: U Test Failed: U John D. Sullivan III, P.E. Test Performed By. Erin Kirchner, Consultant for Town of North Andover BOlµl _ _..... .._._,_ _.. Witnessed By: Comments: ............ t5formV.doc°06/03 Pero Test°Paige 1 of 1