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HomeMy WebLinkAbout- Soil Testing Results - 137 FOREST STREET 3/4/2019 TOWN OF NORTH ANDOVER Community & Economic Development ' 1� HEALTH DEPARTMENT ' o NT% O���EZ 120 Mainn Street NORTH ANDOVER, MASSACHUSETTS 01845 N 978.688.9540—Phone 978.688.9542—FAX healthdept@northandoverma.gov www.northandoverrna.gov APPLICATION FOR SOIL TESTS DATE: March 1, 2019 MAP&PARCEL: Tax Map 106A Lot 175 LOCATION OF SOIL TESTS: 137 Forest Street(rear yard) OWNER: Bob Moore Contact#: 508-509-9440 APPLICANT:Same as Owner Contact#: ADDRESS: 137 Forest Street North Andover, MA 01845 ENGINEER: Jack Sullivan Contact#: 781-854-8644 CERTIFIED SOIL EVALUATOR: Jack Sullivan Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: X Undeveloped Lot Testing: Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership(Tax bill,or letter from owner permitting test) ➢ 8.5"x 11"Plot plan&Location of Testier (please indicate test pit sites o► e lan ➢ Fee of$585.00 per lot for new construction. This covers th rmu wo deep holes and two percolation tests required for each disposal area. Fee of 440.0 er lot for repairs or upgrades. GENERALINFOR N ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. ➢ 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 Health showing the location of all tests(including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Conmrission Approval Date: l S l Signature of Conservation Agent.,-. Date back to Health Department: (stamp in): March 1, 2019 Town of North Andover Health Dept. 120 Main Street North Andover, MA 01845 Re: 137 Forest St,North Andover Owner permission for soil testing Health Dept; I, Robert Moore,owner of 137 Forest Street,North Andover grant permission for soil testing at my property. Very Truly Yours, Ak-I Arl--- Robert Moore (�✓I FE(L �� 137 �o�Esl� Jl, r✓q r Pi AL m � Tgo �fv �i. 01 5567 �iORTH 3 ti • 9 Town of North Andover HEALTH DEPARTMENT ,sS�CHUSES ` � CHECK#: /3 3 DATE: LOCATION: S J 1L. �1 H/O NAME: �O d ,�00 re- CONTRACTOR NAME: a G Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: _ $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ x S _EPTIC S stems: uc�'Septic-Soil Testing $ 7 /0 ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other. (Indicate) $ Hea /Agent Initials White-Applicant Yellow-Health Pink-Treasurer 4/3/2019 137 Forest Street Soil Test Results.jpg I 1 t P� fi 137 / e5<j AS https://mail.google.com/mail/u/O/#label/Mill+River/FMfcgxwBWTFWtkfSDLsJgTtxSGnpPdNz?projector=l&messagePartld=0.1 1/1 <Lx Commonwealth of Massachusetts Goo-D City/Town Of North Andover rti � Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal NOR�NPN�N� - k` '3 uz?P�M A. Facility Information Bob Moore Owner Name 137 Forest Street Map 106A Lot 175 Street Address Map/Lot# North Andover MA 01845 City State Zip Code B. Site Information 1. (Check one) ❑ New Construction ® Upgrade ❑ Repair 2. Soil Survey Available? © Yes ❑ No If yes: NRCS Soil Map 421C Canton Fine Sandy Loam Source Soil Map Unit Soil Name Soil Limitations Coarse Loamy over sandy meltout till Ridge Geologic/Parent Material Landform 3. Surficial Geological Report Available? ❑ Yes ® No If yes: Year Published/Source Publication Scale Map Unit 4. Flood Rate Insurance Map Above the 500-year flood boundary? [9 Yes ❑ No Within the 100-year flood boundary? ❑ Yes ❑ No If Yes,continue to#5. 5. Within a velocity zone? ❑ Yes ® No 6. Within a Mapped Wetland Area? ❑ Yes ® MassGIS Wetland Data Layer:No Wetland Type 7. Current Water Resource Conditions(USGS): Range: ❑ Above Normal ❑ Normal ❑ Below Normal Month/Year 8. Other references reviewed: t5form11.doc-rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 1 of 8 Commonwealth of Massachusetts Cityrrown of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed primary and reserve disposal area) Deep Observation Hole Number: TH-1 3/2 9/19 9 : 00 AM 40 DEGREES/CLEAR Date Time Weather 1. Location SEE ATTACHED SKETCH PLAN Ground Elevation at Surface of Hole: 97 . 