HomeMy WebLinkAboutSoil Percolation Test and Field Results - Soil Testing Results - 125 BOSTON STREET 11/23/2021 Commonwealth of Massachusetts RECEIVED
City/Town of JUL 2 8 2020
Percolation Test TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
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 A. Site Information
filling out forms
on the computer, L uti
use only the tab � �
key to move your Owner Name
cursor-do not I �F-r 0 ds-rc9--A s-� ae�
use the return Street or Lot# ee , y l^key. V`� < yV O� V n A d I is L{_`�_
r� City/Town State Zip Code
��tAA C S �t c9� r �]7?�1--Co cl 4 Aff
Contact Person(if different from Owner) Telephone Number Ir
B. Test Results
&.0a to :OOrerv►
Datel Time Date Time
Observation Hole# ,
Depth of Perc
—tea c�
Start Pre-Soak b�`O
End Pre-Soak `� f
Time at 12"
Time at 9"
Time at 6" ,
Time (9"-6") — VM tvJ
Rate(Min./Inch)
Test Passed: Test Passed: ❑
Test Failed: ❑ Test Failed: ❑
Test Performed By:
J A H.Ig�7S �1►'Ltv
Board of Health Witness SA ^ LA
Comments: o(�
t5form12.doc•08/15 Perc Test•Page 1 of 1
Commonwealth of Massachusetts
- City/Town of
Form 9A - Application for Local Upgrade Approval
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 your local Board of Health to determine the form they use.
Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or
nonconforming septic system with a design flow of less than 10,000 gpd, where full
compliance, as defined in 310 CMR 15.404(1), is not feasible.
System upgrades that cannot be performed in accordance with 310 CMR 15.404 and
15.405, or in full compliance with the requirements of 310 CMR 15.000, require a
variance pursuant to 310 CMR 15.410 through 15.415.
NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the
addition of a new design flow to a cesspool or privy, or the addition of a new desi w above the
existing approved capacity of an on-site system constructed in accordance with eit 4J8
Code or 310 CMR 15.000.
XqF �n
A. Facility Information /y�Y/V°yDFPTy'%'Do
Important:
rfUng out 1. Facility Name and Address: �R7MFNTER
forms on the
computer,use
only the tab key Name
to move your
cursor-do not
use the return Street Address A
key. IN City/Town State Zip Code
2. Owner Name and Address (if different from above):
Name Street Address
City/Town State
Zip Code Telephone Number
3. Type of Facilit check all that apply):
esidential Institutional Commercial School
4. Describe Facility:
5. Type of Existing System:
t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 1 of 5
at-'Xw4"'
Percolation rate min./inch
Depth to groundwater ��
ft.
B. Proposed Upgrade of System (continued)
Relocation of water supply well (explain):
Reduction of 12-inch separation between inlet and outlet tees and high
groundwater
Use of only one deep hole in proposed disposal area
Use of a sieve analysis as a substitute for a perc test
Other requirements of 310 CMR 15.000 that cannot be met— describe
and specify sections of the Code:
If the proposed upgrade involves a reduction in the required separation between the
bottom of the soil absorption system and the high groundwater elevation, an Approved
Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR
15.405(1)(h)(1). The soil evaluator must be a member or agent of the local
approving authority.
Hi h groundwater evaluaticln determined by:
val A S4Signa
— -� L
Eua 's ame(type or print) bate of*aivatibn
C. Explanation
Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible.
(Each section must be completed)
1 . An upgraded system in full compliance with 310 CMR 15.000 is not feasible:
-I L �..�taP t 0 v d-
!iA43M.
t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 3 of 5
Privy Cesspool(s) (::Convention Other (describe below):
6. Type of soil absorption system (trenches, chambers, leach field, pits, etc):
A. Facility Information (continued)
7. Design Flow per 310 CMR 15.203:
Design flow of existing system:
gpd � p�
Design flow of proposed upgraded
system gpd
3'3 Q
Design flow of facility: gpd
B. Proposed Upgrade of System
1. Proposed upgrade is (check one):
Voluntary Required by order, letter, etc. (attach copy)
Required following inspection pursuant to 310
CMR 15.301: date of inspection
2. Describe the proposed upgrade to the system:
U,eto (sno CCJ-G, -rlk.,,J a c 4 c tiA'.JLf
I=%4-1
3. Local Upgrade Approval is requested for (check all that apply):
Reduction in setback(s) — describe reductions:
S ' axS,t* FV'n tFsNw-r To `1 2"'tps' %A-eV,C--
TO I ag my"V26eeAw eould
Reduction in SAS area of up
to 25%: SAS size,sq.ft. %reduction
Reduction in separation between the SAS and high groundwater:
Separation reduction
ft.
