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r _, North Andover Board of Assessors Public Access Page 1 of 2 http://csc-ma.us/PROPAPP/newSearch.do;j sessionid=90BD8F942EB 159446A9AD89B3... 11/29/2010 North. Andover Board of Assessors pORTp Of ,�'�ao t•�.c 40 MATCHING PARCELS S"GH°5 Click on a column title to sort data by that column Click seal To Return 41 items found, dis la in all items.1 Fiscal Year Parcel ID St.No. Street Owner Name BARNSIDE REALTY CORPORATION, C/O 2010 210/107.D-0013-0000.0 " 0 GRAY STREET WILLIS 2010 210/107.D-0050-0000.0 0 GRAY STREET RULLO, FRANK J, BARBARA RULLO Search for Parcels ANDOVER, TOWN OF, C/O 2010 210/107.D-0032-0000.0 0 GRAY STREET CONSERVATION COMMISSION Search for Sales MASSACHUSETTS LAND 2010 210/107.D-0011-0000.0 0 GRAY STREET CONSERVATION TRUST, NORTH ANDOVER IMPROVEMENT 2010 210/107.D-00 0 GRAY STREET SOCIETY, 2010 210/107.B-0078-0000.0 0 GRAY STREET RULLO, FRANK J, BARBARA M RULLO MASSACHUSETTS LAND, 2010 210/107.D-0019-0000.0 0 GRAY STREET CONSERVATION TRUST 2010 210/107.D-0136-0000.0 0 GRAY STREET LONE STAR REALTY TRUST, C/O STELLA 2010 210/107.13-0050-0000.0 1 GRAY STREET RULLO, MICHAEL, 2010 210/107.B-0051-0000.0 17 GRAY STREET READE, CHERYL A, JOHN A READE 2010 210/107.B-0053-0000.0 30 GRAY STREET CUSHING, JOSEPH B, LOIS B CUSHING 2010 210/107.B-0052-0000.0 31 GRAY STREET CRONIN-JENKINS, SUSAN, 2010 210/107.B-0154-0000.0 45 GRAY STREET FENG, DAVID Y, LAURA J ANTONUCCI MCDONOUGH, LUCY ANNE, SCOTT C 2010 210/107.B-0059-0000.0 56 GRAY STREET BRILEY ADICONIS, ROBERT J, MARIE A 2010 210/107.B-0054-0000.0 72 GRAY STREET ADICONIS HALBACH, ERIC E, JR, KATHLEEN K 2010 210/107.D-0055-0000.0 79 GRAY STREET HALBACH 2010 210/107.D-0030-0000.0 89 GRAY STREET GORDON, DIANA, 2010 210/107.D-0121-0000.0 90 GRAY STREET BRANDT, CYNTHIA A., BARTUS, FRANK ROSENBERGER, MICHAEL A, MARY T 2010 210/107.D-0029-0000.0 99 GRAY STREET ROSENBERGER 2010 210/107.D-0026-0000.0 107 GRAY STREET HART, CHARLES, 2010 210/107.D-0120-0000.0 120 GRAY STREET DEMERS, ERIC & MONICA, 2010 210/107.D-0056-0000.0 125 GRAY STREET ROBBAT, PAUL, LINDA L ROBBAT 2010 210/107.D-0119-0000.0 140 GRAY STREET METSCH, DAVID S. & SCHLOSS, RENEE, 2010 210/]07.13-0101-0000.0 162 GRAY STREET STELLA, MARILYN A, 2010 210/107.D-0132-0000.0 168 GRAY STREET COLLART, ERIK, BROUNS, KARINE MFT REALTY TRUST, MURPHY, FRANCIS 2010 210/107.D-0012-0000.0 " 169 GRAY STREET & ELLEN ROBINSON, LEONARD B, HAHN, KAREN 2010 210/107.D-0131-0000.0 174L15 GRAY STREET A 2010 210/107.D-0052-0000.0 180 GRAY STREET STELLA, BARBARA A, NN KEVIN & LINGLEY, 2010 210/107.D-0130-0000.0 190 GRAY STREET IA CYNTHIA, CYNTHHIA,, 2010 210/107.D-0110-0000.0 193 GRAY STREET TWADELLE, SCOTT, KELLEE TWADELLE http://csc-ma.us/PROPAPP/newSearch.do;j sessionid=90BD8F942EB 159446A9AD89B3... 11/29/2010 North Andover Board of Assessors Public Access Page 2 of 2 http://csc-ma.us/PROPAPP/newSearch.do;jsessionid=90BD8F942EB 159446A9AD89B3... 11/29/2010 Page 1 of 1 Dellechiaie, Pamela , From: Sawyer, Susan Sent: Thursday, January 20, 2005 4:08 PM To: Dellechiaie, Pamela Subject: FW: -----Original Message ----- From: joeserwatka@comcast.net [mailto:joeserwatka@comcast.net] Sent: Tuesday, January 18, 2005 2:54 PM To: Patty Schuler; Susan Sawyer Subject: 1/20/2005 Joseph J. Serwatka, P.E. Post Office Box 1016 North Andover, MA 01845 (978)-683-6595 ioeserwatka(ikomcast.net January 17, 2005 Mrs. Susan Sawyer Health Agent Town of North Andover North Andover, MA 01845 Re: Lots 14 and 15 Gray Street Dear Mrs. Sawyer: On behalf of the Litchfield Company and the Stella Family, I would like to request that a meeting be scheduled with you and possibly your consultant. The parties are concerned about the soil and percolation testing requirements that have been placed upon their property, and in particular lots 14 and 15. I realize that much of the history of this project goes back three years, before the arrival of yourself and your consultant, but we would hopefully like to resolve some issues. As you may know, the Stella family paid the Town and their consultant over $6,000 in 2002 to conduct soil and percolation testing on lots 1-12 and 14, 15. We abided by the requirements of the then Health Agent, Ms. Starr, and conducted two deep holes and two percolation tests on lots 1-12. Deep hole testing was successful on lots 14 and 15, but due to high groundwater we were unable to perc in 2002. We were able to get one successful perc on each lot in 2003, but the other peres were hindered due to high groundwater. We tried to schedule overnight peres on these lots with the previous consultant, but were told that they did not do overnight peres and that we would have to schedule with Rudy, who was one of Ms. Starr's assistants. At the time, Ms. Starr stated that it was in fact her consultant's job to inspect overnight peres, and that she would get back to us. We all know that that had been subsequently released from town employment, and that her consultant was replaced. More recently, we have designed and received approval for septic systems on lots 1, 2, and 4-9. These designs were based on the previously conducted and approved soil/perc testing from 2002. It has come to pass that the soil testing on lots 10, 11, 12, 14 and 15 was deemed to be expired since it was more than two years old. We recently paid the Town over $2,000 to have the present consultant witness new soil testing. Based on e- mails previous to the soil testing, it was determined that 4 deep holes and 2 peres would be required on lot 10, 2 deep holes each would be required on lots 11 and 12, and 2 deep holes and 1 perc each would be required on lots 14 and 15. Note that it was decided that the previous deep holes from 2002 would be allowed to be used on lots 11, 12, 14 and 15. That was the understanding prior to the testing on January 13, 2005, but as a result of the procedures and discussions from that day, we are confused as to the requirements being placed on lots 14 and 15. To summarize, two deep holes and one perc was allowed on lot 10, two new deep holes were conducted on lot 11, only one new deep hole was conducted on lot 12, and two new deep holes each were conducted on lots 14 and 15. Peres were again attempted on lots 14 and 15, but high groundwater made them unsuccessful. As you can see, what was agreed upon in the e-mails prior to January 13, 2005 was not what was allowed or required on the day of testing. This not only leads to confusion on the part of the landowner and developer, but begs the following question: "if two deep holes and one perc are deemed adequate on lot 10, why are six deep holes (totals from 2002, 2003 and 2005) and one perc not deemed adequate on lots 14 and 157 Based on the opinions of soil evaluators who have witnessed the testing, the soils on lots 14 and 15 are believed to be as permeable, if not more, than those on lot 10. To complete one more successful perc on each lot will take many more manhours and several thousands of dollars, only to find out what we already know. We are asking that the current testing to date (i.e. six deep holes and one perc) be allowed to be used on lots 14 and 15 for septic designs. This information is above and beyond what has been determined to be adequate on lot 10. An additional perc could be performed when construction begins on the lots, although I do not believe that it is necessary. At that time, adequate machinery and dewatering equipment will be on the site anyway for the construction of the dwelling. Please get back to me about a meeting date and time at your earliest convenience. Sincerely, Joseph. J. Serwatka, P.E. Page 1 of 1 Dellechiaie, Pamela From: Sawyer, Susan Sent: Thursday, January 20, 2005 4:08 PM To: Dellechiaie, Pamela Subject: FW: -----Original Message ----- From: joeserwatka@comcast.net [mailto:joeserwatka@comcast.net] Sent: Sunday, January 09, 2005 2:04 PM To: Susan Sawyer Subject: RE: hi sue: can you get back to me on the original message? i would like to get everything straight before we test. joe ------------- Original message -------------- I am off to an early meeting, but I will get back to you when I can. FYI, I know we sent the short review, but lot 3 will need a closer look. It fell thru the cracks. We are definitely concerned about the LTAR of .74 when it now seems that there may be some doubt in the soils out there. Haven't heard from our installer at 2177 Turnpike street lately. Have you? Is the electric to the house yet, I wonder? Susan -----Original Message ----- From: joeserwatka@comcast.net [mailto:joeserwatka@comcast.net] Sent: Monday, January 03, 2005 12:55 PM To: Susan Sawyer Subject: hi sue: i wanted to get clear exactly what will be required for lots 10, 11, 12, 14 and 15 on gray and boston streets. lot 10 has adequate soil and perc tests but they were conducted in the buffer zone. i intend to conduct 4 test pits and 2 peres outside of the buffer zone. lot 11 has adequate deeps and peres, but the deeps are expired. the peres are still valid. do we need to do 4 new deeps, or 2 new and also use the old ones? I'm concerned about digging into disturbed areas if we have to do 4 new deeps. lot 12 has the same issues as lot 11. lot 14 has expired deeps and one good perc. we will do a second perc if allowed by water table, and 4 new deeps if required. can we use the two old deeps and do two new deeps? lot 15 has the same issues as lot 14. please get back to me on this and copy Andy if possible. thanks, joe 1/20/2005 Page 1 of 1 Sawyer, Susan From: Susan Sawyer[ssawyer@townofnorthandover.com] Sent: Thursday, December 09, 2004 12:03 PM To: 'joeserwatka@comcast.net' Subject: RE: Joe, To follow-up on our conversation. I have reviewed the files for lots 10, 11,12 Boston Road. The paperwork indicates that soil tests were scheduled on February 15, 2002. The file does not contain any of the soil logs and I am not sure where they may be, unless they were confused with the Gray Street lots. With this minimal information it has been determined that the deep hole soil tests are likely over 2 year old and will have to be redone. Assuming that the information is eventually located on the testing between our offices, the health office would only require confirming tests. If no old information is found, than all new tests will be conducted and the number of test holes will be at current standards. The passage of time has negated any previous agreements in the field. The perc tests, (assuming we find the information), would still be acceptable. Please be sure that the perc tests and the deep holes are located within the primary and reserve areas as required. Please let me know if you have any further questions. Thank you, Susan Sawyer -----Original Message ----- From: joeserwatka@comcast.net[mailto:joeserwatica@comcast.net] Sent: Thursday, December 02, 2004 7:32 AM To: ssawyer@townofnorthandover.com Subject: hi sue: just wanted to thank you for taking the time to meet with me yesterday on crusader paper. also, when you get a chance could you e-mail me your thoughts on the final 5 designs for boston/gray streets. i need to know whether to proceed with designs, or wait for additional soil testing. thanks, joe 12/9/2004 FORM 12 - PERCOLATION TEST Location Address. or Lot No. &,eAY-�mEt:-r �ot3 i`6a. 17-70 1y7�1 COMMONWEALTH OF MASSACHUSETTS l)ogru ANoovLp' Massachusetts 011 Septic Plan Submittal Date Last Rev. Date Plan Approved/Denied Date Peres/Deeps within system area Site 4/10/2004 9/10/2004 D-5/04, A -10/5/04 2/1 4/23/2004 & 5/04 7/14/2004 D-6/04, A - 7/23/04 1/2 4/15/2004 design date 8/16/04, no submittal date D-12/04 D-9/04 A -N Engineer change. 4/2/02 & 4/28/04 & 5/25/04 D-6/04 1/1 4/11/02 & 4/23/04 & 6/08/04 7/2/2004 D-6/04 1/2 design date 4/13/04, no submittal date 7/14/04 & 9/10/04 A-9/27/04 2/1 design date 4/13/02; 4/13/04, no submittal date 6/17/2004 A-7/23/04 None n/a n/a No Plan None n/a n/a No Plan None n/a n/a No Plan None n/a n/a No Plan None n/a n/a No Plan None n/a n/a No Plan 011 FORM -12 - PERCOLATION TEST Location Address or Lot No. 6 Riq y STREET 7?0 0 71% COMMONWEALTH OF MASSACHUSETTS AlOrTN 4wAvvFEr2_ Massachusetts Percolation Test* Date:....:::.::.: Observation Hole # ,20 I Depth of Perc 1 j' ° - P� _ 2 38 Start Pre-soak k 1 P N :3zPM End Pre-soak Time at 12" ; Zq Pin Time at 9" Time at 6" Time (9"-6") 5 M�� 5 rn�� Rate Min./Inch Mfinimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed lel eaSite Failed ❑ Performed By: Witnessed By: Comments:.::::. ................................................ ........................... .�oc SF_�Q�,clRiKA f` I WiLLFE 71 DEP APPROVED FORM - 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. CQAY ';QED; i COMMONWEALTH OF MASSACHUSETTS No RT N oovti rz- , Massachusetts Percolation Test* Date:.::.::..::.....5 �2 1 n -L Time:,.....:...:.:......::.:::::::::. Observation Hole # Depth of Perc ° _4+ Start Pre-soak P M 2: lq p�'1 End Pre-soak 2.15 Fm 2:34 P Time at 12" 2 ;15 PM 2., 34 p rA Time at 9"2.31 F M Time at 6" 2:23 PrA — 2:4� P►'h Time (9"-6") S M IQ �►� Rate Min./Inch x Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed ® Site Failed ❑ ................... ............ ............. ........................:.............. Performed By: _T66 5ER w a 7 k 4 , Witnessed By: K W a -l -e -n - Comments: DEP APPROVED FORM - 12/07/95 FORM 11 ;OIL EVALUATOR FORA Page 2 of 3 Location Address or Lot lJo. "e/? Y �; On-site Review _ Deep Hole Number 1� Date: !-�3 0�_ Time: Weather Ct.-c y . 70 Location (identify on site plan) Land Use Q 67 n, Slope (%) Surface Stones Vegetation- ,— e Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line3c'' a --feet '5i� -T— Drinking Water Well _ -__ feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Sol Horizon Sol Texture (USDA) Sol Color !Munsell Soil Mottling Other (Structure. Stones, Boulders, Consistency, % Graven LV YK �f _.�.__ �. r ..r��r V4v�r n• ►��• • • err rrVVnv tiL\ Parent Material (geologic) pap og� C,: p \% / L' �� er/ Death to Groundwater: Standing Water in the Hole: /1%Weeping from Pit Face: A/ OA✓'1 Estimated Seasonal High Ground Water: PC K FOrZ,41 a D a / ; t/ n W i rl4 CE 5 5- 4-- A i3 Y 4/ L X G' A VA 7'0 r -Z ; /�% 1� - G CX -v S #7r r1 a 7 fJ `✓ DEP APPRONIM ioRM -121071!5 FORM SOIL EVALUATOR FORM Paas 2 of 3 Location Address or Lot leo. G, -:t I Y S so 8 .v m l 77a/o 7-q- On -Site Review _ Deep Hole Number 17, Date: �..z3 �=- Time: Weather ez-e;F� 7r7 Location (identify on site plan) Land Use Slope M , Surface Stones �`�a�✓�'-- Vegetation /<7 Landform Position on landscape (sketch on the back) . .... Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line ?n � feet Drinking Water Well feet 'Other, :___...._.._ DEEP OBSERVATION HOLE LOG' Depth from Surface (inches) Soil Horizon Sol Texture (USDA) Sol Color (Munsell) Sol Mottling Other (Structure, Stones, Boulders, Consistency, % Graven 7' syeti/f- d�A-� / C �- S Z S/ s�4 7, 3%2/?� s—� o� b� /1' ✓'L. j GoAeC S �� Parent Material (geologic) Oapd=R ,rMA: / Q Depth to Groundwater; Standing Water in the Hole: /l1 o of lr Weeping from Pit face: Estimated SeasonalN High Lound water: F'or-?,'9 c P Ar E X e VA 'ro /� �•n1 s i'�� v c 7r -s �✓ DF? APPRONIM FORM-12MN95 FORM SOIL EVALUATOR FORM Paas 2 of 3 Location Address or Lot No. Goch � S I j,0 j3 .ti0.. I%7 47 i)a\JOQ� On-site Review _ Deep Hole Number ! �% _ Date: .-2 0 L Time: Weather Location (identify on site plan) Land Use A,, 00'q .5Slope (%) t� Surface Stones Vegetation P l/ w41C Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line3Q feet Drinking Water Well _ __ feet Other __.._..:___...._ .. DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Sol Texture (USDA) Sol Color tMunseln Soil Mottling Other 1Structure. Stones, Boulders, Consistency, % Graven Q _ S A F5 �. 4 .1c Z- � Lam, ,���1,1-0L Parent Material (geologic) Depth,tc Groundwater: Standing Water in the Hole: N ®� Weeping from Pit Face: vAL/ d. Estimated Seasonal High taround Water. VV i 7'/Y c 5 5 IJ 13 y d - _t." � E: Xt eA VA70 rZ DET APPRONIM FORM - UMWIPS FORM 11 OIL EVALUATOR FOR.N1 Page 2 of 3 Location Address or Lot No. ao< 4 On-site Review _ Deep Hole Number �/. Date: Location (identify on site plan) Land Use %yQ a40.3 Slope (%) - Surface Stones 4 "� Vegetation Landform Time: v Weather ,e L-c�', r� 7 CJ \" Position on landscape (sketch on the back) . Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other DEEP OBSERVATION HALE LOGS Depth from Surface (Inches) Soil Horizon Sol Texture (USDA) Sol color (Munceln Sol (Mottling Other (Structure. Stones. Boulders, Consistency. Ifo Graven OYR '3�2 l6-. L S EQy� ?,six `e/ -Ole e. �y7,-->r� 4-2` o�t�v-��% Parent Material (geologic) - - ----- ..�..,...._ r.. _. _. ...- .---- -•- - OapQRoBedrodc: Depth to Groundwater; Standing Water in the Hole: /oXW 4=-- Weeping from Pit face: /✓a',-� S /N Estimator! Seasonal High iaround Water: F'OrZtLJc D 13 y : ✓O.- SCK r� /f 7"<<'4 IN�r��ss�� err ✓ � �Qo.����/ E" X e A VA 'ro r'z ,/L'i 4 AL Go v s ?k ) r- 7/ DEF APPROVIM FORM. UM7193 FORM 1 :OIL EVALUATOR FORM Page 2 of 3 Location Address or Lot loo. 17" jo a N_®„ av Olt-SIfe Review _ Deep Hole Number Z Q Date: �/ '3/0 Z. Location (identify on site plan) -- -- Land Use OG 0 3 Slope (%) Surface Stones Vegetation Landform Time: Weather e4- Position on landscape (sketch on the back) . Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other _...._- _...,... DEEP OBSERVATION HOLE LOGS Depth from Surface (Inches) Soli Horizon Sol Texture (USDA) Sol Color (Munsell) Sol Mottling Other (Structure, Stones, Boulders, Consistency. % Graven L S /oYit 7,TXZ Y/' / l Parent Material (geologic) ---- •• • `•• .. _.- --`- - - - aP�Badrodc: � g D �'L/ Depth to Groundwater; Standing Water in the Hole: �O .teWeeping trornPit Face: AJ+��i� Estimated Seasonal High Ground Water: etl PCF- ForazMen �Y: s ,%D ' 1 ? c,u/"i7`1Z4 ia 1=" X G' A Vii TO r'Z DFP APPRO"k•i) FORM - IZM78S FORM 11 ;OIL EVALUATOR FORM Paas 2 of 3 Location Address o�00 t I-40. e:: Jo 8 Ai 0. 17 70 7 On-site Review _ Deep Hole Number Date: 7/0 Time: Weather G L 70 Location (identify on site plan) Land Use P a ,0 5 Slope (ol{i) `�) Surface Stones —"o'< /1 G 4:3" Vegetation Sol Texture {USDA) Landform Soil Mottling Position on landscape (sketch on the back) . Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Sol Texture {USDA) Sol Color (Munsell) Soil Mottling other (Structure, Stones, Boulders, Consistency, % &raved ._. �._. -. - . - ...1.. ..• _rr - r,-A.,y\ �N Parent Material (geologic) 0eptht*6e roa: "> �4 Depth to Groundwater, Standing Water in the Hole: Weeping From Pit Face: A/O 1—)Z— Estimated Seasonal High Ground Water: PE P% FoRlAyc iJ FY: t�p � S Gc/J¢ 7-t&— �-- E" X G A Vii 7-0 a ; /vi G Q,0v S I- rt DFP APPRONIM FORM - Uffl719S FOPIM 1 ` SOIL EVALUATOR FOR NI Page 2 of 3 Location Address or Lot iso. Gz4 V 577 On-site Review _ Deep Hole Number Z Date: �.7- 3112? Time: Weather LLyz 741 Location (identify on site plan) Land Use ._. Q 0 0 Slope (%) ti„ Surface Stones __l�N+✓ Vegetation Y/ Q r Landform Position on landscape (sketch on the back) . Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other DEEP OBSERVATION HALE LOG' Depth from Surface (Inches) Soil Horizon Sol Texture (USDA) Sol Color (Munsell) Soil Mottling Other (Structure, Stones, Boulders, Consistency, % Graven 6 ^1 7 eio�,,Or5 7— !6 ---------- -..• - - • 1- lIGY�/„1GY �GfG,If nVl VJL/ Y,J� Vi19G MLA /�( Parent Material jgeoiogic) p Dg yam: � f7 Rt/ Depth to Groundwater: Standing Water in the Hole: �IJG N Weeping from Pit Face: AJO/l/64— Estimated Seasonal High Ground Water: /V PE S Foizzllli= n iyl-> ✓0 1-- %957cr-J/T 1-/1- E X e A VA 70 rZ DEF APPRONIM total-121ov95 i FORM SOIL EVALUATOR FORM Paas 2 of 3 Location Address or Lo/t 1-40. r •�� On-site Review _ Deep Hole Number /.%..__ Date: ar.. �z4 aZ- Time: Weather Location (identity on site plan) r r Land Use 67,E Slope M 570'- Surface Stones i ig %'�"�`� '�4a Vegetation Jai I-V zA /--- _ Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line ._____r__ feet Drinking Water Well -_ _- - feet -Other DEEP OBSERVATION HOLE LOG" Depth from Surface (Inches) Soil Horizon Sol Texture 1USDA) Soil Color !Munsell) Soil Mottling Other (Structure. Stones, Boulders, Consistency, % Graven �.4 iAr 2 LIDLIR Parent Material (geologic) OapQnoBedrock: > Jl �N Depth to Groundwater; Standing Water in the Hole: 'pA Weeping from Pit Face: AP or-yL; Estimated Seasonal High Ground Water: Ary" e ,SE_ %f -7- 13 E X e VA TO ,Z O�F-- e=eA'%'.# .t'yx2 V e: it O� DEP APPRONIM PORN-12/071tS I FORM U - PERCOLATION TEST Location Address or Lot No. Sgoq- Soca Qo. 177010-711 COMMONWEALTH OF MASSACHUSETTS .4,v,0DVE n-- , Massachusetts Percolation Test* Date: .:::.:..:......51Z7002- Time: Observation Hole # 2 Depth of Perc ' 24 _ 40 Start Pre-soak lr ;o -i dM End Pre-soak I V. 22 A M Time at 12" l4: 22. A LA Time at 9" 11.2/, AM Time at 6" AkA Time (9"-6") 4 MFw. Rate Min./Inch Miinimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed ®� Site Failed ❑ ......................................................................................................................................_..._......_......_ Performed By: Z Witnessed By: � Comments: DEP APPROVED FORM - 12/07/95 I FORM 12 - PERCOLATION TEST Location Address or Lot No. GRAY 5-19,60 -SOS '0114 COMMONWEALTH OF MASSACHUSETTS Nl0R-To Auoov&iz , Massachusetts Percolation Test* Date:....:...:.... (.23 I 02 Time:...::._:.....::::.:.::::.:. Observation Hole # Depth_ of Perc � _ 22 Start Pre-soak 10,31 4M Sz A End Pre-soak lo -49 tim II:d7 A m Time at 12" to, 49 AM I1:07 A W1 Time at 9" l0' 54 AM I l s I I A t Time at 6" 11 "00'A M Time (9"-6") Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AND reserve area. are/a. Site Passed LS Site Failed ❑ ..............................................................................................:......................................_..__.....__........ Performed By: JE SeP'�woqTkOq Witnessed By: K. k"/'-L-cz_TT Comments: DEP APPROVED FORM - 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. JAS No, 1-77o%?y COMMONWEALTH OF MASSACHUSETTS IV, i27 H 1-9` /00 ✓e 2 , Massachusetts Percolation Test* Date:.::::. 5� Z�o.L Time 'Observation Hole # Depth of Perc Start Pre-soak 10:2.3 AM 111,0G Awe End Pre-soak 10;38 A -A4 AM Time at 12" to : -6 Time at 9" 10: 47 aYK it -, 3a aA, Time at 6" 10 5(1- Am W-43 ant Time (9"-6") R rA,V4 13 Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AND reserve area. area. Site Passed EreSite Failed ❑ ..............................................................................................:......................................._._._........_......._. Performed By: JOE 54 A?,wATkA Witnessed By: viIU.E Comments: DEP APPROVED FORM - 12/07/95 A Joseph J. Serwatka, P.E. Post Office Boz 1016 North Andover, MA 01845 (978)-683-6595 j oeserwatka(a,comcast.net January 17, 2005 Mrs. Susan Sawyer Health Agent Town of North Andover North Andover, MA 01845 Re: Lots 14 and 15 Gray Street Dear Mrs. Sawyer: On behalf of the Litchfield Company and the Stella Family, I would like to request that a meeting be scheduled with you and possibly your consultant. The parties are concerned about the soil and percolation testing requirements that have been placed upon their property, and in particular lots 14 and 15. I realize that much of the history of this project goes back three years, before the arrival of yourself and your consultant, but we would hopefully like to resolve some issues. As you may know, the Stella family paid the Town and their consultant over $6,000 in 2002 to conduct soil and percolation testing on lots 1-12 and 14, 15. We abided by the requirements of the then Health Agent, Ms. Starr, and conducted two deep holes and two percolation tests on lots 1-12. Deep hole testing was successful on lots 14 and 15, but due to high groundwater we were unable to perc in 2002. We were able to get one successful perc on each lot in 2003, but the other peres were hindered due to high groundwater. We tried to schedule overnight peres on these lots with the previous consultant, but were told that they did not do overnight peres and that we would have to schedule with Rudy, who was one of Ms. Starr's assistants. At the time, Ms. Starr stated that it was in fact her consultant's job to inspect overnight peres, and that she would get back to us. We all know that that had been subsequently released from town employment, and that her consultant was replaced. More recently, we have designed and received approval for septic systems on lots 1, 2, and 4-9. These designs were based on the previously conducted and approved soil/perc testing from 2002. It has come to pass that the soil testing on lots 10, 11, 12, 14 and 15 was deemed to be expired since it was more than two years old. We recently paid the Town over $2,000 to have the present consultant witness new soil testing. Based on e- mails previous to the soil testing, it was determined that 4 deep holes and 2 peres would be required on lot 10, 2 deep holes each would be required on lots 11 and 12, and 2 deep holes and 1 perc each would be required on lots 14 and 15. Note that it was decided that the previous deep holes from 2002 would be allowed to be used on lots 11, 12, 14 and 15. That was the understanding prior to the testing on January 13, 2005, but as a result of the M procedures and discussions from that day, we are confused as to the requirements being placed on lots 14 and 15. To summarize, two deep holes and one perc was allowed on lot 10, two new deep holes were conducted on lot 11, only one new deep hole was conducted on lot 12, and two new deep holes each were conducted on lots 14 and 15. Peres were again attempted on lots 14 and 15, but high groundwater made them unsuccessful. As you can see, what was agreed upon in the e-mails prior