HomeMy WebLinkAboutSoil Suitability - Form 11 - Soil Testing Results - 30 MILL ROAD 10/20/2022 Commonwealth of Ma sach setts �EGE�VED U
City[Town of
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Form 11 - Soil kita ility Assessment for On-Site Sewage Disposal p'A ti 02022
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'1004 C�NDEPP 1MENS
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DEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but the information must
be substantially the same as provided here. Before using this form, check with your local Board of Health to determine the form they use.
A. Facility Information
1. Facility Information /C1L4
Owner Name 2 r5 ,! )y !l- ? q
J V / �C.. Map/Lot
✓
Street Address „ /0 /-/n k
City/Town State Zip Code
B. Site Information
1. (Check one) New Construction ❑ Upgrade Repair ❑ ,,/J �,,(' _
2. Published Soil Survey available? Yes 9 No ❑ If yes: 20
LZ a! 'z) �'�c 30/�
� d �I yV Year Published Publication Scale Soil Map Unit
Soil Name , �4r r , Tl
//Soil limitations
3. Surficial Geological Report available? Yes ❑ No/� If yes:
(/ � Year Published Publication Scale Map Unit
Geologic Material Landform
4. Flood Rate Insurance Map:
Above the 500 year flood boundary? Yes No ❑ Within the 100 year flood boundary? Yes ❑ No
Within the 500 year flood boundary? Yes ❑ No Within a Velocity Zone? Yes ❑ No
5. Wetland Area: National Wetland Inventory Map
Map Unit Name
Wetlands Conservancy Program Map
Map Unit Name
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal
Commonwealth of Massa usetts
Cityfrown of IV, Ar)M��
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
,ram
C. On-Site Review (Cont.) _8 J�' �l
Deep Observation Hole Number: f j� ��- �� An,
Date Time Weather
1. Location ??I
Ground Elevation at Surface of Hole /y
Location(Identify on Plan )
2. Land Use: � � "" ✓ v A10177i1v 1-0 V
(e.g.woodland,agricultural field,vacant lot,etc.) NI tt Surface Stones Slope m
Vegetation Landform Position on landscape(attach sheet)
3. Distances from: Open Water Body 7 Z�b Drainage Way 7 Z�6 Possible Wet Area -7 7-0 6
f t feet feet
Property Line _ Drinking Water Well IAN Other
feet feet
4. Parent Material: rl L4
Unsuitable Materials Present: Yes❑ Nc�%
If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s) ❑ Weathered/Fractured Rock❑ Bedrock❑
5. Groundwater Observed: Yes k No ❑ h ^��
If Yes: Depth Weeping from Pit S 7 Depth Standing Water in Hole d/�`�J Z "
Estimated Depth to High Groundwater: 29 ,
y , 97•
inches elevation
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-4
Commonwealt of Massac usetts
City/Town of I
AIVVW
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (Cont.) y' r�
Deep Observation Hole Number: �/�
Date Time Weather
1. Location IIA�
Ground Elevation at Surface of Hole 1693
3
Location (Identify on Plan ) Jf� ICT-rW, ry jr4ercl-Ij A104
2. Land Use: �Yva'xf ''A '`' r4o,)," G'pl Frl vl Y�
(e.g.woodland n �l�"i vacant lot,etc.) � Surface Stones Slope
Vegetation ^� Landform
Position on landscape(attach sheet)
3. Distances from: Open Water Body 7 Drainage Ways Possible Wet Area 7 "0
feet feet � feet
�
Property Line Drinking Water Well � Other
`f feet feetV
4. Parent Material: / L Unsuitable Materials Present: Yes❑ No
4
If Yes
: Disturbed Soil❑ Fill Material❑ Impervious Layer(s) ❑ Weathered/Fractured Rock❑ Bedrock❑
5. Groundwater Observed: Yes No ❑
h J
If Yes: Depth Weeping from Pit Depth Standing Water in Hole L Z ,
Estimated Depth to High Groundwater: 2q _!