9 Latitude/Longitude: / feet Description of Location: Southwesterly Portion of Site 2. Land Use Woodland few 2-5 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) wooded Ridge Vegetation Landform Position on Landscape(SLI,SH,BS,FS,TS) 3. Distances from: Open Water Body n/a Drainage Way n/a Wetlands > 100 feet feet feet Property Line 55 Drinking Water Well >10 0 Other feet feet feet 4. Parent Material: Coarse Loamy Till Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ® Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: Yes ❑ No If yes: 84 Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: �2 91. 9 inches elevation t5form11.doc•rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts p} City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: TH-1 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- Soil Texture %by Volume Soil Depth(in.) Layer Moist(Munsell) (USDA) Soil Structure Consistence Other Depth Color Percent Gravel Cobbles (Moist) &Stones 0-58 FILL 58-108 C 2 . 5 Y 5/4 72 50 SL Additional Notes: Water Weeping at 84" t5form11.doc•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts Cityrrown of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: TH-2 3/2 9/19 9 : 0 0 AM 40 DEGREES/CLEAR Date Time Weather 1. Location See attached sketch plan sheet Ground Elevation at Surface of Hole: 95 .4 Latitude/Longitude: / feet 2. Land Use Woodland few 2-5 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Wooded Ridge Vegetation Landform Position on Landscape(SU,SH,BS,FS, 3. Distances from: Open Water Body n/a Drainage Way n/a Wetlands > 100 feet feet feet Property Line 30 Drinking Water Well > 100 Other feet feet feet 4. Parent Material: Coarse loamy till Unsuitable Materials Present: ❑ Yes [3 No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ® Yes ❑ No If yes: 75 Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 59 90 .5 inches elevation t5forml 1.doc•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: _ TH-2 Redoximor hic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- p Soil Texture %by Volume Soil Depth(in.) Layer Moist(Munsell) (USDA) Soil Structure Consistence Other Depth Color Percent ravel Cobbles (Moist) Stones 0-18 FILL 18-24 A 10 YR 3/3 SL 24-34 B 10 YR 6/8 LS Friable 34-88 C 2 . 5 Y 5/4 59 40 SL Additional Notes: Water weeping and standing at 75" t5form11.doc•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 °0 Commonwealth of Massachusetts City/Town Of North Andover - Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal 3� D. Determination of High Groundwater Elevation 1. Method Used: Obs. Hole# 1 Obs. Hole# 2 ❑ Depth observed standing water in observation hole inches inches ❑ Depth weeping from side of observation hole inches inches ® Depth to soil redoximorphic features (mottles) 72 59 inches inches ❑ Depth to adjusted seasonal high groundwater(Sh) (USGS methodology) inches inches Index Well Number Reading Date Sh = Sr—[Sr X(OWC—OWmax)/OWr] Obs. Hole# Sc Sr OWc OWmax OWr Sh Obs. Hole# Sr Sr OWc OWmax OWr Sh E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Pq Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: 58 Lower boundary: 108 inches inches c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary: inches inches t5form11.doc•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Board of Health Witness Erin Kirchner Rep. for NA BOH Name of Board of Health Witness Board of Health G. Soil Evaluator Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15,017. 1 further cqKily that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form, are accurate and in accorca�nce with 3 CMR 15.100 through 15.107. 5-10-2019 Signature of Soil Evaluator f Date John D. S 4an III/ #2378 6/30/2022 Typed or Printed Name o' aluator/License# Expiration Date of License Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing, and to the designer and the property owner with ,percolation Test Form 12. t5form11.doc•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal 9� O•\ / \ BENCHMARK: \ SPIKE IN 14" TREE PT-1 ELEV=97.82' 24 1 f ABOVE GROUND 10 TH-1 TH-2 24., S SHED 4_1 00 • gvF�R t , /� Commonwealth of Massachusetts City/Town of NORTH ANDOVER Percolation Test Form 12 y` Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP 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 local Board of Health to