to January 13, 2005 was not what was allowed or required on the day of testing. This not only leads to confusion on the part of the landowner and developer, but begs the following question: "if two deep holes and one perc are deemed adequate on lot 10, why are six deep holes (totals from 2002, 2003 and 2005) and one perc not deemed adequate on lots 14 and 15?" Based on the opinions of soil evaluators who have witnessed the testing, the soils on lots 14 and 15 are believed to be as permeable, if not more, than those on lot 10. To complete one more successful perc on each lot will take many more manhours and several thousands of dollars, only to find out what we already know. We are asking that the current testing to date (i.e. six deep holes and one perc) be allowed to be used on lots 14 and 15 for septic designs. This information is above and beyond what has been determined to be adequate on lot 10. An additional perc could be performed when construction begins on the lots, although I do not believe that it is necessary. At that time, adequate machinery and dewatering equipment will be on the site anyway for the construction of the dwelling. Please get back to me about a meeting date and time at your earliest convenience. Sincerely, Joseph. J. Serwatka, P.E. Page 1 of 2 Sawyer, Susan From: Dellechiaie, Pamela Sent: Wednesday, January 05, 2005 2:19 PM To: Sawyer, Susan Subject: FW: 121 Raleigh Tavern Lane and Lot 3 Gray Street Susan, Do you have the septic file for 121 R.T. Lane? I cannot locate it. Thank you. -----Original Message ----- From: Dan Ottenheimer [mailto:info@miliriverconsuldng.com] Sent: Wednesday, December 29, 200410:37 AM To: pdellechiaie@townofnorthandover.com; 'Lisa LeVasseur (E-mail)'; 'McBrearty Andrew (E-mail)' Cc: 'Sawyer, Susan' Subject: 121 Raleigh Tavern Lane and Lot 3 Gray Street Lot 3 Gray Street and 121 Raleigh Tavern are in the queue to be reviewed. We should have it to you on Monday, Tuesday at the latest. Dan D Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com dano@millriverconsulting.com From: Pam Dellechiaie [mailto:pdellechiaie@townofnorthandover.com] Sent: Tuesday, December 28, 2004 4:26 PM To: 'Daniel Ottenheimer (E-mail); 'Lisa LeVasseur (E-mail)'; 'McBrearty Andrew (E-mail)' Cc: Sawyer, Susan Subject: FW: Gray Street Lot 3 Hi guys, Did you receive a plan for this, and if so, did it get reviewed? If you don't have it, let me know asap, so I can get it out. I show that I sent it on December 3rd Thanks! P -----Original Message ----- From: Dan Ottenheimer [mailto:info@millriverconsuldng.com] Sent: Tuesday, August 24, 2004 4:21 PM To: Susan Sawyer; amcbrearty@millriverconsulting.com; 'Pamela Dellechiaie' 1/28/2005 Page 2 of 2 Subject: Gray Street Lot 3 Sue and Pam, Attached please find soil test results for Lot 3 on Gray Street. Joe Serwatka did not wish to run an overnight soak tomorrow. It is unclear if and when he will contact the office to schedule this. It is worthy of noting that we found a perc rate slower than 10 mpi when most of the designs for this project show they obtained a faster rate. I am glad we were out there today making sure he was percing in the most restrictive soil horizon in order to make sure we've got a true representation of site conditions.. Dan 21 Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com info@milltiverconsulting.com 1/28/2005 Page 1 of 1 Sawyer, Susan From: joeserwatka@comcast.net Sent: Monday, January 03, 200512:55 PM To: Susan Sawyer hi sue: i wanted to get clear exactly what will be required for lots 10, 11, 12, 14 and 15 on gray and boston streets. lot 10 has adequate soil and perc tests but they were conducted in the buffer zone. i intend to conduct 4 test pits and 2 peres outside of the buffer zone. lot 11 has adequate deeps and peres, but the deeps are expired. the peres are still valid. do we need to do 4 new deeps, or 2 new and also use the old ones? I'm concerned about digging into disturbed areas if we have to do 4 new deeps. lot 12 has the same issues as lot 11. lot 14 has expired deeps and one good perc. we will do a second perc if allowed by water table, and 4 new deeps if required, can we use the two old deeps and do two new deeps? lot 15 has the same issues as lot 14. please get back to me on this and copy Andy if possible. thanks, joe 1/28/2005 Sawyer, Susan From: joeserwvatka@icomcast.net Sent: Thursday, June 17, 2004 4:14 PM To: Susan Sawyer Subject: Re: Gray street lots litchfield4.doc > Before I give specific answers, 1 wanted to ask you a question about the > test holes. As you know, you verbally told me that Sandy Starr allowed for > only one test pit rather than 2 each for the primary and secondary. I have > been searching for some documentation to that effect, but have not uncovered > any yet. What I did find just today, was an internal memo to the assistant > town manager concerning these sites dated September 24, 2002. The memo has • the following statements: > > • To date the Health Department has not received soil evaluator forms or > subdivision plans relative to the noted site from Mr. Serwatka. We have > received our consultant's records. The Planning Board has also not received > a subdivision filing. The bulk of the tests were done in May and June of > this year. 310 CMR 15.018(2) of the State Environmental Code Title 5 and > North Andover Minimum Requirements for the Subsurface Disposal of Sanitary > Sewage 2.02 and 7.01 state that soil evaluator forms and certifications must > be forwarded to the Board of Health within 60 days of the date of the field > testing. (See attached.) > • Discussion with the Board of Health about the results of the testing > according to our consultant's records resulted in a decision to request > additional testing on some lots as permitted by 310 CMR 15.102(2). We were > awaiting the engineer's (Joe Serwatka) reports and plans, when he called > about further testing involving ovemight soaks, and was told of the > possible problem. 1 had had no conversation with Mr. Serwatka about this > site since May 23, 2002 when I visited the site in response to his request. > • The possible problems on the site have to do with the depth of the deep > observation holes, which, according to 310 CMR 15.102(3) and N.A. 7.02 must > be a minimum of ten (10) feet deep, the depth of some of the percolation > tests, and some of the soil logs themselves. Also 310 CMR 15.102(3) > requires the deep observation holes to be excavated in two segments, the > first to about 5 feet for detailed logging and the second for the total > depth no less than 10 feet. This procedure has been developed by DEP to > address safety issues. > According to 310 CMR 15.104(2) and N.A. 7.06 the percolation test must be > performed in the soil layer that is estimated to be four feet below the > elevation of the leaching facility in the C horizon at roughly 50"i in this > case. The majority of the soil logs have the B horizon ending around 14 to > 20 inches. The Soil Survey of northern Essex County, Map 36 indicates that > the soil is CbB, of the Canton series that typically has a 8 horizon of > about 27" in depth which, with the A horizon would extend generally down to > at least 30" in the soil profile. (See attached.) The soil logs do not > reflect this pattern, and some of the peres MAY be too high. I would like > to see a plan showing all the testing and locations before I make that > determination. > Can you comment on any of these items Sandy Starr listed? I will keep > digging. Thank you for understanding that coming in this late in the project > and it happens to have such unusual issues, I have had an issue with getting > up to speed and getting comfortable with my decisions. > Susan > -----Original Message----- • From: joeserwatka@comcast.net[mailto:joeserwatka@comcast.net] > Sent: Thursday, June 17, 20041:04 PM > To: ssawyer@townofnorthandover.com > Subject: > Joseph J. Serwatka, P.E. Post Office Box 1016 North Andover, MA 978-683-6595 joeserwatka@comcast.net June 17, 2004 Ms. Susan Sawyer Health Agent Town of North Andover North Andover, MA 01845 Re: Lots and Gray Street and Boston Road Dear Sue: This letter is sent to request that you answer some vital questions relative to the status of soil testing for the approved form "A" lots on Gray Street and Boston Road. I am in receipt of septic system review letters for lots 2 and 6 which were originally submitted in April 2004. At your request, they were revised and resubmitted in May 2004. The letters contain the following comments. Item 29 for lot 2 states, "please provide for additional test pits in the vicinity of the southern portion of the soil absorption system to confirm the suitability of the soil in that area." Item 3 5 for lot 6 states "the location of the SAS only encompasses a single test pit. Please provide for additional test pits in the vicinity of the soil absorption system to confirm the suitability of the soil in that area". As you are aware, the Stellas had the lots adequately soil and perc tested in May and June of 2002 under the direction of the previous health agent and her consultant. Many thousands of dollars and man-hours were spent to successfully "prove" these lots. All of the lots were determined to be suitable for the design of an on-site soil absorption system. I realize you were not the health agent in 2002, but I would hope that you will accept the findings of the previous health and her consultant. We have submitted septic design plans for many of lots that encompass a trench system design per your requirements, with reserve areas between the active trenches. All of the trench systems are located in the areas of the approved 2002 soil and perc testing, as required by code. To say, at this point, that additional soil testing should be provided does not take into account the thousands of dollars and weeks/months that will be required to accomplish this task. Further, the originally approved soil and perc tests were conducted two years ago. Will all of the testing have to be redone? We submitted 8 septic plans in April 2002 to take advantage of the 2 year window of opportunity afforded by the previous soil testing, and also to pull building permits in this fiscal year. Given the tone of the above-mentioned review letters, it appears apparent that all the previous work and planning may have been for naught. I trust that you will respond to me in a timely manner as to whether additional soil testing will, in fact, be required, and whether the remaining lots (10-15) can be submitted using the 2002 testing. Should you have any question concerning this letter, please contact me. Sincerely, Joseph J. Serwatka, P.E. Cc: Gary Litchfield Mark Rees, Town Manager Dellechiaie, Pamela From: Sawyer, Susan Sent: Wednesday, January 26, 2005 11:14 AM To: Dan Ottenheimer; amcbrearty@millriverconsulting.com Cc: Dellechiaie, Pamela; Grant, Michele Subject: Gray St. lots Contacts: Dan Ottenheimer A meeting has been tentatively scheduled for Monday, January 31 st, 2:00 PM, at 400 Osgood Street. If there are any changes I will let you both know. We are still working on the spread sheet. Deciding what info is relevant to be included is the most difficult part. Please let me know if you have any thoughts. Thanks Susan Dellechiaie, Pamela From: Dan Ottenheimer [info@miliriverconsulting.com] Sent: Wednesday, January 26, 2005 11:47 AM To: 'Susan Sawyer'; amcbrearty@millriverconsulting.com; 'Lisa LeVasseur (E-mail)' Cc: Pamela Dellechiaie; mgrant@townofnorthandover.com Subject: RE: Gray St. lots Daniel Ottenheimer Gray Street & (info@millr... Boston Street Tr... First, with apologies, I am not available Monday at 2:00. 1 have a 1:00 in Essex and also must go to Beverly some time that day. I could meet with you when my 1:00 is over, which would likely be 2:00 so we could schedule for 3:00 perhaps? Also, I have added additional information to your spreadsheet which may be of use. Dan Daniel Ottenheimer, President Mill River Consulting . Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsultin,q.com dano(a)miliriverconsulting.com -----Original Message ----- From: Susan Sawyerrmailto:ssawyer(�townofnorthandover.com1 Sent: Wednesday, January 26, 2005 11:11 AM To: 'Dan Ottenheimer'; amcbreartv(@millriverconsulting.com Cc: Dellechiaie, Pamela; Grant, Michele Subject: Gray St. lots A meeting has been tentatively scheduled for Monday, January 31s, 2:00 PM, at 400 Osgood Street. If there are any changes I will let you both know. We are still working on the spread sheet. Deciding what info is relevant to be included is the most difficult part. Please let me know if you have any thoughts. Thanks Susan M Joseph J. Serwatka, P.E. Post Office Bog 1016 North Andover, MA 01845 (978)-683-6595 ioeserwatkana,comcast.net January 17, 2005 Mrs. Susan Sawyer Health Agent Town of North Andover North Andover, MA 01845 Re: Lots 14 and 15 Gray Street Dear Mrs. Sawyer: On behalf of the Litchfield Company and the Stella Family, I would like to request that a meeting be scheduled with you and possibly your consultant. The parties are concerned about the soil and percolation testing requirements that have been placed upon their property, and in particular lots 14 and 15. I realize that much of the history of this project goes back three years, before the arrival of yourself and your consultant, but we would hopefully like to resolve some issues. As you may know, the Stella family paid the Town and their consultant over $6,000 in 2002 to conduct soil and percolation testing on lots 1-12 and 14, 15. We abided by the requirements of the then Health Agent, Ms. Starr, and conducted two deep holes and two percolation tests on lots 1-12. Deep hole testing was successful on lots 14 and 15, but due to high groundwater we were unable to perc in 2002. We were able to get one successful perc on each lot in 2003, but the other peres were hindered due to high groundwater. We tried to schedule overnight peres on these lots with the previous consultant, but were told that they did not do overnight peres and that we would have to schedule with Rudy, who was one of Ms. Starr's assistants. At the time, Ms. Starr stated that it was in fact her consultant's job to inspect overnight peres, and that she would get back to us. We all know that that had been subsequently released from town employment, and that her consultant was replaced. More recently, we have designed and received approval for septic systems on lots 1, 2, and 4-9. These designs were based on the previously conducted and approved soil/perc testing from 2002. It has come to pass that the soil testing on lots 10, 11, 12, 14 and 15 was deemed to be expired since it was more than two years old. We recently paid the Town over $2,000 to have the present consultant witness new soil testing. Based on e- mails previous to the soil testing, it was determined that 4 deep holes and 2 peres would be required on lot 10, 2 deep holes each would be required on lots i 1 and 12, and 2 deep holes and 1 perc each would be required on lots 14 and 15. Note that it was decided that the previous deep holes from 2002 would be allowed to be used on lots 11, 12, 14 and 15. That was the understanding prior to the testing on January 13, 2005, but as a result of the for the gravel -less system is a "general use" approval, which allows the use of the system on a "General Use basis". Before I can justify to my client that the system must, in effect, be designed twice, I would respectfully request substantiation of your consultant's request. This could be in the form of recent correspondence from DEP or other Health Agents. Otherwise, I believe the request is subjective and open for interpretation. We are planning to use gravel -less system for the remaining designs, and would like to get the issue settled prior to undertaking these design attempts. Again, we respectfully request that your consultant complete their review of the submitted plans. Should you have any question concerning this letter, please contact me. Sincerely, Joseph J. Serwatka, P.E. Cc: Gary Litchfield V TOWN OF NORTH ANDOVER µOOT" Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET � r �/ QOgnrc° ^°p'i5 NORTH ANDOVER, MASSACHUSETTS 01.845 SACH SES 978.688.9540 - Phone Susan Sawyer, REHS/RS 978.688.9542 - FAX Public Health Director healthdept@townofnorthandover.com www. townofn orth andover. c oni FAX Ta �# l9'edY �7-� r/�a From:JS Fax: 9--7,F 4 J3-S'29L Pages: Phone: Date: ^�7 � y Re: & !!�� /e --i7 CC: ❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle Please contact the Health Department at the above numbers for further assistance. �Dv A CD 'gyp 0000000000000000000000000 N y mmoommCntnAAAAAAAAAW W W WNNN� a OONNNOOONNNNNNNN-• W W OON�-�-� O O COAOOUICJIWUtAODW W W W W W W W-��COW A�-�0 Q^ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O AA AAAAAAAAAAAAAAAAAAAAAAA T x x z x x A x x z z z z z z z z z x x x x x z x z m m m m m m m m m m m m m m m m m m m m m m m m m W N -A N r�cnrrcnW -4rrrrrrrWr D 0 0 4 0 O (00-00 0 0 0 0 0 0 0 0 - Oo co o o O c0 0. 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N N � N � N , N , N N O O O O O O O O O O O O O O O O O O O O O O O O O O 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O A A A A A A A A A A A A A A A A A A A A A A A A A O 000 *D O•p > ODDDD 000010 0u,&6cncnLncnCil i i0 i CA) 1 W v - Dvl NN��� N QOQovvv 00 00 � 00-4 -4 -4 -4 -4 -4 -4 -40 N N C. 00000 A A O O O O O O O O A O O Dai A A A A A A A A A A A A A A A O pr HP Fax K 1220xi Last Transaction Date Time Twe Identification Jun 30 8:55am Fax Sent 89786836895 Log for NORTH ANDOVER 9786889542 Jun 30 2004 8:56am Duration Pages Res 1 0:00 0 No answer HP Fax K1220xi Date Time Ty�g Jun 30 8:58am Fax Sent Log for NORTH ANDOVER 9786889542 Jun 30 2004 8:59am Identification Duration Pages R=h 89786836595 0:00 0 No answer y TOWN OF NORTH ANDOVER f NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT p 4 27 CHARLES STREET gO��ttn .P�yg9 NORTH ANDOVER, MASSACHUSETTS 01845 9SS^CMUSES 978.688.9540 — Phone Susan Sawyer, REHS/RS 978.688.9542 — FAX - Public Health Director healthdept@townofnorthanclover.com www.townot'northandover.coni Tangy From: 1 Fax: Pages: Phone: f Date: Re: � CC: ' ❑ Urgent or Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle Please contact the Health Department at the above numbers for further assistance. r a :S S L-Icn-t- TOWN OF NORTH ANDOVER f NSR*H Office of COMMUNITY DEVELOPMENT AND SERVICES 3 SAL F ~ A HEALTH DEPARTMENT 27 CHARLES STREET `°.- * NORTH ANDOVER, MASSACHUSETTS 01845 �'Ss;CH Susan Y. Sawyer, REHS/RS Public .Health Director June 28, 2004 Joseph J Serwatka, P.E. P. O. Box 1016 North Andover, MA 01845 RE: Lot 7 Gray Street, North Andover, MA Dear Mr. Serwatka, 978.688.9540 — Phone 978.688.9542 — FAX The proposed septic system design plans for the above site dated April 11, 2002 and received on June 8, 2004 has been reviewed. [To avoid confusion by others, please note that two plans bearing the date April 11, 2002 for this parcel have been submitted to the office, one received on April 23, 2004 and one received on June 8, 2004. The former contains a leach field configuration and was previously disapproved while the latter contains leach trenches]. Unfortunately, they cannot be approved until the following items are corrected. Each item is followed by the specific section in Title 5: 310 CMR 15.000, or North Andover regulations which is not met by this design. 1. If created by the Town, please provide a map and lot number for this parcel - 220(4)(u). 2. All pipe joints must be specified to be watertight — 222(3) & (4), N. A. 11.02. 3. Sewer must be specified to be laid on compact, firm base — 222(5). 4. Sewer must be specified to be laid on continuous grade in straight line — 222(7). 5. A minimum of one 24" childproof riser/manhole within 6" of final grade is required. Please clearly indicate which access port(s) are to have risers and if they are to be placed at grade or to what depth below grade. — 228(2). 6. Tees should be depicted extending to the center of the access ports. 7. Soil compaction below tank must be specified — 221(2) 8. Please specify the depth and size of stone that is to be used beneath the septic tank — 221(2) & 228(1). 9. Septic tank is shown with an optional baffle wall. Please clarify if you desire the septic tank to be two-compartment or one -compartment and update the tank section drawing as appropriate. 10. Please provide a notation as to septic tank and distribution box watcrl�ghtness requirements— 221(1). 11. Please specify the cover over the septic tank (9" min, 36" max) 220(1) & 221(7). 12. Please specify the loading of the septic tank — 226(3). 13. Please provide a notation stating that all outlets from the distribution box are to be constructed at the same elevation — 232(3)(b). 14. Please provide a notation stating that the outlet pipes from the distribution box are to be laid level for the first 2' — 232(3)(c) 15. Please specify the soil compaction and the stone size beneath the distribution box - 221(2) 16. Please specify the depth of cover over the distribution box — 221(7). 17. Please provide the elevation of the percolation tests — NA 8.02 (n) 18. Please provide calculations to demonstrate the correct size soil absorption system has been provided. 19. North Andover requires the excavation to extend 6" into natural soil. Please depict and provide notation of this requirement — N.A. 9.02. 20. Please provide specifications for the fill material — 255(3). 21. Please specify a minimum 0.02 ft/ft final grade slope over leach field - 240(10). 22. It does not appear that 15' of fill material is being maintained prior to the 3:1 slope on the eastern side of the soil absorption system. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a septic system that will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincerel , S an Y. Sawyer, S/R� `�� Public Health Director cc: Owner Applicant File f gORT11 TOWN OF NORTH ANDOVER Community Development & Services Division ►° HEALTH DEPARTMENT * 1i,_ ,r 400 OSGOOD STREET SACHU`+� NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 - Fax DanielOttenheimer From: Pamela To: Mill River Consulting 978.282.0012 Pages: Fax: 1.800.377.3044 or Date: Phone: 978.282.0014 Request for Soil Testing or CC: Re: Septic Plan Review ❑ Urgent x For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle • Comments: Septic Plan Review Soil Test `-- OTHER Address: Please call 978-688-9540 for assistance wit any questions. Thank you. ^ Cc: File TRANSMISSION VERIFICATION REPORT TIME 12/30/2004 11:34 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 12130 11:30 FAX NO./NAME 819782820012 DURATION 00:03:31 PAGE{S} 19 RESULT OK MODE STANDARD ECM Sawyer, Susan From: Susan Sawyer [ssawyer@townofnorthandover.com] Sent: Thursday, December 09, 200412:03 PM To: 'joeserwatka@oomcest.net' Subject: RE: Joe, To follow-up on our conversation. I have reviewed the files for lots 10, 11,12 Boston Road. The paperwork indicates that soil tests were scheduled on February 15, 2002. The file does not contain any of the soil logs and I am not sure where they may be, unless they were confused with the Gray Street lots. With this minimal information it has been determined that the deep hole soil tests are likely over 2 year old and will have to be redone. Assuming that the information is eventually located on the testing between our offices, the health office would only require confirming tests. If no old information is found, than all new tests will be conducted and the number of test holes will be at current standards. The passage of time has negated any previous agreements in the field. The pert tests, (assuming we find the information), would still be acceptable. Please be sure that the perc tests and the deep holes are located within the primary and reserve areas as required. Please let me know if you have any further questions. Thank you, Susan Sawyer -----Original Message ---=- Frons: joeserwatka@comcast.net[mailto:joeserwatka@comcast.net] Sent: Thursday, December 02, 2004 7:32 AM To: ssawyer@townofnorthandover.com Subject hi sue: just wanted to thank you for taking the time to meet with me yesterday on crusader paper. also, when you get a chance could you e-mail me your thoughts on the final 5 designs for boston/gray streets. i need to know whether to proceed with designs, or wait for additional soil testing. thanks, joe 12/9/2004 FORM SOIL EVALUATOR FORM Pabe 2 of 3 Location Address or Lot v4o. �FY rl* '5' `t> On-site Review - Deep Hole Number JL C;J Date: la'?-_ Time: Weather _4 Location (identify on site plan) Land Use 4,-/ '2 Slope Surface Stones Vegetation Landform Position on landscape (sketch on. the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Wateir WeH feet 'Other DEEP OBSERVATION HOLE LOG® Depth from SW Horizon Soil Texture Soil Color Soil Other Surface (inches) (USDA) (Munsell) afictifing (Structure, Stones, %ulders. Consistency. % Graven 1-4 r r$ e ;.7 '0 MINIMOM OF 2 HOLEN REQUIRED A I EVERY rRUMSED DISPOSAL AREA Parent Material (geolooc) Dep thtoR I md: Depth to Groundwater Standing Water in the Hole: Weeping Rom ft Face: —/4/ Estimated Seasonal High Ground Water: PC 1K E X eq VA 'ro f W -P APPRONIM FORM 0M71tS FORM 1 SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. On-site Review Deep Hole Number Date: Time: Weather <7'; Location (identify on site plan) Land Use Slope M Surface Stones V4igetation Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (inches) JUSDA) (Munsell) Mottling (Structure. Storms, Boulders. Consistency. % Graven MINIMUM OF 2 HOLI:5, REQUIRED AT tVkKY PKUeU,5LD LA5PQ5ALARLA ftrant Material (geot"ic) 0vpihW8edrat*: Depth to Groundwater Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water. FOR 14116: 27 '611 E )( 47,1 VA 7-0 XZ 7 FL DEP APPROMM FOILM. 