440 Septic Soil & Perc Tests ;Hit
Location Address or Lot No
FORM 11 - SOIL EVALUATOR FORA
Page 2 of 3
4/0= (/,K 'i/, N/d fir/
On-site Review
Deep Hole Number/J/7,Z/i'i'2 Date: 7- 3-Q7 Time: Q 4'e cs Weather c> r7re«3r
Location (identify on site plan)
Land Use r?e3'Cr.t-t-c/ Slope (%) 5 %O Surface Stones ../&
Vegetation /oc&>- 7, „C,,—)e5r
Landform !cc-/-44 e
Position on landscape (sketch on the back)
Distances from:
Open Water Body > O feet Drainage way ) 360 feet
Possible Wet Area ) 5°6' feet Property Line 20°t feet
Drinking Water Well •-r'& 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)
/0- g "
!J _2H„
.214 '!i/2 "
42'- 92„
/9
/3
C',
d
3z-
1//-'S4
F ISL
/c/---7i,
25v"-i/3
2 5, '/
rsyrV/y
hohr
.-.orN-D1/2
,i`v9x'-/
'5.65v je
zor�ti.ci.
PLkiWryr
5%a ,7ce -2/
/O`%� 2,----c> Caf�i/wt-•
30% cai /,5 5/wr; "9y"/-
('‘,,-).2Pacr; /5 @! done'/
p-fj "
g --2y"
24/"--17/.2"
2
9 " 92
y
/3
l'
.S'r
5<
it's s/-
;'s ue
/vyry/3
2Syr4/•
2 51'6'2/
2 s ,-
ix'ne
�5 c
/U�k c'-�/
csKnsr we
5e/v yro,-P/
/o% ?Dove/, ro/ /cf
0'& 70 /!S, 5-4'r!.'.-*`,
<< ��cTc.D- , _, < oy,</,>
Parent Material(ge logic) (-/oi.h / T ,/, J?c, -/ I/
Depth to Groundwater: Standing Water in the Hole: N. Q.
Estimated Seasonal High Ground Water: Jy "
Dep htoBedrock: > wnS09
Weeping(corn Pit Face: A/
DEP APPROVED FORM-12T07195
Howard Environmental Services
750 N. Pleasant Street
Amherst, MA 01002
No.
FORM 11 - SOIL EVALUATOR FORM
Page 1 of 3
Date: 7. //- 57
Commonwealth of Massachusetts
<aec/s , Massachusetts
foil Suitability Assessment for On-site Sewage Disposal
Performed By: 1,-)r7-7
AZ tz$<hf
Witnessed By: «zvr /-1-&< ;;s.->
Date:
7,393
mia^Alba.a Hy/cv ches/e.--,/,'e/d At K
W,
•
./ccc/S-
New Construction ❑ Repair
u.R ..0 m. /3,
Adds..
.b Pc-/
nmpm.I
Lccd S , M/l
(Y 3- 5Sea -99aoO
Office Review
Published Soil Survey Available: No ❑ Yes
Year Published / %br/ Publication Scale /1/5:YY0 Soil Map Unit /N,( C
Drainage Class nx//-okw .w<C/ Soil Limitations J aSot a/,�cr_cf?rc/
dru.nKO —
Surficial Geologic Report Available: No ❑ Yes -_
Year Published
Geologic Material (Map Unit)
Landform
Publication Scale
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑Yes ❑
Within 500 year flood boundary No ❑Yes ❑
Within 100 year flood boundary No ❑Yes H
Wetland Area:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map (map unit)
Current Water Resource Conditions (USGS): Month
Range :Above Normal ❑Normal Below Normal ❑
Other References Reviewed:
DEP APPROVED FORM- 11/09/95
Howard Environmental Services
750 N. Pleasant Street
Amherst, MA 01002
'01
Location Address or Lot No.
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
/!✓/ h/s r writ Ar/ t-gc/S
On-site Review
Deep Hole Number/-)//7./.0112 Date: 7. 3-9t Time: 9.'-frO0')--, Weather dfP Tru.$r s 'rite
Location (identify on site plan)
Land.Use _f?{,Siacni.etC/ Slope (%9) v /p Surface Stones /0"°%-,
Vegetation
Landform _..lerraLe__
Position on landscape (sketch on the back)
Distances from:
Open Water Body >, 3'O feet Drainage way > 300 feet
Possible Wet Area 2.504 feet Property Line 2 cry t feet
Drinking Water Well >--V0_° feet Other
DEEP OBSERVATION HOLE LOG*
Depth from
Surface(Inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(MunseII)
Soil
Mottling
Other
(Structure,Stones, Boulders, Consistency, %
Gravel)
0— a "
g"-2H"
2H'! 92 "
424- 92"
/9
/3
C,
. 0
SL
Si-
vises
f SL
2a r
5%.M"�/e-
5%5r.o'/
veye
zoea,rrI,
m�kiwr
5420 !J✓RV2/
/0%2 ravel.,CaGh/e-r
/
30(% c i&/r._y S l✓'#- rA
�n7 ae /50/2 9'nfe/
/
Amy,-
2Sy"-3
2 '`/`i 'c%'
2-5yr v/2
a-8 "
g"- 241"
H"—-92"
/2"- 92i
H
Q
C.
("z
-
S<
v/'$4-
/5
/ayr Y/3
2'5y4/3
2.57.4./y
3 Syr5"?2
/72ne
/r5 n%St
i/ey44.
s0,osr-&6
20•>ebvr4/,
_avc rver
$°/v0✓ovP/
/0°/a tc!e/i rn/f/rf
30°/v Cobh/rS, S%ne-,lo zr.
