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Home My WebLink AboutSoil Testing Results - Soil Testing Results - 1975 SALEM STREET 8/31/2020 RECEIVED`' Commonwealth of Massachusetts City/Town of North Andover - Lot 1 DEC L 2017 ,LL ! Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal TOWN OF NORTH ANDUVER t HEALTH DEPARTMENT A. Facility Information Lois Lachapelle Owner Name 1975 Salem Street Map 106 Block 106.E Lot 16 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: Web Soil Survey 422D Source Soil Map Unit Canton Soil Slope and stoniness Soil Name Soil Limitations Glacial Till Moraine 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? ® 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 ® No MassGIS Wetland Data Layer: Wetland Type 7. Current Water Resource Conditions (USGS): 6/16 Range: ❑ Above Normal Q Normal ® Below Normal Month/Year 8. Other references reviewed: t6 done T9,T10•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 . Commonwealth of Massachusetts ' 'f► City/Town of North Andover - Lot 1 fr 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: DH-9 6/2/16 10:00 a.m. Sunny& Mild ..._..._.. Date Time Weather 1, Location Ground Elevation at Surface of Hole: See plan Latitude/Longitude: 42 38' 16"N / 71 03'6"W feet --- - _ _ Description of Location: See plan 2, Land Use Woodland Some Stones 0-5% (e.g,,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders.etc,) Slope(%) Oak & Pine Moraine SH Vegetation Landform Position on Landscape(SU,SH,BS,FS,TS) 3. Distances from: Open Water Body > 100 ft Drainage Way > 100 ft Wetlands > 100 ft feet feet feet Property Line > 25 ft Drinking Water Well > 100 ft Other feet feet -- feet 4. Parent Material: Glacial 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: None None Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: inches elevation t5 done T9,T10-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 - Lot 1 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: DH-9 Lot 1 Redoximorphic Features Coarse Fragments %b Volume Soil Depth in. Soil Horizon/Soil Matrix:Color-i Soil Texture Y p ( ) Layer Moist(Munsell) (USDA) Soil Structure Consistence Other Depth Color Percent Gravel Cobbles (Moist) 8 Stones 0-12" Ap 10 yr 2/2 FSL Granular Friable 12-24" Bw 10 yr 4/6 FSL Massive Friable 24-82" C 1 2.5y 5/3 LS 20% 50% Single Grain Friable Firm I Additional Notes: tS done T9.T10-rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal Page 3 of 8 Commonwealth of Massachusetts vu City/Town of North Andover - Lot 1 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: DH-10 6/2/16 10:00 a.m. Sunny & Mild Date Time Weather 1, Location Ground Elevation at Surface of Hole: See plan Latitude/Longitude: 42 38' 16"N / 71 03'6"W feet 2, Land Use Woodland Some Stones 0-5% (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones-(e.g..cobbles,stones,boulders,etc.) Slope(%) Oak& Pine Moraine _ _ _ _ SH Vegetation Landform Position on Landscap e(SU,SH,BS,FS, 3. Distances from: Open Water Body > 100 ft Drainage Way > 100 ft Wetlands > 100 ft feet feet feet Property Line > 25 ft Drinking Water Well > 100 ft Other feet feet feet 4. Parent Material: Glacial Till Unsuitable Materials Present: El Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5, Groundwater Observed: ❑ Yes ® No If yes: None None Depth Weeping from Pd Depth Standing Water in Hole Estimated Depth to High Groundwater: inches elevation t5 done T9,T10-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 - Lot 1 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: DH-10 iLot 1} Redoximorphic Features Coarse Fragments Depth(In.) Soil Horizon/Soil Matrix:Color Soil Texture %by Volume Soil Layer Moist(Munsell) (USDA) Soil Structure Consistence Other Depth Color Percent Gravel Cobbles (Moist) &Stones 0-12" Ap 10 yr 2/2 FSL Granular Friable 12-24" Bw 10 yr 4!6 FSL Massive Friable 24-82" C1 2.5y 5/3 LS 10% 50% Single Grain Friable Firm Additional Notes: t5 done T9.T10-rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 5 of 8 Commonwealth of Massachusetts City/Town of North Andover - Lot 1 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal 4 D. Determination of High Groundwater Elevation _ 1. Method Used; Obs. Hole#DH-9 Obs. Hole#DH-10 ❑ Depth observed standing water in observation hole inches inches ❑ Depth weeping from side of observation