determine the form they use. Important: A. Site Information When filling out forms on the BOB MOORE computer,use only the tab key Owner Name to move your 137 FOREST STREET cursor-do not Street Address or Lot# use the return MA 01845 key. NORTH ANDOVER City/Town State Zip Code 508-509-9440 Contact Person(if different from Owner) Telephone Number B. Test Results 3/29/2019 Date Time Date Time PT-1 Observation Hole# 66"-84" Depth of Perc 9:26 Start Pre-Soak 9 :41 End Pre-Soak 9 :41 Time at 12" 10 :25 Time at 9" 11:40 Time at 6" 75 MIN Time(9"-6") 25 MPI Rate(Min./Inch) Test Passed: ® Test Passed: ❑ Test Failed: Test Failed: ❑ John D. Sullivan III, PE, &E Test Performed By: Erin Kirchner, Consultant for Town Witnessed By: Comments: t5form12.doc-06/03 Perc Test-Page 1 of 1 Commonwealth of Massachusetts "'" �� Cityrrown Of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal �� A. Facility Information Bob Moore Owner Name 137 Forest Street Map 106A Lot 175 Street Address Map/01 North Andover MA 01845 City State Zip Code B. Site Information 1. (Check one) ❑ New Construction ® Upgrade ❑ Repair 2. Soil Survey Available? ❑x Yes ❑ No If yes: NRCS Soil Map 421C Canton Fine Sandy Loam Source Soil Map Unit Soil Name Soil Limitations Coarse Loamy over sandy meltout till Ridge GeologidParent Material Landform 3. Surficial Geological Report Available? ❑ Yes ® No If yes: Year Published/Source Publication Scale Map Unit 4. Flood Rate Insurance Map Above the 500-year flood boundary? ® Yes ❑ No Within the 100-year flood boundary? ❑ Yes ❑ No If Yes,continue to#5. 5. Within a velocity zone? ❑ Yes ® No 6. Within a Mapped Wetland Area? El Yes Wetland Data Layer:Yes ® No Wetland Type 7. Current Water Resource Conditions(USGS): Range: ❑ Above Normal ❑ Normal ❑ Below Normal Month/Year 8. Other references reviewed: t5form1l.doc-rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed primary and reserve disposal area) Deep Observation Hole Number: TH-1 3/2 9/19 9 : 00 AM 40 DEGREES/CLEAR Date Time Weather 1. Location SEE ATTACHED SKETCH PLAN Ground Elevation at Surface of Hole: 97 . 9 Latitude/Longitude: / feet Description of Location: Southwesterly Portion of Site 2. Land Use Woodland few 2-5 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) wooded Ridge Vegetation Landform Position on Landscape(SU,SH,BS,FS,TS) 3. Distances from: Open Water Body n/a Drainage Way n/a Wetlands > 100 feet feet feet Property Line 55 Drinking Water Well >10 0 Other feet feet feet 4. Parent Material: Coarse Loamy Till Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ® Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: 0 Yes ❑ No If yes: 84 Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 72 91. 9 inches elevation t5forml 1.doc-rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 2 of 8 Commonwealth of Massachusetts City/Town of North Andover _ Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: TH-1 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- Soil Texture %by Volume Soil Depth(in.) Layer Moist(Munsell) (USDA) Soil Structure Consistence Other Depth Color Percent Gravel Cobbles (Moist) Stones 0-58 FILL 58-108 C 2 . 5 Y 5/4 72 50 SL Additional Notes: Water Weeping at 84" t5form11.doc•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: TH-2 3/2 9/19 9 : 00 AM 40 DEGREES/CLEAR Date Time Weather 1. Location See attached sketch plan sheet Ground Elevation at Surface of Hole: 95 .4 Latitude/Longitude: / feet 2. Land Use Woodland few 2-5 (e.g.,woodland,a ricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Woodesd Ridge Vegetation Landform Position on Landscape(SU,SH,BS,FS, 3. Distances from: Open Water Body n/a Drainage Way n/a Wetlands > 100 feet feet feet Property Line 30 Drinking Water Well > 100 Other feet feet feet 4. Parent Material: Coarse loamy till Unsuitable Materials Present: ❑ Yes 2 No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ® Yes ❑ No If yes: 75 Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 59 90 . 