inches elevation
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-R
Commonwealth of Massac usetts
City/Town of pJ
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (Cont.) 2 /,�'� ��6�j�
Deep Observation Hole Number: �11�j� Vz-� �� v r t�� ,/
Date Time Weather
1. Location �)Ground Elevation at Surface of Hole
Location (Identify on Plan ) WX
2. Land Use: OwgAffy' IY14T Arbk 1-
(e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%)
U✓b add �JI 1,�2�
Vegetation Landform Position on landscape(attach sheet)
3. Distances from: Open Water Body 7 46 u Drainage Way.? 7-Od Possible Wet Areatep
t feet feet
Property Line Drinking Water Well Other
1 feet feet
4. Parent Material: �I�" Unsuitable Materials Present: Yes❑ N�
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 Wa "Irr Hole
Estimated Depth to High Groundwater: 6, 1.
inches elevation
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-fege4efa
Commonwealth of Massac usetts
City/Town of �/ �/
Form 11 - S-1 Sui a flit Assessment for On-Site
Y Sewage Disposal
C. On-Site Review (Cont.)
Deep Observation Hole Number: �'Y' 7 02-
Date Time Weather
1. Location Ground Elevation at Surface of Hole 9q)
Location (Identify on Plan ) ✓O�YfjO� � � �C�l� �LY�
2. Land Use:
(e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%)
w05�Fy
Vegetation Landform Position on landscape(attach sheet)
3. Distances from: Open Water Body 7 240 Drainage Way 7 _7 0 Possible Wet Area 7 ;'O'
eel feet feet
feet feet
Property Line Drinking Water Well _� Other
4. Parent Material: ! Unsuitable Materials Present: Yes❑ N
0
If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s)❑ Weathered/Fractured Rock[] Bedrock[]
5. Groundwater Observed: Yes ❑ No
If Yes: Depth Weeping from Pit v, Depth Standing Wzzi)7
Estimated Depth to High Groundwater: 60 1
inches
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-
Commonwealth of Massachusetts
City/Town of IVY ArVOIT.
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal S 17 7�t
inches elevation
Deep Observation Hole Number: DTH-1
Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Structure Soil
Depth Horizon/ Color-Moist (mottles) Texture %by Volume Consistence Other
p USDA Layer (Munsell)
(In.) (USDA) (Moist)
Depth Color Percent Gravel Cobbles
&Stones
0-9 A 10 YR 3/3 SL
9-28 Bw 10 YR 6/8 28" SL
28-80 C 2.5 Y 6/4 SL
Additional Notes Water Standing @ 57"; Soil moist @ 30"
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-
Commonwealth of Massa husetts
City/Town of PI,WOR(
` Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
inches elevation
Deep Observation Hole Number: DTH-2
Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Structure Soil
Depth Horizon/ Color-Moist (mottles) Texture %by Volume Consistence Other
(In) layer (Munsell) (USDA)
Depth Color Percent Gravel Cobbles (Moist)
&Stones
0-10 A 10 YR 3/3 SL
10-29 Bw 10 YR 6/8 29 SL
29-118 C 2.5 Y 6/4 SL
Additional Notes Water Standing @ 64 Soil moist @ 30"
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal
Commonwealth of Mass husetts D7;-2Z,/,
City/Town of IV, A�1.06
Fo
rm 11 - Soil Suitability Assessment for On-Site Sewage Disposal
inches elevation
Deep Observation Hole Number: DTH-3
Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Structure Soil
Depth Horizon/ Color-Moist (mottles) Texture %by Volume Consistence Other
(in ) Layer (Munsell) (USDA)
(Moist)
Depth Color Percent Gravel Cobbles
&Stones
0-9 A 10 YR 3/3 SL
9-42 Bw 10 YR 6/8 LS
42-116 C 2.5 Y 5/4 LS 10
Additional Notes: No groundwater observed; no refusal
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal
Commonwealth of Mass3�husetts
.U'UCity/Town of [Vv A NVDD�ri
'r" Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
inches elevation
Deep Observation Hole Number: DTH-4
Soil Soil Matrix; Redoximorphic Features Soil Coarse Fragments Soil Structure Soil