t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 2 of 5
2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not
feasible:
C. Explanation (continued)
3. A shared system is not feasible:
4. Connection to a public sewer is not feasible:
5. The App cation for Local Upgrade Approval must be accompanied by all of the
following (che the appropriate boxes):
pplication for Disposal System Construction Permit
omplete plans and specifications
Site evaluation forms
�A list of abutters affected by reduced setbacks to private water supply
wells or property lines. Provide proof that affected abutters have been
notified pursuant to 310 CMR 15.405(2).
Other (List):
D. Certification
"I, the facility owner, certify under penalty of law that this document and all attachments,
to the best of my knowledge and belief, are true, accurate, and complete. I am aware
that there may be significant consequences for submitting false information, including,
but not limited to, penalties or fine and/or imprisonment for deliberate violations."
(�. a-�.- ) !:�—(/C, 0 jr-0
Facility Ow`` Signature Date
-3
Print Name I
Name of Prep a Date
Date
Preparer's address City/Town
'—J7 N --lO
t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 4 of 5
�17Ke 77q --���- a}� �
State/ZIP Code Telephone
t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 5 of 5
Commonwealth of Massachusetts RECEIVED
a= ( City/Town of
G�
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal JUL 2 82020
Te*i nC tinRTH ANDOVER
A. Facility Information HEALTH DEPARTMENT
�� _t Lu,.Ag n_ c
Owner Name
� Dts_— 9 en S tr5-Y, ST Qxt,
Street Address Map/Lot#
City State Zip Code
B. Site Information
1. (Check one) ❑ New Co ction /upgrade ❑ Repair
2. Soil Survey Available? Yes ❑ No If yes:
C, Se �O N� Source Soil Map Unit
Iw ., pA►'yl
Soil Name Soil Limitations
5,L C ,�, I* k4tl),-(
Soil Parent material Landform
3. Surficial Geological Report Available? ❑ Yes❑ No If yes:
Year Published/Source Map Unit
Description of Geologic Map Unit:
4. Flood Rate Insurance Map Within a regulatory floodway? ❑ Yes ff No
5. Within a velocity zone? ❑ Yes No
6. Within a Mapped Wetland Area? ❑ Yes 9 No If yes, MassGIS Wetland Data Layer:
Wetland Type
7. Current Water Resource Conditions(LISGS): Range: ❑ Above Normal Normal ❑ Below Normal
Mor*h/Day/Year
8. Other references reviewed: �c.p c .L �-�t v� a-1
t5form11.doc•rev.3/15/18 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 5
Commonwealth of Massachusetts
a 1 City/Town of
r
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: -NzA `7 l a O � '� t0100�0 Syr��
ole# Date/ Time Weather I Latitude Longitude:
s toM 3 .
1. Land Use (e.g.,woodland,agricultural field,vacant lot,etc.) Veget ion Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%)
Description of Location: 15;0 T t i;,1 It,&VA-10
2. Soil Parent Material:
Landform Position on Landscape(SU,SH,BS,FS,TS)
3. Distances from: Open Water Body '> feet Drainage Way?tB'o feet Wetlands C9'A feet
Property rNO
�0 feet Drinking W Well 7t00 feet Other feet
4. Unsuitable Materials Present: ❑ Yes If Yes: ❑ Disturbed Soil ill Material ❑ Weathered/Fractured Rock ❑ Bedrock
5. Groundwater Observed:❑ Yes No If yes: t) b Depth Weeping from Pit 64q_
Depth Standing Water in Hole
Soil Log
Redoximorphic Features Coarse Fragments° Soil
/°Soil Horizon Soil Texture Soil Matrix:Color- by Volume
Depth(in) /Layer (USDA Moist(Munsell) Cobbles 8, Soil Structure Consistence Other
Depth Color Percent Gravel Stones (Moist)
0— A SL 7sy�15/v
(a-'!rb gS L iby rl.r10
f g--Go C S %,,NT baa 40" a�
t00-9 c 10`I 7ba-
Additional Notes:
t5form11.doc•rev.3/15/18 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 2 of 5
_ Commonwealth of Massachusetts
fa City/Town of
u
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: 'C �- It 2�oa0 cp0 v
Hole# Date Time Weather Latitude Longitude:
1. Land Use: � �t M, af Al^
g(e. .,woodland,agricultural field,vacant lot,etc.) Veg ation Surface Stones(e.g.,b6bbles,stones,boulders,etc.) Slope(%)