5 inches elevation t5form11.doc•rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 Commonwealth of Massachusetts City/Town of North Andover ` Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal r C. On-Site Review (continued) Deep Observation Hole Number: TH-2 Redoximorphic Features Coarse Fragments Soil Soil Horizon/Soil Matrix:Color- Soil Texture �o by Volume Depth(in.) Layer Moist(Munsell) (USDA) Soil Structure Consistence Other Depth Color Percent ravel Cobbles (Moist) Stones 0-18 FILL 18-24 A 10 YR 3/3 SL 24-34 B 10 YR 6/8 LS Friable 34-88 C 2 . 5 Y 5/4 59 40 SL Additional Notes: Water weeping and standing at 75" t5form11.doc•rev.8115 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 ZrN, Commonwealth of Massachusetts Cityffown of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: Obs. Hole# 1 Obs. Hole# 2 ❑ Depth observed standing water in observation hole inches inches ❑ Depth weeping from side of observation hole inches inches ® Depth to soil redoximorphic features (mottles) 72 59 inches inches ❑ Depth to adjusted seasonal high groundwater(Sh) (USGS methodology) inches inches Index Well Number Reading Date Sh=S,—[Sr X(OW,—OWmex)/OWE] Obs. Hole# S, Sr OWC OWmIX OWl Sh Obs. Hole# SC Sr owl OWmI, OWE Sh E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? El Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: 58 Lower boundary: 108 inches inches c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary: inches inches t5form11.doc•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Board of Health Witness Erin Kirchner Rep. for NA BOH Name of Board of Health Witness Board of Health G. Soil Evaluator Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. 1 further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form, are accurate and i cordance with 310 CMR 15.100 through 15.107. r 5-10-2019 Signature of Soil E lu Date Jo livan III/ #2378 6/30/2022 Typed or Printed 144a oil Evaluator/License# Expiration Date of License Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and to the designer and the property owner with Percolation Test Form 12. t5form11.doc•rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 8 �\ Commonwealth of Massachusetts City/Town Of North Andover Form I - Soil Suitability Assessment for On-Site Sewage Disposal 163.87'C2 soft SPIKE NAR14" TREE PT-1 ELEV=97.82' / Q 24" 1'f ABOVE GROUND TH-t TH-2 .24"' \ \ — ' kP 0 `a BUFFER /� Commonwealth of Massachusetts City/Town of NORTH ANDOVER Percolation Test Form 12 Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP 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 local Board of Health to determine the form they use. Important:When filling out A. Site Information forms on the BOB MOORE computer,use only the tab key Owner Name to move your 137 FOREST STREET cursor-do not Street Address or Lot# use the return key. NORTH ANDOVER MA 01845 City/Town State Zip Code ± 508-509-9440 Contact Person(if different from Owner) Telephone Number B. Test Results 3/29/2019 Date Time Date Time PT-1 Observation Hole# 66"-84" Depth of Perc 9:26 Start Pre-Soak 9 :41 End Pre-Soak 9 :41 Time at 12" 10 :25 Time at 9" 11 :40 Time at 6" 75 MIN Time(9"-6") 25 MPI Rate(Min./Inch) Test Passed: ® Test Passed:es ❑ John D. Sul l ivan t Failed: , PE, C'SE Test Failed: ❑ Test Performed By: Erin Kirchner, Consultant for Town Witnessed By: Comments: t5form12.doc•06/03 Perc Test•Page 1 of 1 r Commonwealth of Massachusetts Executive Office of Energy &Environmental Affairs Department of Environmental Protection One Winter Street Boston, MA 02108.617-292-5500 Charles D. Baker Matthew A.Beaton Governor Secretary Karyn E.Polito Martin Suuberg Lieutenant Governor Commissioner APPROVAL FOR GENERAL USE R�G�,vVD Pursuant to Title 5, 310 CMR 15.000 ^'`j Name and Address of Applicant: 0 pF N A Infiltrator Water Technologies,LLC. P.O. Box 768 6 Business Park Road Old Saybrook,CT 06475 Trade name of technology and model: High Capacity chamber, High Capacity H-20 chamber', Quick4 High Capacity chamber, Quick4 High Capacity HD chamber, Quick4 Plus High Capacity chamber (8- inch invert), Quick4 Plus High Capacity chamber (13-inch invert), Standard chamber, Quick4 Standard chamber, Quick4 Standard HD chamber, Quick4 Plus Standard chamber (5.3-inch invert), Quick4 Plus Standard chamber (8.0-inch invert), Quick4 Plus Standard LP (Low