hole inches inches ❑ Depth to soil redoximorphic features (mottles) inches inches ❑ Depth to adjusted seasonal high groundwater(Sh) > 82" >82" methodology) inches inches Index Well w—mb—er Reading Date Sh= Sc—[Sr x(OWc—OWmax)/OWrl Obs. Hole# Sc Sr OWc OWmax OWr Sh Obs, Hole# Sc 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? ® Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: 24" Lower boundary: 82" inches inches c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary: inches inches t5 done TO.T 10•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 - Lot 1 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Board of Health Witness Isaac Rowe North Andover Board of Health Name of Board of Health Witnese 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 in accordance with 310 CMR 15.100 through 15,107. 6/9/16 _ Signature of Soil Evaluator Date Steven Eriksen/SE685 6/30/18 Typed or Printed Name of Soil 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. t5 done T9,T10-rev.8115 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 7 of 8 Commonwealth of Massachusetts a City/Town of North Andover - Lot 1 j Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal .i4 d Field Diagrams Use this sheet for field diagrams: t5 done T9,T10•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8 Commonwealth of Massachusetts 3a City/Town of North Andover - Lot 1 i 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: DH-11 6/2/16 11:00 a.m. Sunny& Mild Date Time Weather 1. Location Ground Elevation at Surface of Hole: See plan Latitude/Longitude: 42 38 16"N / 71 03'6"W feet _ Description of Location: See plan 2. Land Use Woodland Some Stones 0-5% (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Oak & Pine Moraine SH Vegetation Landform Position on Landscape(SU,SH,BS,FS,TS) 3. Distances from: Open Water Body > 100 ft Drainage Way > 100 ft Wetlands > 100 ft feet feet _t_ _ fee Property Line > 25 ft Drinking Water Well > 100 ft Other feet feet feet 4. Parent Material: Glacial 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: None None Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: inches elevation tg done T11,T12-rev,8115 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 2 of 8 Commonwealth of Massachusetts 3� City/Town of North Andover - Lot 1 a x� Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: DH-11 {Lot 1} Redoximorphic Features (Coarse Fragments Soil Horizon/Soil Matrix:Color- Soil Texture %by Volume Soil Depth(in.) Layer Moist(Munsell) (USDA) Soil Structure Consistence ottw Depth Color Percent Gravel Cobbles (Moist) 8 Stones 0-12" Ap 10 yr 2/2 FSL Granular Friable 12-26" Bw 10 yr 4/6 FSL Massive Friable 26-86" C1 2.5y 5/3 LS 20% 50% Single Grain Friable Firm I Additional Notes: t8 done T11,T12•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 - Lot 1 r� Form 11 - Soil Suitability Assessment for Can-Site Sewage Disposal On-Site Review (continued) Deep Observation Hole Number: DH-12 6/2/16 11:00 a.m. Sunny,& Mild Date Time Weather 1. Location Ground Elevation at Surface of Hole: See plan Latitude/Longitude: 42 38' 16"N / 71 03'6"W feet _ - 2. Land Use Woodland Some stones 0-5% _._ — _ — - (e.g.,woodland,agricultural field,vacant lot,etc) Surface Stones(e.g.,cobbles,stones, boulders,etc.) Slope(%) Oak & Pine Moraine SH Vegetation Landform Position on Landscape(SU,SH,BS,FS, 3. Distances from: Open Water Body > 100 ft Drainage Way > 100 ft Wetlands > 100 ft feet feet feet Property Line > 25 ft Drinking Water Well > 100 ft Other feet feet feet 4. Parent Material: Glacial 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: None None Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: inches elevation t8 done T11,T12-rev.8115 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 Commonwealth of Massachusetts City/Town of North Andover - Lot 1 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) - Deep Observation Hole Number: DH-12{Lot 11 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 ! GravelA�obbles (Moist) 0-12" Ap 10 yr 2/2 FSL Granular Friable 12-26" Bw 10 yr 4/6 FSL Massive Friable 26-83" C1 2.5y 5/3 LS 10% 50% Single Grain Friable Firm Additional Notes: t6 done T11,T12-rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts J, City/Town of North Andover - Lot 1 r" Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1, Method