121071PS FORA 1 SOIL EVALUATOR FORM Paoe 2 of 3 Location Address or Lot iso. On-site Review _ r' Deep Hole Number '-t Date: ---z', _ Time: Weather Location (identify on site plan) . Land Use %`�' -°° ` k' Slope M _ Z Surface Stones Vegetation Landform Position on landscape (sketch on the back) Distances from: Open Water Body _ feet Drainage way feet Possible Wet Area feet Property Line ==A a feet Drinking Water Well feet 'Whey DEEP OBSERVATION HOLE LOG" Depth from Soil Horizon Sol Texiure Sol Color Sol other Surface (Inches) (USDA) (Munsell) !Mottling (Structure, Stones, Boulders, Consistency, % Graven J pM Parent (Material (geotogie) f r'fb pepd=g.d.:. Death to Groundwater ;`'°� Standing Water in the Kok: Weeping from Pit face: Estirnated Seasonal High raround water. Z f�^a� I 9 Wir/ila5iE'A aY: MP APPRONIM FORM . CM7195 FO%%1 I SOIL EVALUATOR FORM Noe 2 of 3 Location Address or Lot No. .Jo a H 0. 17 /12 Z.T- A,, On-site Review Deep Hole Number Date: i Weather Time: I Location (identify on site plan) Land Use Aol Slope Surface Stones V6getation a/l J':: Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet 'Other DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Soil Color sod Other Surface (inches) (USDA) 001unsaill Uottling (Structure. Stones,,Boulders. Consistency. % Graven /o o -7 "4" <7' Parent Material (geologic) 0Wd=6-*'a: / ,,, 4:1 Depth to Groundwater Standing Water in the Hole: Weeping kown Pit Face: 'j, Estimated Seasonal High Ground Water: PC K F0iR/"!EZ7 jy / 11 ✓6f?< t-1 1`9 7ic /4. Wi'r1qa5%CV E X',CA VA TO XZ IMP APPROVIM FORM - DWitS FORM SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot 1-40. eeoey-'O'l jo a ov 0. On-site Review Deep Hole Number Date:z z!' 51./�7- 1/r Time: Weather Location (identify on site plan) Land Use 2 Slope M Surface Stones v6getation Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well - feet 'Other DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Soil Color SON Other Surface (inches) (USDA) (Munsell) Uottling (Structure. Stones. Souldars. Consistency. % Graven ell A 4. HUIES AEQUIRED AT NkiiY FRUeUSED LMSPLMAL ALRLA P&r*M Material (geologic) Depth to Groundwater- Standing Water intM "We: P 47 Weeping from ft Face: Est -wiled Seasonal, High Ground Water F'OiR ,I a Z7 gr are. e"- .4 WPr/Ya5s70_-v 3 Y_- /Ndl XeA VA 70 A 4, OFF APPRON'M FORM - 1WItS FORM I SOIL EVALUATOR FORM Page 2 or 3 Location Address or Lot i4o. 4,- oe 4 "V On-site Review Deep Hole Number Date: ' A? Time: Weather Location (identify on site plan) Land Use k/ IV IV, L", :7) Slope M Z.- Surface Stones 477-� Vefdetation f/1' Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet 'Other DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Soil Color SON Other Surface (Inches) (USDA) (Munsell) Mottling (Structure. Stones, Boulders. Consistency. % X Graven Q P F5 L 7 r,y 0 MINIMUM OF 2 HOLES REQUIRED A I k:VEKY rtwilObLIJ L)INrLr-AL ARVA Parent Material jaeologic) 9C, De --pthtoGroundwater: Standing Water inthe Hole: Weeping horn ft Face: A.,o, Estimated Seasonaf High Ground Water. - PIE K F'OR,41 1611, j 4- ad 'At EXeA VA TO ZZ t 9 DEP APPROVED FORM - UWAS FORM 11 ;OIL EVALUATOR FORNI Page 2 or 3 Location Address or Lot. i4o. Joe Va. On-site Review Deep Hole Number Date: Z --..Time: Weather- Location fiden'tifV on site plan! Land Use4:1'e C) 0 0 ""� Slope Surface Stones Vegetation Lej 7 Landform Position on landscape (sketch on the back) Distances from: Open Water Eo'dy feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well - feet 'Other DEEP OBSERVATION HOLE LOG Depth from Surface (Inches) Soil Horizon Soil Texture Soil color sod Other {USDA) tMunsell) Mottling (Structure. Stones, Boulders. Consistency, % Graven F v5 12- 4:: --c"- 'eA MINiMUM OF .2 ML -11 1-4, R JaLarlpill-L. 1 —1— — — Parent Material (geojogic)'00 Donepexwf: 1�01 19 Z— Depth to Groundwater. Standing Water in the Hole: Weeping from Pit Face: ev a ftfirnated Seasonal High Ground Water: ?AE K F0;R/'1Z: P 49r/11 Ile t", fiiW'7*/Yass�cv aot 09, 'K., EX,CA VA -ro xz o0tl 6� 7'�� v e.- 7 o -4— IMP APPJto-* ED FORM. UM7195 FORM 11 ;OIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. ° ' r ` — On-site Review _ Deep Hole Number I . Date: . Time: Weather—, . 4, y Location (identify on site plan) Land Use c'� ��' Slope (96) Surface Stones `'» s Vegetation Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line TO feetT' Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG+ Depth from Sol Horizon Sol Texture Sol Color Sol Other Surface (inchesl {USDA) tMunsell) Mottling 1Structure. Stones. Boulders. Consistency. % ven mo i Gr• ', K•4� r,.9 � J �� iiifw. �Z. p) ✓3.".,.. �e� p i',s �:°f�e i.W .:'' t _ ., ✓:M�' ic= fra'r�iQ.. f ,�M:n, L....,.:-Sd"` 1 Parent Material (geologic) apQKoBedic� - rodc• Depth to Groundwater; Standing Water in the Hole:d Weeping hom P,it Face. err,.. 7%" 6 :' Estimated Seasonal High Ground taster: IMP APPROVED FORM - UWAS FORM 12. - PERCOLATION TEST 1 . Location Address or .., Lot No. �;�:� • �_� �....,, COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test' Date:.",' _. Time:. Observation Hole # Depth of Perc r _, Start Pre-soak % 1t r1 End Pre-soak41 , .^ Time at 12" Time at 9" r' ' Time at 6" a L..y—,- ap � C `»• Time (9"-6") Rate Min./inch 7 Minimum of I percolation test must be performed in both the primar area AN reserve area, y D Site Passed Site Failed _.................... _ Witnessed By: Comments: DFP A no"M FORM-12HfHS FORM 12 - PERCOLATION TEST Location Address or ot No Q:� '7- 0 --L� 1'7, 7f COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test* Date:...:... Time:, Observation Hole #. Depth of Perc Start Pre-soak End Pre-soak o .14- Time at 12" 7 Time at 9" Time at 6" Time (9"-6") Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed D .............................. .......... ...................................................... . . . ......... ........ Performed By: Witnessed By:a. A.) Comments: DEP APPROVED FORM - 12/07/95 FORM 12 - PERCOLATION TEST Location Addressr Lot No. Lv-T J05 NO: �aZy COMMONWEALTH OF MASSACHUSETTS N,,1)RT A n, a-�ov c-, R Massachusetts Percolation Test* Date:....:...:..:.. . . 0 2 Time:......::. Observation Hole # Depth of Perc e Start Pre-soak, 22�4�1 End Pre-soak �� 3� ' �� 2; � �• � stn Time at 12" Time at 9" 1:0 3 P w Time at 6" A,\ -^ JL+ Time (9"-6") Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AND reserve ,area. Site Passed L_7 Site Failed ❑ ..............................................................................................:.......................................___................_ Performed By: Witnessed By: Comments: .::.:::.:.::::::_:..:.....:............ W ........ ........... DEP APPROVED FORM - 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. aRpy -r Soca ado. I i7U b COMMONWEALTH OF MASSACHUSETTS A1627" .%i�.ODVE rZ_ , Massachusetts Percolation Test* Date: Time:....:.. .:...:.......:.:::.::::::::. Observation Hole # I Z Depth of Perc _ iia Start Pre-soak Lt :a�t AH End Pre-soak ! V. 22. A wl Time at 12" Time at 9" iit.6 Mv, Time at 6" Time (9"-61 4 Mrto. Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary .area AND reserve area. Site Passed 12' Site Failed ❑ DEP APPROVED FORM - 12/07/95 C FORM 12 - PERCOLATION TEST Location Address or Lot No._° 'Too, V(o e t , COMMONWEALTH OF MASSACHUSETTS i`k UD OV z.. , Massachusetts Percolation Test* Date: ....:.;.:.:..... , :,,..., . ::.:. Time:....:..::...: Observation Hole # i Depth of Perc Start Pre-soak y tr End Pre-soak Time at 12" Time at 9" 4/} py 4 16�.1I{ AM _ Time at 6" s f a` c lFs A fv Time (9"-6") Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AN6 reserve area. Site Passed Site Failed ❑ ......................................................................................_......:.................----------- - --- Performed By: Witnessed By: Comments:.:::.. DEP APPROVED FORM -12/07/95 I U . FORM 12 - PERCOLATION TEST Location Address or Lot No.''F°"'rx..1 COMMONWEALTH OF MASSACHUSETTS , Massachusetts Percolation Test* Date: Time:, Observation Hale # Depth of Perc J, Start Pre-soak End Pre-soak,a + A Eh+ Time at 12 0, A Pti Time at 9" Time at 6" Time (9"-6") Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ Performed By: Witnessed By: Comments:.:::.:.::::::.::.:.:.:::... DEP APPROVED FORM - 12/07/95 '.:7H AF FORM 11 -SOIL EVALUATOR FORI`s GF N w Page 1 of 3 OCTX002 , No. Date:�� Commonwealth of Massachusetts /Vo � Av Lrj! P , Massachusetts Soil Suitability Assessment for On-site Sewape 1Nvnncn1 Performed By: 0 5 P Date: 5h- Witnessed By: 4oj ................. . Bo�To ti l T Aaa.us. � -Y ej r Tckowx I A/0, N ]ADV �',� #114. a) New Construction Repair ❑ 9%�� ��� O Office Review Published Soil Survey Available: No ❑ Yes Year Published Publication Scale �' ���%�a Soil Map Unit Gbbj .Su 13 Drainage Class Soil Limitations . ........... Surficial Geologic Report Available: No ® Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) .......................................................... Landform Flood Insurance Rate Map: Above 500 year flood boundary No []Yes Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No ❑ Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) . Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS):..-Month- Range :Above Normal ❑Normal ®Below Norma_ l ❑ Other References Reviewed: DFP APPROVED FORM . 12/07/95 FOR -%1 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. J� On-site Review Deep Hole Number %f—' % Date: 6/ le/per Time: A /y% Location (identify on site plan) s c � pL,4 Weather �j v n� N >/ Land Use vv pp 0 le? Slope (%) Surface Stones \165 Vegetation 1"i N 6, YVIA 2 U S N Landform Position on landscape (sketch on the back) 5 je_ i✓ p LA jo 5 Distances from: Open Water Body 7 IV D feet Drainage way Y 7 'gip feet Possible Wet Area feet Property Line gD feet Drinking Water Well I oo feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) a "' Soil Horizon Soil Texture (USDAI L Soil Color (Munsell) 141)14 Soil Mottlin 9 Other •Structure, Stones, Boulders, Consistency, % Gravel) -J/Z Z"yr Parent Material (geologicl _ -7�-2 L L g4' 10 �p'dtto8edrock:_ .. Death to Groundwater Standing Water in the Hole:7 7 ' Weeping_from Pit Face: Estimated Seasonal High Ground Water: i DEP APPROVED FORM - MUM FOR -N1 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. d Opt -site Review Deep Hole Number / S/ ZDate: Location (identify on site plan) 5;cE PL -,41,/15. Land Use VU 4 0 C) .5 Slope (%) '9" 10 Vegetation Ill tq 6 M 4 PL e� Landform T,-.? T M L 11d Position on landscape (sketch on the back) 6 Distances from: O e W Time: f'% /)i- Weather Surface Stones \J�S PLA A.16 F n ater Body y 10 p feet Drainage way 7 4�5!0 feet Possible Wet Area --. you feet Property Line 17_D '* feet Drinking Water Well -;,.100 feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texture (USDAI Soil Color (Munsell) Soil Motilin Other g •Structure, Stones, Boulders, Consistency, % .z2-7'/ PL laye3Z Gravel) 1_7—J02, C �Q. �� f 0�12'�I� 7,y'f lei✓/ 2 �j.► 3 % �k' , 54 Parent Material (geologic) . y"ZL, DiPthxoBedroek: 2� Death to Groundwater Standing Water in the Hole:J--oo U Weeping from Pit Face: g� Estimated Seasonal High Ground Water: i DEP APPROVED FORM • 12/07/95 FOR\1 11 - SOIL EVALUATOR FORM Page 2of3 Location Address or Lot No. Ott -site Review Deep Hole Number Date: I—le, �✓�Z%Time: Location (identify on site plan) Weather �dNNy Land Use WOO P,55, Slope Surface Stones Vegetation P1 N E1� (n A (7Lr Landform 0 P --U rA L / " Position on landscape (sketch on the back) )0/_ Distances from: Open Water Body bop feet Drainage way>.y`a feet Possible Wet Area -_-"> / o a feet Property Line 'fid t feet Drinking Water Well 7 poo feet . Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Surface (Inches) Soil Texture (USDA) Soil Color Soil (Munsell) Mottling Other .Structure, Stones, Boulders, Consistency, % Gravel! goy 64 ) -� r� % y/ Z Parent Material (geologic! Oeprlxo8odrock: � � G% Depth to Groundwater Standing Water in the Hole: Weeping born Pit Face: C/ Estimated Seasonal High Ground Water: i DFP APPROVED FONM - 12/07195 FOR%I 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. ply /&IM,yiOAJ ,��- Opt -site Review Deep Hole Number 7�' # Date: 61ZO- 5%231oZ Time: P, Weather Location (identify on site plan) 4E65- OL,+acv. Land Use VV 0 0 P �J Slope (%) 2 --L4 Surface Stones Vegetation Fl N i;� AA -PLS Landform -0 1Z t--) r, -t r" ) NJ Position on landscape (sketch on the back) 67 1�,15 P4_,,4- AJ 5 Distances from: Open Water Body 7 10 0 feet Drainage way feet Possible Wet Area feet Property Line &O't feet Drinking Water Well >l00 feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texture (USDAI Soil Color (Munsell) /oyok Soil Mottling other .Structure, Stones, Boulders, Consistency, % Gravel) 11mut-A UF 2 HOLES Pr, arent Material (geologiq _ Dopttan8*dr«k- ��L Gv Oeoth to Groundwater Standing Water in the Hole: -72 �2 Weeping from Pit Face: % Z A Estimated Seasonal High Ground Water: DEP APPROVED FORM • 12107,95 FORM 11 - SOIL EVALUATOR FORNI Page 2 of 3 Location Address or Lot No. 1-3z 125rg Opt -site Review Deep Hole Number7Aa- Oate: f/20// Time: Weather '0J1JIV i Location (identify on site pian) Gi,�5r_— Land Use NV Q 0�� Slope (%) Z-4 Surface Stones \1 i; Cj y z:—'Vegetation (�� 10,.