Profile) chamber (3.3-inch invert), Quick4 Plus Standard LP (Low Profile) chamber (8-inch invert), Infiltrator 3050 (Storm Tech SC-740) chamber, Equalizer 24 chamber, Quick4 Equalizer 24 chamber, Equalizer 36 chamber, Quick4 Equalizer 36 chamber, Quick4 Equalizer 24 LP(Low Profile) chamber(6 inch invert), and Quick4 Equalizer 24 LP (Low Profile) chamber(2 inch invert) (hereinafter the"System"). Schematic drawings of the System and a design and installation manual are a part of this Certification. This approval allows the installation of the above identified chambers without aggregate. Transmittal Number: X259183 Date of Revision: February 19,2015,modified June 12,2015 Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000,the Department of Environmental Protection hereby issues this Certification to: Infiltrator Water Technologies, LLC., P.O. Box 768, 6 Business Park Road, Old Saybrook, CT 06475 (hereinafter "the Company"), for General Use of the System described herein. The sale, design, installation, and use of the System are conditioned on compliance by the Company, the Designer, the Installer and the System Owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Approval constitutes a violation of 310 CMR 15.000. June 12,2015 David Ferris,Director Date Wastewater Management Program Bureau of Water Resources This information is available in alternate format.Call Michelle Waters-Ekanem,Diversity Director,at 617-292-5751.TTY#MassRelay Service 1-800-439-2370 MassDEP Website:www.mass.00waec Printed on Recvcled ranne Infiltrator Chamber,Infiltrator Water Technologies. Page 2 of 6 Approval for General Use—June 12,2015 I. Design Standards 1. The models listed in Table 1 are covered under this Certification. Table 1: Chamber Dimensions Dimensions Invert Model W x L x H Height Inches Inches Equalizer 24 15 x 100 x 11 6 Quick4 Equalizer 24 16 x 48 x 11 6 Quick4 Equalizer 24 LP 6-inch invert) 16 x 48 x 8 62 Quick4 Equalizer 24 LP 2-inch invert 16 x 48 x 8 2 Equalizer 36 22 x 100 x 13.5 6 Quick4 Equalizer 36 22 x 48 x 12 6 Standard Chamber 34 x 75 x 12 6.5 Quick4 Standard 34 x 48 x 12 8 Quick4 Standard HD 34 x 48 x 12 8 Quick4 Plus Standard 5.3-inch invert 34 x 48 x 12 5.3 Quick4 Plus Standard 8-inch invert 34 x 48 x 12 8 Quick4 Plus Standard LP (3.3-inch invert) 34 x 48 x 8 3.3 Quick4 Plus Standard LP 8-inch invert 34 x 48 x 8 83 Infiltrator 3050 or StormTech SC-740 51 x 85.4 x 30 22.254 High Capacity Chamber 34 x 75 x 16 11 High Capacity H-20'Chamber 34 x 75 x 16 11 Quick4 High Capacity 34 x 48 x 16 11.5 Quick4 High Capacity HD 34 x 48 x 16 11.5 Quick4 Plus High Capacity 8-inch invert) 34 x 48 x 14 8 Quick4 Plus High Capacity(I 3-inchinvert) 34 x 48 x 14 135 ' This approval allows the use of the high capacity H-20 chambers but makes no determination as to the chambers meeting the H-20 loading requirements. 2 Includes Infiltrator MultiportTm invert adapter attached to the side of the end cap. 3 Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All-in-One 8 Endcap. 4 Only systems installed with this invert height shall be allowed to use the effective leaching area associated with this model in Table 2. 5 Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All-in-One 12 Endcap. 2. The System is an open-bottom leaching unit molded from polyolefin resin. It can be installed without aggregate or distribution pipe as an absorption trench or as a bed or field. If the System is installed with stone aggregate then the "Effective Leaching Area" in Tables 2 and 3 is not applicable, and must be designed in accordance with the provisions of 310 CMR 15.000. Infiltrator Chamber,Infiltrator Water Technologies. Page 3 of 6 Approval for General Use—June 12,2015 3. The total effective leaching area for any Chamber Model shall be calculated by multiplying the Effective Leaching Area per square foot of chamber times the total length of chamber from end cap to end cap including end caps. 4. For new construction or upgrades, the applicant can size the System in a trench configuration,using the effective leaching areas presented in Table 2. Table 2: Effective Leaching Area in Trench Configuration for New Construction