Used; Obs. Hole#DH-11 Obs. Hole#DH-12 ❑ Depth observed standing water in observation hole inches inches ElDepth weeping from side of observation hole niches inches ❑ Depth to soil redoximorphic features (mottles) inches inches ❑ Depth to adjusted seasonal high groundwater(Sh) > 86" >83" methodology) inches inches Index Well Number Reading Date Sh = Sc—[Sr X(OWc—OWmax)/OWr] Obs. Hole# Sc Sr OWc OWmax OWr Sh Obs. Hole# Sc 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? ® Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: 26" _ Lower boundary: 86" inches _ inches c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary: inches inches 1:8 done T11,T12•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 6 of 8 :._ Commonwealth of Massachusetts t� City/Town of North Andover - Lot 1 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Board of Health Witness Isaac Rowe North Andover Board of Health 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 in accordance with 310 CMR 15.100 through 15.107, 6/9/16 ignat�reofoil Evaluator Date Steven Eriksen/SE685 6/3.0/18 Typed or Printed Name of Soil 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. t8 done T11,T12-rev.8115 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 8 Commonwealth of Massachusetts N City/Town of North Andover - Lot 1 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: W done 711,712•rev.8115 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 8 of 8 Commonwealth of Massachusetts City/Town of North Andover - Lot 1 Percolation Test Form 12 ` J^ 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 forms A. Site Information on the computer. Lois Lacha use only the tab pelle key to move your Owner Name cursor-do not 1975 Salem Street-Map 106 Block 106.B Lot 16 use the return St - - key. reet Address or Lot# North Andover MA 0 45 .........-......... r� City/Town State Zipp Code Contact Person(if different from Owner) Telephone Number B. Test Results 6/2/16 11:26 a.m. 6/2/16 11:43 a.m. .......... Date Time Date Time Observation Hole# Perc 5(DH-11) Perc 6 (DH-12) Depth of Perc 42 - -- 67'- Start Pre-Soak 11:26 11 43 End Pre-Soak 11:41 11:58 Time at 12" 11:41 11:58 Time at 9" 11:52 - 12:04 Time at 6" 12:11 12:16 Time(9"-6") 19 Min. - 12 Min. Rate(Min./Inch) 6 Min./Inch 4 Min/Inch Test Passed: ® Test Passed: Test Failed: ❑ Test Failed: ❑ Steven Eriksen Test Performed By. Issac Rowe-North Andover Board of Health Board of Heakh Witness Comments: t5formt2.doa 011115 Perc Test-Page 1 of 1 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal A. Facility Information Thomas Hodson_ --..- - — ---- - Owner Name 1975 Salem Street Bldg Lot 1 -- ---_..-..�-._-._...-- - --- - _ -- 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: WebSoil Survey__________ 422D/711C Source Soil Map Unit Canton This is not Canton, its Charlton Hollis Rockiness& Slope Soil Name Soil Limitations Glacial till Drumloidal formation deologic/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? ® 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? ElYes ElNo MassGIS Wetland Data Layer: Wetland Type 7. Current Water Resource Conditions(USGS): 10/17 Range: ❑ Above Normal ® Normal ❑ Below Normal Month/Year 8. Other references reviewed: t5form11 (3)Lot 1 -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: TP-1 11/15/17 1:00 cool sunny Date Time Weather 1. Location Ground Elevation at Surface of Hole. See Plan Latitude/Longitude: / _feet-- - Description of Location: within concave formation to rear of property 2, Land Use Woodland 10% 5-10% (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Oak, Pine Drumloidal SH Vegetation Landform Position on Landscape(SU,SH,13S,FS,TS) 3. Distances from: Open Water Body >100 ft. Drainage Way >100 ft. Wetlands >100 ft, feet feet feet Property Line Drinking Water Well >100 ft. Other feet feet feet 4. Parent Material: Glacial 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: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 54" inches elevation t5forml 1 (3)Lot 1 •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: TP-1 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- Soil Texture �a by Volume Soil Depth(in.) Layer Moist(Munsell) (USDA) Soil Structure Consistence Other Depth Color Percent Gravel Cobbles (Moist) &Stones 0-9" Ap 10yr 2/2 fsl grandular friable 9-28" Bw 