Depth Horizon/ Color-Moist (mottles) Texture %by Volume Consistence Other
(In.) Layer
(Munsell) (USDA) (Moist)
Depth Color Percent Gravel Cobbles
&Stones
0-11 A 10 YR 3/3 SL
11-52 Bw 10 YR 6/8 SL
52-134 C 2.5 Y 5/4 LS
Additional Notes: No groundwater observed; no refusal
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal Blow
Commonwealth of Massachusetts
City/Town of
Form 11 - Soil Sui ability Assessment for On-Site Sewage Disposal
D. Determination of High Groundwater Elevation
1. Method used: ❑ Depth observed standing water in observation hole A. B. C,
inches inches
❑ Depth weeping from side of observation hole A. B. G, O
inches inche l
Depth to soil redoximorphic features (mottles) A. B.�—
inches inches
❑ Groundwater adjustment(USGS methodology) A. B. G
inches inches
2. Index Well Number Reading Date Index Well Level
Adjustment Factor Adjusted Groundwater Level
E. Depth of Pervious Material
1. Depth of Naturally Occurring Pervious Material
a. Does at least four feet of naturqI1W 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: C�Z Lower boundary:
inches inches
F. Certification
I certify that I*havassed the evaluator examination`approved by the Department of Environmental Protection and that the above
analysis was e sistent with the required training, expertise a d x erience described in 310 CMR 15.017.
/� I� �Jz
Signature of Sag Eva uator J&j lv 4�1, l E r /, , `, n��� Date
Typed or Printed Name of Soil Evaluator J V(/(� / 'Date of Soil Evaluator Exam
Name of Erbird of Health Witness r` �y Board of Health
Note: This form must be submitted to the approving uthority with Percolation Test Form 12
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Ql
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MILL ROAD
Commonwealth of Massachusetts
City/Town of
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
computer,use Alan Jordan
only the tab key Owner Name
to move your 30 Mill Road
cursor-do not
use the return Street Address or Lot#
key. North Andover MA 01845
City/Town State Zip Code
978-327-5963
Contact Person(if different from Owner) Telephone Number t
B. Test Results
5/17/22 9:00 am 8/26/22 10:00 am
Date Time Date Time
Observation Hole# @ TH-1 PT-2 (@ TH-4)
Depth of Perc @ 40"Soil Sample taken 57"-75"
for lab analysis
Start Pre-Soak 9:58
End Pre-Soak 10:13
Time at 12" 10:13
Time at 9'> 10:20
Time at 6" 10:29
t
Time(9"-6") 9 Min
W gpd/sf per lab report 3 MPI
Rate(Min./Inch) (0.33) xx c
Test Passed: ® Test Passed:
Test Failed: ❑ Test Failed: ❑
John D. Sullivan III, PE, CSE#2378
Test Performed By:
Dan Ottenheimer of Mill River Consulting (Consultant for NA BOH)
Witnessed By.
Comments:
}
t5form12.doc•06/03 Perc Test•Page 1 of 1
195 Frances Avenue Client Information: Project Information:
THIELSCH Cranston RI,02910 Sullivan Engineering Group,LLC 30 Mill Road
Phone:(401)467-6454 Woburn,MA North Andover,MA
Fax:(401)-467-2398 PM:Jack Sullivan,P.E. TEI Project Number:74-22-2002.314
thielsch.com Assigned By:Jack Sullivan,P.E. Summary Page: 1 of I
Let's Build a Solid Foundation Collected By:Client Report Date: 05.31.2022
LABORATORY TESTING DATA SHEET,Report No.: 7422-E-11012
Identification Tests Proctor/CBR/Permeability Tests
As Dry Yd Target
Received Test Laboratory g
Depth Laboratory LL PL Gravel Sand Fines Org. pH unit Yd MAX(cefl Test Setup CBR�a CBR @ Permeability ��ra[o Lo
Source Sample ID Moisture u o 0 0 0 o Moisture MAX(ocfl ,o o and
(ft) No. Content �0 �o /o /o /o �o Content% Woo,(%) w°w(�) as/oof 0.1" 0.2" cm/sec Soil Description
% (pcf) (Corr.) Proctor
D2216 D4318 D7928 D2974 D4792 D1557
On Site Brown 22-S-13362 8.4 44.3 47.3 Brown silty sand(SM)
Clayey Sand
Date Received: V5.18202 Reviewed By: Date Reviewed: 05.31202
This report only relates to items inspect and/or tested.No warranty,expressed or implied,is made.