and Remedial Sites" Effective Effective Model Leaching' Leaching$ Area Area SF/LF SF/LF Equalizer 24 3.76 N/A Quick4 Equalizer 24 3.90 N/A Quick4 Equalizer 24 LP (6-inch invert) 3.90 N/A Quick4 Equalizer 24 LP 2-inch invert 2.78 N/A Equalizer 36 4.73 N/A Quick4 Equalizer 36 4.73 N/A Standard Chamber 6.53 N/A Quick4 Standard 6.96 N/A Quick4 Standard HD 6.96 N/A Quick4 Plus Standard 5.3-inch invert 6.20 N/A Quick4 Plus Standard 8-inch invert 6.96 N/A Quick4 Plus Standard LP 3.3-inch invert 5.65 N/A Quick4 Plus Standard LP (8-inch invert) 6.96 N/A Infiltrator 3050 or StormTech SC-740 N/A 6.71 High Capacity Chamber 7.79 N/A High Capacity H-20' Chamber' 7.79 N/A Quick4 High Capacity 7.93 N/A Quick4 High Capacity HD 7.93 N/A Quick4 Plus High Capacity(8-inch invert) 6.96 N/A Quick4 Plus High Capacity(13-inch invert) 7.93 N/A 6 Effective April 21,2006, 310 CNM 15.251(1)(b)maximum trench width is 3 feet. '.Effective leaching area is equal to 1.67(bottom width+(2x invert height)) for Systems 3 feet or less in width. g. Effective leaching area is equal to 1.0(3 +(2x invert Height))for Systems with a width greater than 3 feet. 9. The maximum trench width allowed to calculate effective leaching area is 3 feet. 5. Systems installed on remedial sites shall be allowed to utilize the effective leaching areas presented in Tables 2 or 3, or additional reductions in soil absorption system may be allowed. In no instance shall the reduction in the soil absorption system required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. Infiltrator Chamber,Infiltrator Water Technologies. Page 4 of 6 Approval for General Use—June 12,2015 6. For new construction or an upgrade,the applicant can size the System in bed or field configuration,using the effective leaching areas presented in Table 3. Table 3: Effective Leaching Area for Bed or Field Configuration New Construction and Remedial Sites Effective Model Leaching1e Area SF/LF Equalizer 24 2.09 Quick4 Equalizer 24 2.23 Quick4 Equalizer 24 LP 6-inch invert 2.23 Quick4 Equalizer 24 LP (2-inch invert) 2.23 Equalizer 36 3.06 Quick4 Equalizer 36 3.06 Standard Chamber 4.73 Quick4 Standard 4.73 Quick4 Standard HD 4.73 Quick4 Plus Standard 5.3-inch invert 4.73 Quick4 Plus Standard 8-inch invert 4.73 Quick4 Plus Standard LP 3.3-inch invert 4.73 Quick4 Plus Standard LP (8-inch invert) 4.73 Infiltrator 3050 or StormTech SC-740 7.10 High Capacity Chamber 4.73 High Capacity H-20' Chamber 4.73 Quick4 High Capacity 4.73 Quick4 High Capacity HD 4.73 Quick4 Plus High Capacity(8-inch invert) 4.73 Quick4 Plus High Capacity(13-inch invert) 4.73 10 Effective Leaching area is equal to 1.67 times bottom width only. 7. When the System is used with a secondary treatment unit approved in accordance with 310 CMR 15.284 or 15.288, additional reductions in soil absorption system may be allowed. In these situations the reduction in the SAS cannot exceed the maximum allowed under the secondary treatment units approval. In no instance shall the reduction in the soil absorption system area required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. II. Special Conditions 1. The System is an approved Alternative Chamber for use as an Alternative Soil Absorption System. In addition to the Special Conditions contained in this Approval, the System shall comply with the "Standard Conditions for Alternative SAS with General Use Certification and/or Approved for Remedial Use" (the Infiltrator Chamber,Infiltrator Water Technologies. Page 5 of 6 Approval for General Use—June 12,2015 'Standard Conditions'), except where stated otherwise in these Special Conditions. 2. New Construction This Certification is for the installation of a System to serve new construction or an existing facility with a proposed increase in flow, for which a site evaluation in compliance with 310 CMR 15.000 has been approved by the Approving Authority and the site meets the siting requirements for new construction, as provided in Paragraph 6 in section II Design and Installation Requirements of the Standard Conditions. 