10yr 4/4 fsl weak blocky friable 28-84" C1 2.5yr 5/4 5"4 2.5y 3/3 5% Is&g 75% massive firm angular Additional Notes: t5form11 (3)lot 1 rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 3 of 8 `'. Commonwealth of Massachusetts r� City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: TP-2 11/15/17 1:00 cool sunny Date Time Weather 1. Location Ground Elevation at Surface of Hole: See Plan Latitude/Longitude: / feet 2. Land Use Woodland 10% 5-10% (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Oak, Pine Drumloidal SH Vegetation Landform Position on Landscape(SU,SH,BS,FS, 3. Distances from: Open Water Body >100 ft. Drainage Way >100 ft. Wetlands >100 ft. feet feet feet Property Line >10 ft. Drinking Water Well >100 ft. Other feet feet feet 4, Parent Material: Glacial 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: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: inches elevation t5form11 (3)Lot 1 •rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 :? Commonwealth of Massachusetts r� City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: TP-2 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 ravel Cobbles (Moist) Stones 0-8" Ap 10yr 2/2 fSl grandular friable 8-27" Bw 10yr 4/4 fsl weak blocky friable 27-88" C1 2.5y 5/4 75" Is&g 30% massive firm angular stones Additional Notes: t5form11 (3)Lot 1 •rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts Cityfrown of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: TP 3 11/15/17 1:00 cool sunny Date Time Weather 1. Location Ground Elevation at Surface of Hole: See Plan Latitude/Longitude.- feet 2. Land Use Woodland 10% 5-10% (e.g,,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Oak, Pine Drumloidal SH Vegetation Landform Position on Landscape(SU,SH,BS,FS, 3. Distances from: Open Water Body >100-ft_ Drainage Way >100 ft. Wetlands >100 ft. feet feet feet Property Line >10 ft. Drinking Water Well >100 ft. Other feet feet feet 4. Parent Material: Glacial 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: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 76" inches elevation t5form11 (3)Lot 1 -rev.8115 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 4 of 8 Commonwealth of Massachusetts CitylTown of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: TP-3 Redoximorphic Features Coarse Fragments Depth in. Soil Horizon!Soil Matrix:Color- Soil Texture %by Volume Soil p ( ) Layer Moist(Munsell) —� (USDA) Stones Structure Consistence Other Depth ColorPercent ( ravel Cobbles tones (Moist) 0-8" Ap 10yr 2/2 fsl grandular friable 8-28" Bw 10yr 4/4 fSl weak blocky friable 28-107" C1 2.5y 5/4 76" 2.5y 3/3 5% Is&g 75% massive firm angular stones Additional Notes: t5form11 (3)Lot 1 •rev.8/15 Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1, Method Used: Obs. Hole#TP-1 Obs. Hole#TP-3 ❑ Depth observed standing water in observation hole inches inches ❑ Depth weeping from side of observation hole inches inches Depth to soil redoximorphic features (mottles) 54" 76" inches inches ❑ Depth to adjusted seasonal high groundwater(Sh) (USGS methodology) inches inches Index Well Number Reading Date Sh= S,—[Sr X(OW,—OWma),)/OW,] Obs. Hole# Sc S, OWc OWm. OW, Sh Obs. Hole# Sc 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? ® Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: 27 Lower boundary: 107" inches inches c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary: inches inches t5form11 (3)Lot 1 •rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 ' I Commonwealth of Massachusetts City/Town of North Andover - Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Board of Health Witness Issac Rowe North Andover 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 in ac dance with 310 CMR 15.100 through 15.107. 11/16/17 Signature of Soil Ev ator Date Steven Eriksen 6/30/2019 --- ---- — --- Typed or Printed Name of Soil 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. t5forml 1 (3)Lot 1 -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 Field Diagrams Use this sheet for field diagrams: t5form11 (3)Lot 1 -rev.B/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8 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 forms A. Site Information on the computer, use only the tab Thomas Hodgkins — --- ---- key to move your Owner Name cursor-do not 1975 Salem Street use the return ----------_.