� i�- Landform 12 ]P. L) M L Position on landscape (sketch on the back) Distances from: Open Water Body > 6 ©i' feet Drainage way 7 `Vp feet Possible Wet Area7)CO feet Property Line Wil) fi feet Drinking Water Well 7)00feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texture Surface (inches) (USDA) Soil Color Soil Other (Munsell) Mottling .Structure, Stones, Boulders, Consistency, % o --12 Gravel) 0Y9 - ;z MINIMUM W - Parent Material (geologicl %L,� Oepeko8edrock: Depth to Groundwater: Standing Water in the Hole: d � Weeping.(rom Pit Face: Estimated Seasonal High Ground Water: i i DFP APPROVED FORM • 12107195 FORM 11 - SOIL EVALUATOR FORNI Page 2 of 3 Location Address or Lot No. D_Fle e!�9AY 95 - dr. -7--, Oji -site Review Deep Hole Number ��' 6o Date:I S�� ~ �d 2�/a2T• P /Y/, me: Location (identify on site plan) cj 615. )04A IQ 5 Weather Land Use VAI 00105 Slope (%) 2---4 Surface Stones 147—' -'— Vegetation P) iQ ('• / o A 14, Landform D (2U pA L { l j Position. on landscape (sketch on the back) Distances from: Open Water Body ->!oo . feet Possible Wet Area >{d7> feet Drinking Water Well -:,--106 feet Dfainage way - .740 feet Property Line too t feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Monling Other •Structure, Stones, Boulders, Consistency, % Gravel) z, SY Parent Material (geologic)L DaptfrtoBeQrock: 7 Depth to Groundwater•�� '� ' Standing Water in the Hole:Wee-7 ping from Pit Face: _ Estimated Seasonal High Ground Water: i DEP APPROVED FORAt • 12/0719S FOR -%I 11 - SOIL EVALUATOR FORh1 Page Z of 3 location Address or Lot No. p�� � �� / l�aog ./o 011 -site Review Deep Hole Number�'%/ Za r '51Z_/D e' Date: Time: J?ii�l Location (identify on site plan) p/�, N-5 Land Use W o d P '5 Slope (%) 2 40' Surface Stones Vegetation Jam) k4 8_1-�/ A Landform FZ M L Position on landscape (sketch on the back) Distances from: Open Water Body."j 00 feet Possible Wet Area 71a 0 feet Drinking Water Well `7 100 feet z7t-& PGS IJP Drainage way --4 0 feet Property Line JZ,D - feet Other DEEP OBSERVATION HOLE LOG' Weather 1 f 0 iU/U \/ Depth from Surface (Inches) Soil Horizon Soil T4to�.' (USunsell) il Color Soil Motilin g Other -Structure, Stones, Boulders, Consistency, % Gravel) o �q ,�,e3l3 "lea ,/ J/ -7? L Z.0 s/ r 7"�Y� p Z CW., Parent Material (geologic! DePfto8odrock: fy _Depth to Groundwater Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: i . DEP APPROVED FORt%t . 1,2/07191 FOR -%I 11 - SOIL EVALUATOR.FORh1 Page 2 of 3 Location Address or Lot No. Df,�G'j�,4 / e '/00" Oji -site Review Deep Hole Number7- 25 Date. ��a ime: p n .4 Weather "VU,vN Location {identity on site plan) G/4�� /p44 -A j-5 Land Use VV 00 V 15 Slope (%) Z - Surface Stones Vegetation P) N e Landform Tz:> );—;, L) M L l Position on landscape (sketch on the back) 4 t"4 J Distances from: Open Water Body >ry D D feet Drainage way -;> 50 feet Possible Wet Area7too feet Property Line�v i feet Drinking Water Well 7 -/JIB feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color Soil . (Munsell) Mottling Other Suucture, Stones, Boulders, Consistency, % )oyrulz Gravel) .20 w� �oy94k �-- iP4 Parent Material (geologic)) �Fd�8e4rock:_ >� 9121tlaGroundwater Standing Water in the Hole:--?---,/ Weeping from Pit Face: U Estimated Seasonal High Ground Water:'r. i Of.P APPROVED FOW t . 12/07/95 FOR -\1 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No.`��1^ J Ott -site Review Deep Hole Number 6 Date:f440 ZTime: %J yYJ, Weather Location (identify on site plan) Gi 2�-6 land Use VU00gr;7,, Slope (96) `j Surface Stones Vegetation OAK -1144 Landform Q �Z U M L 1l`/ Position on landscape (sketch on the back) p4-4 N Distances from: Open Water Body 7 f od feet Drainage way feet Possible Wet Area }I oD feet Property Line feet Drinking Water Well 7 /ad feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texture Soil Color Soil Surface (Inches) (USDA) Other !Munsell) Mottling Structure, Stones, Boulders, Consistency, % G(avel) A/9 / -7,ry V110 Parent Material (geologicl ::2� 0@Pt?l�o8edrock: 7 D_ eath to Groundwater Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: Z F DEP APPROVED FORt.t - 12/07r9S FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. Oil -site Review Deep Hole Number?—1/io —7l Z3`9 Date: lme: Weather Location (identify on site plan) 46,6�-- R1— t4s Land Use W 0 op c5 Slope (%) 'r Surface Stones v "5 Vegetation OAK -1 j �A.fpLC5 Landform D a L `tJ Position on landscape (sketch on the back) P&,4 A% Distances from: Open Water Body 7/Oa feet Drainage way 7:✓vp feet Possible Wet Area feet Property Line ?j00 *feet Drinking Water Well >/pd feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texture (US Soil Color (Munsell) Soil Mottling Other .Structure, Stones, Boulders, Consistency, % Gravel) *Y Parent Material (geologic! ) f - '4- fes_ P�RoBeQrock• f _ Depth to Groundwater Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water. ry - i DFP APPROVED FORA) - l2/07/9S FORA 11 - SOIL EVALUATOR FORh1 Page 2 of 3 location Address or Lot No. Oyu Oil -site Review Deep Hole Number�/�/Z2 Date: Time: Weather Location (identify on site plan) G,/ eo Land Use VV 0(:pJ7 .j Slope m Z-4 Surface Stones Vegetation Landform ©v Position on landscape (sketch on the back) G✓ 6—e✓ t\-) 5 Distances from: Open Water Body >Z)e f eet Drainage way 7 ,�prG? feet Possible Wet Area %/oo feet Property Line feet Drinking Water Well 7lop feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Surface (Inches) Soil Texture Soil Color Soil (USDA) (Munsell) Motilin g Other -Structure, Stones, Boulders, Consistency, % Gravel) r/ //gyp� Z- p 1i �CTI'2, 9y"7/ Parent Material (geologic) _ L•„ Depfao8e&ock:_ D� % Depth to Groundwater Standing Water in the Hole:, Weeping from Pit Face: Estimated Seasonal High Ground Water: i DEP APPROVED FO"t. 12/o7/95 FORA 11.- SOIL EVALUATOR FORh1 Page 2 of 3 Location Address or Lot No. Oil -site Review Deep Hole Number �2 Oates/� _ ��Z'�laZ Time: F J'✓! . Location (identify on site plan) �j150. R41 P53 Land Use V.) OD j7,$ Slope M 2 —4 Surface Stones Vegetation 1-115 / 0,4 t- landform 0M L/ Position on landscape (sketch on the back) Distances from: Open Water Body 7loa feet Possible Wet Area 7►jC0 feet Drinking Water Well7)p0 feet Weather5a 1,J ti 1j yC-- 5 Drainage way 7 *0 feet Property Line 36d Z: feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texte ur (USDA1 Soil Color (Munsell) Soil Motilin g Other .Structure, Stones, Boulders, Consistency, % Gravel) 444 ,fv�y-P Parent Material (geologicl — T� L DeprttKo8a3rxk: Depth to Groundwater Standing Water in the Hole: �Wee' ping from Pit Face: �Q Estimated Seasonal High Ground Water._ i DFP APPROVED FORM - 12/07,9S EOR..\1 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. g z e?/ � Ott -site Review Deep Hole Number �`��/2o J �/Z 3JD Z Date: Time: P 0, Location (identify on site plan) "�4,5 45 r��,4Al5 Land Use Vv/'00 12, .15; Slope (%) Z "z-1 Surface Stones Vegetation int N �L— / p A K - landform D R -U YY -t L E Position on landscape (sketch on the back) Distances from: Open Water Body >s'aa feet Possible Wet Area > iad feet Drinking Water Well -;--jad feet LJ e ,E5 F4A S A; -r - Drainage way 7 rVd feet Property Line -4,00 t- feet Other Weather 'VL 5 DEEP OBSERVATION HOLE LOG* Depth from Surface (Inches! Soil Horizon Soil Texture Soil Color (Munsell) Soil Mottling Other .Structure, Stones, Boulders, Consistency, % Gravel) 42Y.Ohr Iva,,e'o loy�4� oyg.4 Parent Material (geologicl DepdX06edr0ck. tP-4 d d ? Depth to Groundwater Standing Water in the Hole: t�� _ Weeping from Pit Face: �d Estimated Seasonal High Ground Water: i DEP APPROVED FORM - 11/07ryS FOP -\I 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. 4 i�Y �y/�a5 7/-7 Oil -site Review Deep Hole Number Date: pate:'f/ZO-'S/ VO"o Time: /�' ly%, Weather �jUNiC/ y Location (identify on site plan) Ljer'- RI -47u _S Land Use WO D P cj Slope MZ -4 Surface Stones Vegetation Landform Position on landscape (sketch on the back) Distances from: Open Water Body ->140) feet Possible Wet Area %6� feet Drinking Water Well>w`,,,0 feet Drainage way -;;, &�a feet Property Line Af PO t feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other .Structure, Stones, Boulders, Consistency, % Gravel) , Z,yy�l� J Parent Material (geologic) _ // r! QeWxoBedrock: Death to Groundwater Standing Water in the Hole: • - W -ping from Pit Face: �----' Estimated Seasonal High Ground Water: .J i DEP APPROVED FORN1 • 12/07!95 FORA 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. L?'X�r� ��,��/ I Ad --,1729 N �!7—, 011 -site Review Deep Hole Number_7'_%'P� pate*/zo yI12ai/aZ Time: 1�2,7o Location (identify on site plan) Land Use1NQ p per- Slope M) }o-Zo Surface Stones Vegetation !7'tk/ I✓/ /v F--' Landform P P-' L.) 01 L / n/ Position on landscape (sketch on the back) Distances from: Open Water Body';; -)go feet Possible Wet A-fea >16j feet Drinking Water Well}/Z>Z> feet Weather �rJ NAV Yc-,-5 Drainage way 7 ,s --d feet Property Line 600 -r feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Hof izon Soil Texture Surface (Inches) (USDA) Soil Color (Munsell) Soil Motttin g Other •Structure, Stones, Boulders, Consistency, % Gravel) 45y,10416 69L5 Ijye-5/6 F::�oL�) L� w 15,) 5� �a Z 2-0 Parent Material (geologic) = ttoBadrock: — " t?ePU Depth to Groundwater Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: w DEP APPROVED FORM • 12J07nS FORA 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No.�� Soil Horizon Oft -site Review -- Deep Hole Number 7--16 Dater � �` °Z Time: l�li!, Weather �lvN�u Location (identify on site plan) ,4P Land Use YJOO ©!5 Slope Vegetation Surface Stones Landform Position on landscape (sketch on the back) 5C—�e PL.,q A►..) S Distances from: Open Water Body --,- lOZi feet Drainage way 7 e%a feet Possible Wet Area 0 feet Property Line -70 -t feet Drinking Water Well 71t+b feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texture (USDA] Soil Color (Munsell) Soil Mottling Other Svucture, Stones, Boulders, Consistency, % Gravel) ,4P T�,L loyle 7, 5y12 5 00 lY��Z /d Parent Material (geologicl OcPttAoBedrock:__�f� 'f" Depth to Groundwater Standing Water in the Hole:. — Weeping from Pit Face: Estimated Seasonal High Ground Water:_ Z/Z—/'� . i DEP APPROVED FORA!. 12107nS FOR -'%I 11 - SOIL EVALUATOR FORM Page 2 of 3 Ucalion Address or Lot No.y Ori -site Review Deep Hole Number 7%77Dare:O— Z� D `Time: P /1/J , Weather �U N N Location (identify on site plan) P4-1-)5 Land Use yU p p1 5 Sloe (%) /6 —zD Surface Stones p p Yj- Vegetation Landform pp L) M L Position on landscape (sketch on the back) 4j6E_� pZ N S Distances from: Open Water Body - feet Drainage waY7 c j4 feet Possible Wet Area ?-/Da feet Property Line feet Drinking Water Well 7/ba feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inchesl Soil Horizon Soil Texture (USOAI Soil Color (Munsell! Soil Mottling Other .Structure, Stones, Boulders, Consistency, % Gravel) 0 � 1/ 'SPG >ayg3�Z •l ��j L. � D3�i�j!(o ��'Rsl� z�v % C i� M'Nimum Lit- 2 HULLS RE Parent Material (geologicl ?'l L�`� . Depttato8edrock: Depth to Groundwater: Standing Water in the Hole: "-'—�- We+eping from Pit Face: Estimated Seasonal High Ground Water: i DFP APPROVED FORM - 1,2/07nS FOR -m 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. Opt -site Review Deep Hole Number 7—'`? Date®rza Time: X10 Weather �u�N Location (identify on site plan): Land Use Slope (%) yo• -20 Surface Stones VAS Vegetation Ad r--/ p,44 landform Position on landscape(se h Al the back) Distances from: Open Water Body—,.<ba feet Possible Wet Area feet Drinking Water Wellfeet Drainage way 7rp6 feet Property Line 70 t feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texture (USDAI Soil Color (Munsell) Soil g Other Moulin .Structure, Stones, Boulders, Consistency, % Gravel) 313 i Parent Material (geologic) QePttao8o6rxk: Depth to Groundwater Standing Water in the Hole: Wceping from Pit Face: Estimated Seasonal - High Ground Water: ��// 7 �� i DEP APPROVED FOMI. i1/07/95 FOR%I 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. r On-site Review Deep Hole Number�'�� 512v` 5��:>,�Z Date. Time: P. i)i , Weather Location (identify on site plan) PL- b-1 Land Use w Ob O 9j Slope M Z --V Surface Stones Vegetation Landform J;;? Position on landscape (sketch on the back) Distances from: Open Water Body?/O7> feet Possible Wet Area 7/bd feet Drinking Water Well—,;; -Ida feet `0 6 6-! 