3. Remedial Site This General Use Certification also applies to the installation of a System for the upgrade or replacement of an existing failed or nonconforming system,provided that the facility meets the siting requirements for upgrades, as provided in Paragraph 7 in section II Design and Installation Requirements of the Standard Conditions 4. The System shall be exempt from the minimum inlet spacing requirements of 310 CMR15.253. 5. The System shall have a minimum of one inspection port through the top of one of the chambers. The inspection port shall be capped with a screw type cap and accessible to within three inches of finish grade. 6. When the System is installed in trench configuration,then the system shall comply with these requirements: a) Length (each trench) 100 feet maximum(310 CMR 15.251(1)(a)); b) Width(each trench)2 feet minimum to 3 feet maximum (310 CMR 15.251(1)(b)). - Chambers greater than 3 feet wide, when specifically approved, are subject to other Special Conditions and limitations; c) The minimum separation distance between any two trenches shall be two times the effective width or depth of each trench,whichever is greater, or where the area between trenches is designated as reserve area, three times the effective width or depth of each trench, whichever is greater(310 CMR 15.25 1(1)(d)); d) The effective leaching area shall be calculated using the bottom area and a maximum of two feet(per side) of side wall area for each trench(310 CMR 15.251(1)(e)); e) Trenches shall be situated, where possible,with their long dimension perpendicular to the slope of the natural soil.Where possible they shall follow the contour lines (310 CMR 15.251(2)); f) Trenches constructed at different elevations shall be designed to prevent effluent from the higher trench(es) flowing into the lower trench(es) (310 CMR 15.251(3)); g) The area between trenches may be designated as system reserve area only where the separation distance between the excavation sidewalls of the primary trenches is at least three times the effective width or depth of each trench, whichever is greater(310 CMR 15.251(4)) -Chambers greater than 3 feet Infiltrator Chamber,Infiltrator Water Technologies. Page 6 of 6 Approval for General Use—June 12,2015 wide,when specifically approved, shall be separated by three times the actual width and are subject to other Special Conditions and limitations; and h) Effluent distribution lines exceeding 50 feet in length shall be connected and venting provided in accordance with 310 CMR 15.241 (3 10 CMR 15.251(11)). 7. When installed in trench configuration, approved Alternative Chambers greater than 3 feet wide: a) shall be installed with a minimum separation distance between any two trenches of two times the actual width of the chamber, or where the area between trenches is designated as reserve area, three times the actual width of the chamber; and b) shall only be entitled to a maximum effective width of 3 feet for the purposes of calculating total effective leaching area. 8. When installed in a bed or field configuration,the System may be installed without distribution piping,but must comply with the following requirements in 310 CMR 15.252: a) the use of leaching beds or fields is restricted to systems with a calculated design flow of less than 5,000 gpd per leaching bed or field (3 10 CMR 15.252(1)); b) the maximum length of chambers in series shall be 100 feet(3 10 CMR 15.252(2)(b)); c) separation distance between adjacent beds/fields shall be ten feet(3 10 CMR 15.252(2)(f)); and d) the effective leaching area shall include only the bottom area, not the sidewalls (3 10 CMR 15.252(2)(i)). 9. For Systems constructed in fill and installed, the System shall be installed as specified in 310 CMR 15.255 Construction in Fill, except the minimum 15 foot horizontal separation distance to be provided between the soil absorption area and the adjacent side slope shall be measured horizontally from the top of the chamber. 10. The System is exempt from 310 CMR 15.287, specifically items: (5)requiring written notification of alternative system prior to property transfer, (6)need for a certified operator, (9) need for an operation and maintenance contract with an operator and(10)deed notice requirement.