__--- ---------------------- - key. Street Address or Lot# North Andover Ma 01845 411�ub City/Town State Zip Code Steven Eriksen 978 649-9932 --- Contact Person(if different from Owner) Telephone Number B. Test Results 11/15/17 2:00 11/15/17 2:00 Date Time Date Time Observation Hole# DH-2/Perc 2 DH-3/Perc 1 Depth of Perc 48 48 - Start Pre-Soak 1:28 - 1:36 End Pre-Soak 1:44 _ 1:52 — Time at 12" 1:44 1:52 --- --- --- Timeat 9„ 2:— --- -----------.-...-..._... --- 2=19 ---------------- Time at 6" 2:34 3:10 Time(9"-6") 34 min 51 min Rate(Min./Inch) 11 min/in 17 min/in Test Passed: ® Test Passed: Test Failed: ❑ Test Failed: ❑ Maureen Herald Test Performed By: Issac Rowe Board of Heath Witness Comments: t5form12,do-D&15 Perc Test•Page 1 of 1 Commonwealth of Massachusetts City/Town of North Andover - Lot 3 Percolation Test Form 12 e 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 forms A. Site Information on the computer, use only the tab Lois Lachapelle key to move your Owner Name cursor-do not 1975 Salem Street- Map 106 Block 106.13 Lot 16 use the return key. Street Address or Lot# North Andover MA ,� 5:1 City/Town 0 State Zipp Code IL Contact Person(if different from Owner) Telephone Number B. Test Results 6/1/16 1:18 p.m. 6/1/16 1:40 p.m. Date Time Date Time Observation Hole# Perc 3 (DH-6) Perc 4 (DH-8) Depth of Perc 44 44" Start Pre-Soak 1:18 1:40 End Pre-Soak 1:33 1:57 Time at 12" 1:33 1:57 Time at 9" 1:53 2:08 Time at 6" 2:21 2:20 Time (9"-6") 28 Min. 12 Min. Rate (Min./Inch) 9 Min./Inch 4 Min/Inch Test Passed: ® Test Passed: Maureen Herald Test Failed: ❑ Test Failed: ❑ Test Performed By: Issac Rowe- North Andover Board of Health Board of Health Witness Comments: t5form12.doc•08/15 Perc Test•Page 1 of 1 Commonwealth of Massachusetts City/Town of North Andover - Lot 1 W Percolation Test Form 12 / M 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 forms A. Site Information on the computer, use only the tab Lois Lachapelle key to move your Owner Name cursor-do not 1975 Salem Street- Map 106 Block 106.E Lot 16 use the return key. Street Address or Lot# North Andover MA 01845 � City/Town State Zip Code Contact Person(if different from Owner) Telephone Number Bn° B. Test Results 6/2/16 11:26 a.m. 6/2/16 11:43 a.m. Date Time Date Time Observation Hole# Perc 5 (DH-11) Perc 6 (DH-12) Depth of Perc 42" 67° Start Pre-Soak 11:26 11:43 End Pre-Soak 11:41 11:58 Time at 12" 11:41 11:58 Time at 9" 11:52 12:04 Time at 6" 12:11 12:16 Time (9"-6") 19 Min. 12 Min. Rate (Min./Inch) 6 Min./Inch 4 Min/Inch Test Passed: ® Test Passed: Steven Eriksen Test Failed: ❑ Test Failed: ❑ Test Performed By: Issac Rowe- North Andover Board of Health Board of Health Witness Comments: 15form12.doc•08/15 Perc Test•Page 1 of 1 Commonwealth of Massachusetts J(d City/Town of North Andover - Lot 2 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal A. Facility Information Lois Lachapelle Owner Name 1975 Salem Street Map 106 Block 106.E Lot 16 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: Web Soil Survey 422D Source Soil Map Unit Canton Soil Slope and stoniness Soil Name Soil Limitations Glacial Tilll Moraine 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? ® 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 ® No MassGIS Wetland Data Layer: Wetland Type 7. Current Water Resource Conditions (USGS): 6/16 Range: ❑ Above Normal ❑ Normal ® Below Normal Month/Year 8. Other references reviewed: Q done T3,T4•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 - Lot 2 - � 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: DH-3 6/1/16 11:00 a.m. Sunny & Mild Date Time Weather 1. Location Ground Elevation at Surface of Hole: See plan Latitude/Longitude: 42 38 16"N / 71 03'6"W feet — Description of Location: See plan 2. Land Use Woodland Some stones 0-3% _ (e.g.,woodland, agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Oak & Pine Moraine SH Vegetation Landform Position on Landscape(SU,SH, BS,FS,TS) 3. Distances from: Open Water Body > 100 ft Drainage Way > 100 ft Wetlands > 100 ft Fee feet feet Property Line > 25 ft Drinking Water Well > 100 ft Other feet feet feet 4. Parent Material: Glacial 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: None None Estimated Depth to High Groundwater: Water Depth Weeping from Pit Depth Standing ter in Hole inches elevation t2 done