4j 5 Drainage ways �Fa feet Property Line Zoo _* feet Other DEEP OBSERVATION HOLE LOG' Depth horn Soil Horizon Soil Texture Soil Color Soil Surface (Inches) (USpAI Other (Munsell! Mottling .Structure, Stones, Boulders, Consistency, % Gravel) )L y�e 3l »- '0 Parent Material (geologic) Oeath to Groundwater Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water; OFP APPROVED FORM . 1,2107/9S FORM 11 - SOIL EVALUATOR FOPP l Page 2 of 3 Location Address or Lot No. Oil -site Review Deep Hole Number T— 241 Time: Oate ~ wf �! OL 0, l / I✓ I Weather NY Location (identify on site plan) � � pJAN J . Land Use MOO 0 5 Slope (%I Z-- c/ Surface Stones Vegetation P) tiE, I o K_ Landform p�vM ��Q Position on landscape (sketch on the back) Distances from: Open Water Body -_-� 100 feet Possible Wet Area 7100 feet Drinking Water Well feet �v PLAN 5 Drainage way715y� feet Property Line 170`! feet Other DEEP OBSERVATION HOLE LOG* Soil Other Mottling .Structure, Stones, Boulders, Consistency, % Gravell Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munselq ldyX4l eje G 15 /oygvl Z-yy�lt 2 0 " Parent Material (geologic) �G OepttKoBedrock: Deoth to Groundwater Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: i DFP APPROVED FORA1 . 12/07/95 FOR -%I 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. F� •C} Z—rl?!27V AJ - Oil -site Review Deep Hole Number �J2 Date�� �f �TTime: Location (identify on site plan) 48C—. PL1414S Land Use V\j 00 C; �J Slope (%) 5'-/0 Surface Stones Vegetation P//JL--- / 0A K Landform D f)/YY1 ( Position on landscape (sketch on the back) Distances from: Open Water Body 7/04> feet Possible Wet Area /4a feet Drinking Water Well 7/DTj feet Drainage way7rpp feet Property Line Z feet Other Weather-7vivNy y�S DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other .Structure, Stones, Boulders, Consistency, % Gravel) 7� 2"9r 5/4 �,�yl���� y�o/ 4!5�eJ MINIMUM Parent Material (geologic! �— OePtta48e4rock:_ 1 Death to Groundwa[er Standing Water in the Hole: Weeping from Pit Face: �-- Estimated Seasonal High Ground Water: A i i DFP APPROVED FORld • L2/07195 FORA 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. 4? X ' �j ,,��A) A17-, Oji -site Review Deep Hole Number T�2Z Date: Za D Z 2 Time: / Weather 4aA) Al Location (identify on site plan) Land Use yu DD ©45 Slope (%) 15�-10 Surface Stones YZ S Vegetation OAK) l Landform P P.v M L - Position on landscape (sketch on the back) r.; -r J-5 Distances from: Open Water Body-�7/p4p feet Drainage way? ✓ted feet Possible Wet Area - feet Property Line Ppp :e feet Drinking Water Well 7i6e) feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell! Soil Mottling Other .Structure, Stones, Boulders, Consistency, % Gravel) J // v I% gC� �,� L5 ' 1 2,40yy5 Z Parent Material (geologic! Z1L`j Deptxo8edrock: 9CP Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: — Estimated Seasonal High Ground Water: DFP APPROVED FORM - 12107NS FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No.. o � termination for Seasonal Ri Method Used: ❑ Depth observed standing in observation hole ❑ Depth weeping from side of observation hole �/ T / Depth to soil mottles `7 inches ❑ Ground water adjustment ............... feet Index Well Number Adjustment factor .... Reading Date ............... I inches inches Index well level ... Adjusted ground water level .. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all re s observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on (date) I have Passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date � DEP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole . inches ❑ Depth weeping from side of observation hole inches Depth to soil mottles -� inches ❑ Ground water adjustment ............... feet Index Well Number - Reading Date ................ Index well level ... Adjustment .factor ........... Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on �� (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature '� - Date "7',0 7Z— DEP APPROVED FOR,! • 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. 4 hI etermination for Method Used: ❑ Depth observed standing in observation hole . ❑ Depth weeping from side of observation hole —�j X Depth to soil mottles —66P inches ❑ Ground water adjustment ................ feet Index Well Number ...... _. Reading Date ................ 'ater T inches inches Index well level Adjustment factor ........... Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on 1 1 q (date) I have Passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date --La Z�---d z, DFP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. o�,r-- G Uetermingtiojl -for Seasonal Higji Water Table Method Used: ❑ Depth observed standing in observation hole . inches ❑ Depth weeping from side of observation hole inches Depth to soil mottles '/*45�7 inches Ground water adjustment ............... feet Index Well Number ......... Adjustment factor ............ Reading Date ................. Index well level .. Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in a I areas observed throughout the area proposed for the soil absorption system? � If not, what is the depth of naturally occurring pervious material? Certification I certify that on 1 � q (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. SignaturJ4z eDate G"" '751 DFP APPROVED FOR.%1 - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. 9-7 G � Determinatin,7 or/,Seasonal Hieh Water Tabl Method Used: ❑ Depth observed standing in observation hole inches ,i ❑ Depth weeping from side f observation hole inches 7� 4V ❑ Depth to soil mottles inches ❑ Ground water adjustment ....._........ feet Index Well Number .. Reading Date ................ Index well level Adjustment factor ........... Adjusted ground water level .........:... Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? s If not, what is the depth of naturally occurring pervious material? Certification I certify that on11 �%g (date) I have Passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date DEP APPROVED FOR:%1 - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3. of 3 Location Address or Lot No.p� ,� Afr Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole . inches ❑ Depth weeping from side of observation hole inches �O � Depth to soil mottles 1�O inches El Ground water adjustment ............... feet Index Well Number _. Reading Date ................ Index well level . Adjustment factor ........... Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification F I certify that on(date) I have passed the soil evaluator examination D approved by the epar ment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date _ 0 DFP APPROVED FOPW - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. vsG Illy,�J ��•- Determination ,far Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of observation hole inches Depth to soil mottles inches ❑ Ground water adjustment ................. feet Index Well Number - ... .:... Reading Date ................. Index well level . . Adjustment factor ............ Adjusted ground water level ........................ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material existin all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification 11 0 I certify that on I) 9 (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature - Date ",a -7 --az DFP APPROVED FOP -%I • 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. etermination for Method Used: ❑ Depth observed standing in observation hole . inches ❑ Depth weeping from side of observation hole inches Depth to soil mottles *4g inches ❑ Ground water adjustment ................ feet Index Well Number ...... _ .. Reading Date ................. Index well level _.. Adjustment factor ........... Adjusted ground water level ... :.. ...................... Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in al areas observed throughout the area proposed for the soil absorption system? V IC71 le— If not, what is the depth of naturally occurring pervious material? Certification I certify that on t 1 9 (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date "-7 0 Z DFP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No.,� G Determination ,for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole . ❑ Depth weeping from side of observation hole Depth to soil mottles —//Z/ inches ❑ Ground water adjustment ................. feet Index Well Number - Adjustment factor ............ Reading Date ................. inches inches Index well level Adjusted ground water level .. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist inal area observed throughout the area proposed for the soil absorption system? — If not, what is the depth of naturally occurring pervious material? Certification I certify that on // q (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. SignatureD �7 ate DFP APPROVED FOR11 - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. o a G Determination for Seasonal Hi gji Water Table Method Used: ❑ Depth observed standing in observation hole.. inches ❑ Depth weeping from sidef observation hole inches Depth to soil mottles �� inches ❑ Ground water adjustment ................ feet Index Well Number ......... Reading Date ................. Index well level ... Adjustment factor ............ Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on I (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. r Signature /` Date DFP APPROVED FORA1 - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. p� Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing -in observation hole . t ❑ Depth weeping from side of observation hole '! Depth to soil mottles A/q inches ❑ Ground water adjustment ................. feet Index Well Number ....... . Adjustment factor ...... Reading Date ................. inches inches Index well level Adjusted ground water level .. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all are s observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on(date) I have Passed the.soil evaluator examination approved by the Depa tment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. f Signature Date DEP APPROVED FORM - 12/07/95 eo" —?-0 z Location Address or Lot No. p inalion for Method Used: FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 M ❑ Depth observed standing in observation hole inches ❑ Depth weeping fromside f observation hole inches Depth to soil mottles inches ❑ Ground water adjustment ............... feet l Index Well Number .......... Reading Date ................. Index well level ... Adjustment factor ........... Adjusted ground water level .........:. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? -�- If not, what is the depth of naturally occurring pervious material? Certification I certify that on I/ (date) I have Passed the soil evaluator examination approved by the Dep rtment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature - Date 1Z DEP APPROVED FOR11 - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. j�y .��. Determination -for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole inches El Depth Depth weeping from side of observation hole inches 1r % =l3 Depth to soil mottles inches ❑ Ground water adjustment ................. feet Index Well Number ......... Reading Date ................. Index well level ... Adjustment factor Adjusted ground water level .. ........... Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all ar as observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification 11 0 I certify that on1 J q (date) I have passed the soil evaluator examination approved by the Depa tment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date _ Com -7 Q% DFP APPROVED FOR:11 - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. Determination for Seasonal Higjh Water Table Method Used: ❑ Depth observed standing in observation hole ❑ Depth weeping from side of observation hole 7—/4/ 0 Depth to soil mottles -27"?4.7 inches ❑ Ground water adjustment ................ feet Index Well Number Adjustment factor .... ...... *. Reading Date .............. inches inches Index well level ... Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on(date) 4tment (date) I have passed the soil evaluator examination approved by the Depaf Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature ~-` Date 4:;� 7 °�" ,�' '41) ,. DEP APPROVED FOR:1t - 12107l9S FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. easonal Hi Method Used: ❑ Depth observed standing in observation hole ❑ Depth weeping from side of observation hole / Depth to soil mottles 'e;�P inches ❑ Ground water adjustment ................ feet at inches inches Index Well Number ......... Reading Date ................. Index well level .. Adjustment factor ........... Adjusted ground water level .........:. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material existin al area observed throughout the area proposed for the soil absorption system? _ Y If not, what is the depth of naturally occurring pervious material? Certification I certify that on q (date) I have pas sed the soil evaluator examination approved by the Department of Environmental'Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date %`'41 z DEP APPROVED FORM - 12/07/9S FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. p� �d or Method Used: ❑ Depth observed standing in observation hole ❑ Depth weeping from side of observation hole Depth to soil mottles inches Ground water adjustment ................ feet Index Well Number Adjustment factor ............ Reading Date ................ inches inches Index well level Adjusted ground water level .. ............... .. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all are s observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification F - I certify that on(date) I have passed the soil evaluator examination approved by the Dep rtment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date DEP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. p 0 71': eterminatioi;i for Seasonal Hi Method Used: ❑ Depth observed standing in observation hole ❑ Depth weeping from side of observation hole 7--/7 ® Depth to soil mottles —" c- inches ❑ Ground water adjustment ................ feet Index Well Number Adjustment factor ........... Reading Date ................. WA inches inches Index well level Adjusted ground water level .. ................... ............... Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system?.�� If not, what is the depth of naturally occurring pervious material? Certification I certify that on(date) I have passed the soil evaluator examination approved by the Depa me t of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. . Signature ._ Date DEP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. p�,� ,��gS/ e� I��� C J Determinatioji ,for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of observation hole inches 16P M Depth to soil mottles `-/7 inches ❑ Ground water adjustment ........ ....... feet Index Well Number .......... Reading Date ................. Index well level Adjustment factor ........... Adjusted ground water level .........:. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in II areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on A (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature - Date G— %-az, ki DFP APPROVED FORS! - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. `jam Determination for Seasonal High Water Table Method Used - El Depth observed standing in observation hole ❑ Depth weeping from side of observation hole aDepth to soil mottles "-'IP inches Ground water adjustment ................. feet Index Well Number .......... Adjustment factor ...... Reading Date .............. inches inches Index well level .. Adjusted ground water level .. ......... :...... ........... ........ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth.of naturally occurring pervious material? Certification I certify that on (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature" _ Date 1� DEP APPROVED FOR\! - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No.R,�s< Determination for Seasonal Hig z Water Table Method Used: ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of observation hole inches 1--O Depth to soil mottles �y inches ❑ Ground water adjustment ................. feet Index Well Number - ....... Reading Date .............. Index well level ... Adjustment factor ........... Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on 1I q (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature e,i Date le 7"J DEP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. f .� Determinatioji -for Seasonal Hieh Water Table Method Used: ❑ Depth observed standing in observation hole ❑ Depth weeping from side of observation hole Depth to soil mottles '�� inches ❑ Ground water adjustment .............. feet Index Well Number ......... Adjustment factor .......... Reading Date ................ inches inches Index well level .. Adjusted ground water level .. .........:.. ...................... Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all are as observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on i q (date) I have Passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date --'i "d �. DFP APPROVED FORM - 12/07/95 Location Address or Lot No. ermination for Method Used - FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 El Depth observed standing in observation hole ❑ Depth weeping from side JJo observation hole �-� RP Depth to soil mottles ' t inches ❑ Ground water adjustment ............... feet Index Well Number .. Adjustment .factor ....... Reading Date ................. r inches inches Index well level ... Adjusted ground water level .. .............. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in al areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on d (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date G� ova Z DEP APPROVED FORM - 12107/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS /Vo. 1,Y1V0D V,05e— Massachusetts " Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ ............................................... .................................. ....................................................... _.. ...... Performed By: Witnessed By: 4a on Comments: DFP APPROVED FORM - 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS IV&. /;)-;U DO V �54 , Massachusetts * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed 0 Site Failed ❑ Performed By: Witnessed By: Comments: DFP APPROVED FORM . MUMS FORM 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS /va,, Massachusetts " Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ .............................. .................. ...................... ................ ..... ............................................... :._.. Performed By:1,J c/a Witnessed By: _ L1 ,f j, Isd_A 1 Comments: DFP APPROVED FORM - 12/07/9S FORM L' - PERCOLATION TEST Location Address or Lot No. pyf 4e4 COMMONWEALTH OF MASSACHUSETTS A'a, �7 N fJdy°, .. , Massachusetts . Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ ...................... ........................... ........................................................ .. ...... Performed By:�,A K Witnessed By: Comments: DEP APPROVED FORM . 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. jq.A;: e,C4-c�— COMMONWEALTH OF MASSACHUSETTS A)o , 4it) Oo \/,,=7e, Massachusetts * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed /�o Site Failed ❑ Performed By: Witnessed By: Comments: F DEP APPROVED FORM - 12/07/95 ...................... ...................... ............... .............................. I ....................... _.. ...... FORM 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS 1�-b, 1'41-),00V , Massachusetts Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed PW Site Failed ❑ ................ ........................................................... ........................ ................ ............. _.. ...... Performed By: -771- � fit' P 1A LA --#--/ -A Witnessed By: � � / Pi 41%,, fl: Comments: . . ego DFP APPROVED FORM. 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS /V -P, �N1�OV�,�Massachusetts Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed JO Site Failed ❑ ................................................................................... . Performed By: Witnessed By: Comments: DEP APPROVED FORM . 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS Aia, Massachusetts Percolation Test` Date: ��Zo —r,/Z� Time: Ll c Z - Observation Hole # i -- Depth of Perc Start Pre-soak End Pre-soak Time at 12" Time at 9" Time at 6" Time � Q Rate Min./Inch � Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed Performed By: ❑ _- Witnessed By: Comments: DFP APPROVED FORM . 12/07/9s 0 FORM 12 - PERCOLATION TEST Location Address or Lot No. ,g� COMMONWEALTH OF MASSACHUSETTS /\�P, , Massachusetts * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed ❑ Site Failed ❑ ............................... .................... ................................ ..... .................................................. _.. ...... Performed By: Witnessed By: Comments: DEP APPROVED FORM - 12/07/9S FORM 12 - PERCOLATION TEST Location Address or Lot No.�-- d� G/7 - COMMONWEALTH OF MASSACHUSETTS %�% . �0 0e) , Massachusetts FORM 12 - PERCOLATION TEST Location Address or Lot No. erF 6;e4)��y�� A.1 L— COMMONWEALTH OF MASSACHUSETTS /Uzi, OOV _ Massachusetts * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed /1P Site Failed ❑ ................................................................................... ....................... .................... .. - Performed By: Witnessed By: Comments: 0 7- c� DEP APPROVED FORM - 12/07/9S FORM 12 - PERCOLATION TEST Location Address or Lot No. p� =�o�, COMMONWEALTH OF MASSACHUSETTS N4, �-�w Oo1/E-;e , Massachusetts " Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed x Site Failed ❑ .................................................. Performed By: Witnessed By: _� ® Kj Comments: DEP APPROVED FORM - 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF OF MASSACHUSETTS P,° • ��� paY�5--- Massachusetts Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed /Z Site Failed ❑ ................................................................................................................................... _.. ..... Performed By: Witnessed By: K kki&) �j Comments: DFP APPROVED FORM - 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. ge,5,L- COMMONWEALTH OF MASSACHUSETTS V , Massachusetts FORM 12 - PERCOLATION TEST Location Address or Lot COMMONWEALTH OF MASSACHUSETTS /leo, ,42jpo , Massachusetts " Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ ................................ ................................... ....................................................... _.. ...... Performed By: Witnessed By: 1�, {db A �. Comments: DFP APPROVED FORM . 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. �L �T COMMONWEALTH OF MASSACHUSETTS `lVa , ,J�u Oo \-/ 1�5 g- , Massachusetts Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ .............................................................................................. _.. ...... Performed By:p<� Witnessed By: Comments: 9 DFP APPROVED FORM . 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. e - L7-1 COMMONWEALTH OF MASSACHUSETTS /up , /-//-;upp " , Massachusetts Percolation Test` Date: ���-L,—/Time: q 3 Observation Hole # A�7 Depth of Perc Start Pre-soak End Pre-soak / 4v' Time at 12" � C�o Time at 9" Time at 6" Time (9"-6") Rate Min./Inch * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed P::�? Site Failed ❑ Performed By: Witnessed By: Comments: ............................... .................................................... ....................................................... _.. ...... DFP APPROVED FORM. 12/07/95 FORh1 12 - PERCOLATION TEST Location Address or Lot No. p�,� � �/ -/ �A) .. COMMONWEALTH OF MASSACHUSETTS Massachusetts Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ ........................................................ Performed BG,,�.� y: Witnessed By: Comments: r- DEP APPROVED FORM - 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. 4e l / COMMONWEALTH OF MASSACHUSETTS 1&)e. 4') Do V , Massachusetts * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ .................................................... . Performed By:G,��.j,�' �.. Witnessed By: .414 J Comments: F- DEP APPROVED FORM . 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. pyo Q"y COMMONWEALTH OF MASSACHUSETTS pip AwpOV4,�,--, Massachusetts " Minimum of 1 percolation test must be performed in both the primary area AND reserve area. DFP APPROVED FORM . 12/07/9S FORM 12 - PERCOLATION TEST Location Address or Lot No. 1 COMMONWEALTH OF MASSACHUSETTS 5 , Massachusetts Percolation Test# Date: 6/40 _,� / f Time: 1 �� Observation Hole # Depth of Perc J� Start Pre-soak End Pre-soak 12;3, Time at 12" Time at 9" ,2 Time at 6" Time (9"-6") Rate Min./Inch ' Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed Performed By: Witnessed By: Comments: ❑. ................................................................................... DEP APPROVED FORM - 12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. or, rtq COMMONWEALTH OF MASSACHUSETTS �UO . N Oaa-V 6�T-ie , Massachusetts * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ ......................................................................................... .-.. ...... Performed By: _ . c✓ Witnessed By: - Comments: DEP APPROVED FORM - 12/07/95 FORAT 12 - PERCOLATION TEST Location Address or Lot No. -,5 COMMONWEALTH OF MASSACHUSETTS �/V6 4—" P-0 Massachusetts } Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed ;R11 Site Failed ❑ Performed By: Witnessed By: Comments: DFP APPROVED FORM - 12!07!95