Oe„' /S i
Cor 0 9eeeeee
Parent Material Igeologic) %// / l //, /?ek Cc"/ r 2/
Depth to Groundwater: Standing Water in the Hole: N. Q.
Depthtoeedrock:
Estimated Seasonal High Ground Water: 7y
Weeping from Pit Face: Al- /).
DEP APPROVED FORM.t2/07/95
Howard Environmental Services
750 N. Pleasant Street
Amherst, MA 01002
Location Address or Lot No
FORM 12 - PERCOLATION TEST
h"/Lr Ch S�P�e/0/ lrrr/S
COMMONWEALTH OF MASSACHUSETTS
2eca'5 , Massachusetts
Percolation Test*
Date: 7• - 7 ? Time:, 9127.ctn.-)
Observation Hole #
�—
Depth of Perc
Start Pre-soak
52; 2 l ay"-,
End Pre-soak
9: y-/
Time at 12"
9.yi
Time at 9"
/0: ,5 /
Time at 6"
Time (9"-6")
-73 m, r1
Rate Min./Inch
7Y- 3 n.. ,/,;,
Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed Z Site Failed ❑
Performed By: ,'2 h 4/
Witnessed By: /).z. /1,C/2«,—)
Comments: lx- sc stc,./s_.
DEP APPROVED FORM-12/07/95
Howard Environmental Services
750 N. Pleasant Street
Amherst, MA 01002
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No. S-12/(,, /2v5.F/fe/c/A2J /-ray
Determination for Seasonal High Water Table
Method Used:
❑ Depth observed standing in observation hole inches
_❑ Depth weeping from side of observation hole inches
iicr)Depth to soil mottles 2"" inches
Ground water adjustment feet
I
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? Yes
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on /anr,7x{./sv/(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 I Jii+1i4,n>/t7 Date
DEP APPROVED FORM-1210E95
Howard Environmental Services
750 N. Pleasant Street
Amherst, MA 01002
FORM 12 - PERCOLATION TEST
Location Address or Lot No. rE'
COMMONWEALTH OF MASSACHUSETTS
2 ecors
, Massachusetts
Percolation Test'
Date: ... .7- 3 . 9 7 Time:. 9.12 -70-m
Observation Hole #
Depth of Perc
Start Pre-soak
End Pre-soak
9.` z7a �-)
9.: y-/
Time at 12"
9'y/
Time at 9"
/&; 5 /
Time at 6"
Time (9"-6")
Rate Min./Inch
7H- 3
Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed ® Site Failed ❑
Performed By: j:20,, 44 ;47 s ch f
Witnessed By: l�we rroc/har)
Comments• .... rXi�sS. S� /s.__.-
DEP APPROVED FORM.12/07/95
Howard Environmental Services
750 N. Pleasant Street
Amherst, MA 01002
PERCOLATION TEST(S)
Time: J I Time:
Observation Hole #1 Observation Hole #2
Depth of Perc Depth of Perc
Start Pre-soak Start Pre-soak
End Pre-soak End Pre-soak
Time at 12" Time at 12"
Time at 9" ,. ) Time at 9°
Time at 6° Time at 6"
Time (9"-6°) Time (9°—6")
Rate Min./Inch Rate Min./Inch
'minimum of 1 percolation test must be performed in both the primary area AND reserve area.
• f.. ■ ■ ..' •
Performed by -- - I Performed by
Witnessed by Witnessed by
Comments:
r
a
i."7.:"'
On-Site Review
LocationAddress or Lot
Owner
Address
Date
Time
Weather
Engineering Finn
Identity on Site Plan
Land Use
Engineer or Sanitarian
Slope%
Surface Stones
Vegetation
landform
Position on Landscape
Open Water Body
Possible Wet Area
feet
feet
Distancesirom
Drinking Water Well
feet
Drainage Way
feet
Property Line
Other
feet
feet
Deep Hole#: 1
Depth from
, Surface(Inches
—
DEEP OBSERVATION HOLE LOG*
'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil Mottling
Other
(Structure,Stones, Boulders,Consistency,%Gravel)
Parent Material.(geologic).
Depth to groundwater. Standing Y¢atgDplthe Hole
t9P3sIrock
Estimated Seasonal High
Weeping from Pit Face
Deep Hole#: G
DEEP OBSERVATION HOLE LOG*
MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Depth from
Surface(Inches)
I Sail Horizon
Soil Texture Soil Color
(USDA) (Munsell)
Soil Mottling
Other
(Structure.Stones.Boulders.Consistency.%Gravel)
Parent Material(geologic)
Depth to Bedrock
Depth to groundwater. Standing Water in the Hole
Weeping from Pit Face I
Estimated Seasonal High Ground Water
/1 /0;Oz_
/D' 'ad/D - z/
7" a+//: 55
uu C//S =k/"1
PERCOLATION TESTIS)
Time:
Time:
Observation Hole
#1
Observation Hole
#2
Depth of Perc
L711C„
Depth of Perc
Start Pre
. �,�
-soak
Start Pre-soak
End Pre-soak
9 ; 32
End Pre-soak
Time at 12”
G . 4L/
Time at 12"
Time at 9°
0% 51
Time at 9°
Time at 6°
1--':04=
Time at r
Time(9°-6°)
73
Time(9°-6°)
Rate Min./Inch
2z./ 3
Rate Min./Inch
'minimum of 1 percolation test must be performed in both the primary area AND reserve area.
Performed by
lir A//0/7225C/;""
Performed by
Witnessed by
Witnessed by
Comments:
STf q'O99AM
f15,4'; 12 /5