T3,T4•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 - Lot 2 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: DH-3{Lot 2} Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix: Color- %b Volume Soil Depth(in.) Soil Texture Y Layer Moist(Munsell) (USDA) Soil Structure Consistence Other Depth Color Percent Gravel Cobbles (Moist) &Stones 0-10" Ap 10 yr 2/2 FSL Granular Friable 10-20" Bw 10 yr 4/6 FSL Massive Friable 20-86" C1 2.5y 5/3 LS 20% 50% Single Grain Friable Firm Additional Notes: t2 done T3,T4•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 - Lot 2 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: DH-4 6/1/16 11:00 a.m. Sunny & Mild Date Time Weather 1. Location Ground Elevation at Surface of Hole: See plan Latitude/Longitude: 42 38' 16"N / 71 03'6"W feet 2. Land Use Woodland Some stones _ 0-5% (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones, boulders,etc.) Slope(%) Oak & Pine Moraine _ SH Vegetation Landform Position on Landscape(SU,SH, BS,FS, 3. Distances from: Open Water Body > 100 ft Drainage Way > 100 ft Wetlands > 100 ft feet feet feet Property Line > 25 ft Drinking Water Well > 100 ft Other feet feet feet 4. Parent Material: Glacial Till Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock El Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: None None Estimated Depth to High Groundwater: Depth Weeping from Pit Depth Standing Water in Hole inches elevation t2 done T3,T4•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 - Lot 2 rt -- Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: DH-4 {Lot 21 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- Soil Texture %by Volume Soil Depth(in.) Layer Moist(Munsell) Soil Structure Consistence Other (USDA) Depth Color Percent Gravel Cobbles (Moist) &Stones 0-101, Ap 10 yr 2/2 FSL Granular Friable 10-20" Bw 10 yr 4/6 FSL Massive Friable 20-99" C1 2.5y 5/3 LS 10% 50% Single Grain Friable Firm Additional Notes: t2 done T3,T4•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 5 of 8 _ Commonwealth of Massachusetts City/Town of North Andover - Lot 2 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: Obs. Hole#DH-3 Obs. Hole#DH-4 ❑ Depth observed standing water in observation hole ElDepth weeping from side of observation hole inches inches ❑ Depth to soil redoximorphic features (mottles) inches inches inches inches Depth to adjusted seasonal high groundwater(Sh) > 86" > 991, (USGS methodology) inches inches Index Well Number Reading Date Sh = Sc—[Sr X (OWc—OWmax)/OWr) Obs. Hole# Sc Sr OWc OWmax OWr Sh Obs. Hole# Sc 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? ® Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: 20" Lower boundary: 991, inches inches c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary: inches inches t2 done T3,T4•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 - Lot 2 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Board of Health Witness Isaac Rowe North Andover Board of Health 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 in accordance with 310 CMR 15.100 through 15.107. 6/9/16 Signature of Soil Evaluator Date Steven Eriksen/SE685 6/30/18 Typed or Printed Name of Soil 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. t2 done T3,T4•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 - Lot 2 �m Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal ( g Field Diagrams Use this sheet for field diagrams: Q done T3,T4•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8 Commonwealth of Massachusetts City/Town of North Andover - Lot 2 Form 11 - Soil Suitability Assessment for On-Sit a Disposal e Sewage A. Facility Information Lois Lacha elle Owner Name 1975 Salem Street Street Address Map 106 Block 106.13 Lot 16 North Andover Map/Lot# city — Ma 01845 State Zip Code B. Site Information 1. (Check one) ® New Construction ❑ Upgrade ❑ Repair 2. Soil Survey Available? ® Yes ❑ No If yes: Web Soil Survey _422 D Canton Soil Source Soil Map Unit _Slope and stoniness Soil Name Sod Limitations Glacial Till Moraine 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? ® Yes ❑ No Within the 100- ear flood bounds If Yes,continue to#5. y boundary? Yes ® No 5. Within a velocity zone? ❑ Yes ® No 6. Within a Mapped Wetland Area? ❑ Yes ® No MassGIS Wetland Data Layer: 7. Current Water Resource Conditions USGS : 6/16 wetland Type ( ) Range: El Normal El ® Below Normal Month/Year 8. Other references reviewed: RECEIVED JUN 14 2016 TOWN OF NORTH ANDOVER t1 done T1,T2•rev.8/15 HEALTH DEPARTMENT Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 rti Commonwealth of Massachusetts City/Town of North Andover - Lot 2 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: DH-1 6/1/16 10:00 a.m. Sunny& Mild Date Time Weather 1. Location Ground Elevation at Surface of Hole: See plan Latitude/Longitude: 42 38 16"N / 71 03' 6"W feet Description of Location: See plan 2. Land Use Woodland Some Stones 0-3% (e.g.,woodland, agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Oak & Pine Moraine SH Vegetation Landform Position on Landscape(SU,SH, BS, FS,TS) 3. Distances from: Open Water Body > 100 ft Drainage Way > 100 ft Wetlands > 100 ft feet feet feet Property Line > 25 ft Drinking Water Well > 100 ft Other feet feet feet 4. Parent Material: Glacial 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: None None Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: inches elevation t1 done T1,T2•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts W� City/Town of North Andover - Lot 2 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: DH-1 (Lot 21 Redoximorphic Features Coarse Fragments Depth(in.) Soil Horizon/Soil Matrix: Color- Soil Texture %by Volume Soil Layer Moist(Munseli) USDA Soil Structure Consistence Other Depth Color Percent ( ) Gravel Cobbles (Moist) &Stones 0-9" Ap 10 yr 2/2 FSL Granular Friable 9-20" Bw 7.5 yr 4/6 FSL Massive Friable 20-90" C1 2.5y 5/3 LS 10% 50% Single Grain Friable Firm Additional Notes: t1 done T1,T2•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 - Lot 2 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: DH-2 6/1/16 10:00 a.m. Sunny& Mild Date Time Weather 1. Location Ground Elevation at Surface of Hole: See plan Latitude/Longitude: 42 38' 16"N / 71 03'6"W feet 2. Land Use Woodland Some Stones _ 0-3% (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Oak & Pine Moraine SH Vegetation Landform Position on Landscape(SU,SH, BS, FS, 3. Distances from: Open Water Body > 100 ft Drainage Way > 100 ft Wetlands > 100 ft feet feet feet Property Line > 25 ft Drinking Water Well > 100 ft Other feet feet feet 4. Parent Material: Glacial 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: None None Estimated Depth to High Groundwater: Depth Weeping from Pit Depth Standing Water in Hole inches elevation t1 done T1,T2•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 - Lot 2 - _ Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: DH-2 (Lot 2) Redoximorphic Features Coarse Fragments Depth(in.) Soil Horizon/Soil Matrix: Color- Soil Texture %by Volume Soil Layer Moist(Munsell) (USDA) Soil Structure Consistence Other Depth Color Percent Gravel &Stones Cobbles (Moist) 0-101, Ap 10 yr 2/2 FSL Granular Friable 10-20" Bw 10 yr 4/6 FSL Massive Friable 20-87" C1 2.5y 5/3 LS 10% 50% Single Grain Friable Firm Additional Notes: t1 done T1,T2•rev. 8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 _ Commonwealth of Massachusetts City/Town of North Andover - Lot 2 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: Obs. Hole#DH-1 Obs. Hole#DH-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) inches inches ❑ Depth to adjusted seasonal high groundwater(Sh) > 901, > 87" (USGS methodology) inches inches Index Well Number Reading Date Sh = Sc—[Sr X (OWc—OWmax)/OWrl Obs. Hole# So Sr OWc OWmax OWr Sh Obs. Hole# Sc 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? ® Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: 20" Lower boundary: 901, inches inches c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary: inches inches t1 done T1,T2•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 - Lot 2 - _ Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Board of Health Witness Isaac Rowe North Andover Board of Health 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 in accordance with 310 CMR 15.100 through 15.107. 6/9/16 Signature of Soil Evaluator Date Steven Eriksen /SE685 6/30/18 Typed or Printed Name of Soil 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. t1 done T1,T2•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 - Lot 2 �m -A° Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: t1 done T1,T2•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8