This report shall not be reproduced,except in full,without prior written approval from the Agency,as defined in ASTM E329.
v
a
E '
Particle Size Distribution Report
u
O O Op �pD O Q O
100
I I I I I I I I I I I I
Y I I I I I I I I I I I I I
90 CL
I I 1 1 I I I I I 1 I I
1 I I 1 I I I I
CL
I I I I I 1 I I I 1
I I 1 I I I I I I I I I I I
f0 I I I I I I 1 I I 1 I I I I
w 80 I 1 1 1 I I I I I I I I I
� I I I I I I I I I I I I I I
I 1 I I I I I I I 1 I
> I I I I I I I I I I I I I I
U 70 I I 1 I I I I I I 1 I
I 1 I I I 1 I 1 I 1 I I I
0 W 60 I 1 I I I I I I 1 I 1 I
C W
Z I I I I I I I 1 I 1
L W I I I I 1 I I I 1 I 1
f0 I I 1 1 I I I I 1 I I I I
Z I I I I I 1 I I
Z 50 I I I I I I I I I
C W I I 1 I I I I I 1 I
(J I I I I I I I 1 I
a1 W I I I I I 1 1 I I I
IY/) � 40 I I I I 1 I I I I I I I I I
a1
Y 1 1 I I I I I I I I I I I I
I I I I I 1 1 I I I I I
a1 1 1 1 1 1 1 1 1
E 30
ro
1 I I I 1 1 I I 1 1 I I 1
Ln
I I I I 1 1 1 I I I I I
I 1 I I I 1 I I I I I 1 I
I I 1 I 1 1 I 1 I 1 I I
L 20 1 1 I 1 I I I 1 I I
Y I I I I I I I I 1 I I I 1 I
I I I I I I I I 1 I I I I I
101FF
I 1 I I I I I 1 1
0 I I 1 I I I I I I I I 1 I I
I I 1 I I 1 I 1 I
1 I I I 1 1 I I
0 I 1 I I 1 1 I I I I I I I I
M 100 10 1 0.1 0.01 0.001
GRAIN SIZE-trim.
%+3" %Gravel %Sand %Fines
v Coarse Fine Coarse Medium Fine Silt Clay
c
0.0 0.4 8.0 5.5 15.3 23.5 41.5 5.8
0
v SIEVE SIZE PERCENT SPEC." PASS? Soil Description
ai
3 OR DIAMETER FINER PERCENT (X=NO) Brown silty sand
N 2" 100.0
L 11/2" IOQO
+' 1" 100.0
E 3/4" 99.6
0 1/2" 97.1 Atterberg Limits
3 3a4" 91.6 PL= LL= PI=
#10 86.1
a20 80.0 Coefficients
v #60 63.7 D90= 3.6416 D85= 1.6939 D fi0= 0.1915
#100 ai:6 D50= 0.0871 D30= 0.0394 D15= 0.0094
a) 0.0427 mm. 31.4 D10= 0.0048 Cu= 39.58 C� 1.68
L 0.0316 mm. 27.2
Y
0.0232 mm. 23.4 Classification
O 0.0122 mm. 17.9
a) 0.0091 mm. 147 USCS= SM AASHTO= A-4(0)
0.0061 mm. IL8
0.0046 mm. 9.7
Remarks
0.0034 mm. 8.1
0.0014 mm_ 43 Sample visually classified as plastic.Sample rolled to 1/4"
U
X
N
a)
r (no specification provided)
Y
L
0 Source of Sample:On-Site
2! Sample Number:S-1 Date: 05.26.22
m
Client: Sullivan Engineering Group
Thielsch Engineering Inc.
v Project: 30 Mill Road
a' North Andover,MA
a�
Cranston, RI Project No: 74-22-0002.314 Figure 22-S-B362
Tested By:CC/SL/SL Checked By:Rebecca Roth