Description of Location: �+ Qz&4` Y s��- J4 WV%R �►2 S ��
2. Soil Parent Material: y I tjA L4t ( L' S
--� Landform Position on Landscape(SU,SH,BS,FS,TS)
3. Distances from: Open Water Body �� feet Drainage Way � feet Wetlands -IL feet
Property ine � feet Drinking Water Well �feet Other feet
4. Unsuitable
Materials Present: El No If Ye ElDisturbed Soil El Fill Material ❑ Weathered/Fractured Rock ElBedrock
5. Groundwater Observed:❑ Yes No If yes: Depth Weeping from Pit Depth Standing Water in Hole
Soil Log
Coarse Fragments
Soil Horizon Soil Texture Soil Matrix: Redoximorphic Features °/° Soil
Depth(in) by Volume Soil Structure Consistence Other
/Layer (USDA) Color-Moist Cobbles&
(Munsell) Depth Color Percent Gravel Stones (Moist)
!0 iZ
$� C 7
C-L GO -7
—7
Additional Notes:
t5form11.doc-rev.3/15/18 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 5
_ Commonwealth of Massachusetts
h (� City/Town of
Form 11 - Soil SuitabilityAssessment for On-Site Sewage Disposal
9 p
D. Determination of High Groundwater Elevation
1. Method Used: Obs. Hole#IaL_� Obs. Hole#
❑ Depth observed standing water in observation hole inches inches
7ept
h weeping from side of observation hole inches inches
h to soil redoximorphic features (mottles) ��inches IsiQ inches
❑ Depth to adjusted seasonal high groundwater(Sh) inches inches
(USGS methodology)
Index Well Number Reading Date
Sh = Sc—[Sr X(OW,—OWma)YOWr)
Obs. Hole/Well# SC Sr Owe OWmax OWr Sh
2. Estimated Depth to High Groundwater: Jrfl inches
E. Depth of Pervious Material
1. Depth of Naturally Occurring Pervious Material
a. Does 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 (exclude A and O Upper boundary: IT Lower boundary: Q/
Horizons)? inches inches
c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary:
inches inches
t5forml 1.doc•rev.3/15/18 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 5
Commonwealth of Massachusetts
City/Town of
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
F. 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.
S `Z / �'-o -;L-d
Signature o So valua r Date
Typed or Printed Name of Soil Evaluator/License# Expiration Date of License
S 5 ACC Q0u/Pi
Name of Approving Authority Witness Approving Authority
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.
Field Diagrams: Use this area for field diagrams:
t5form11.doc•rev.3/15/18 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 5
ON III
_ _ .��► 1 fir- ,,�91Clij. 11
FA
�n .
uw
1 It 'd !� !J�! ,► , . 1 1
gin�
Iln,
� :-f iw _ °� � 1 IIri1 11■1 IIII 1 1 1
; e I9R9 - t�1 11 1111
1 1 11 it 1 1 1
1 1111 111 1
i 11 1 ■ 1 11 i
NorthEast
w Engineering
_ S _
RECEIVED
7/10/2020 JUL 2 8 2020
TOWN OF NORTH ANDOVER
North Andover Board of Health HEALTH DEPARTMENT
120 Main Street
North Andover, MA 01845
Re: 125 Boston Street
Dear Members:
Please accept this letter as a request for a variance/waiver of the Title 5 Regulations for the above
referenced property.
The property at 125 Boston Street is an existing 3-bedroom home. The current owners are trying to
restore the home and sell the property. The property can meet all the Title 5 requirements except For the
Following:
Local Regulations
Offset Regulations Require 100' from a wetland to a leach Field. 63' Provided.
Maximum Feasible Compliance
• Required 5' Separation from bottom of leaching facility to ESHWT in Soils with 2MP1 percolation
rates. 4' Provided.
• Required Breakout regulations for grading is out 15' horizontal then a 3 to 1 slope. 5' horizontal
40 mil barrier provided then a 3 to 1 slope.
Both maximum feasible upgrade requests are needed to provide the maximum distance to the wetland.
In closing, I would like to mention every attempt to place the system in the optimal location was
considered, particularly in light of the existing conditions. I would like to thank you for your consideration.
rely,
CGS h'�L
Ja Morin, RS 41132
P.O. Box #155 • Bolton, MA 01740 9 Phone # 774-696-2246 • jim@neclassicengineering.com