Loading...
308 Septic Soil & Perc Test 2011 1\ Commonwealth of Massachusetts ® City/Town of Northampton Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal _3v A. Facility Information Patrick Melnik _ E GM Owner er Name 308 Chesterfield Road Street Address Map/Lot# Northampton MA 01060 City State Zip Code B. Site Information 1. (Check one) ® New Construction ❑ Upgrade ❑ Repair 1:6510 711E 08 1 2. Published Soil Survey Available? ® Yes ❑ No If yes: 20 :6, Year Published Publication Scale Soil Map Unit Charlton-Rock outcrop-Hollis complex, steep (711E) >80"to restrictive feature, well drained, see soil report Soil Name Soil Limitations 1999 1:250,000 3. Surficial Geological Report Available?❑ Yes ❑ No If yes: — — - Sc Year Published Publication Scale Map Unit Till& Bedrock Drumlin Geologic Material Lantlfarm 4. Flood Rate Insurance Map Above the 500-year flood boundary? ® Yes ❑ No Within the 100-year flood boundary? ❑ Yes Z No Within the 500-year flood boundary? ❑ Yes ® No Within a velocity zone? ❑ Yes ® No 5. Wetland Area: National Wetland Inventory Map - - ---- Map Unit Name Wetlands Conservancy Program Map Map Unit Name 6. Current Water Resource Conditions (USGS): 12/2011 - Range: Z Above Normal ❑ Normal ❑ Below Normal Month/Year 7. Other references reviewed: — --- -- - __--- - - --- t5form11-1.tloc•rev. 1/10 Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 Commonwealth of Massachusetts • City/Town of Northampton Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: 1 11/21/2011 9:30 Sunny, 58 Date Time Weather 1. Location Ground Elevation at Surface of Hole: -56.8 Location (identify on plan): See plan 2. Land Use (e.g.,woodland,agricultural field vacant at etc.) Surface Stones Slope(%) Wooded Drumlin Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body '200 Drainage Way >5Q - Possible Wet Area N/A feet feet feet Property Line 444 Drinking Water Well NSA Other ..feet feet feet 4. Parent Material: Glacial Till Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: ---- --- - Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 54 inches elevation t5forml 1-1.doc•rev.1/10 Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts ,to City/Town of Northampton »ffi Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 1 -- Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color (mottles) Soil Textu • %by Volume Soli Soil Depth(in.) La Layer Moist(Munsell) (USDA) Structure Consistence Other y ( ) Depth Color Percent ( ) Gravel Cobbles& (Moist) Stones A 10YR 3/2 LS V.Friable 2"-26" B 10YR 5/2 LS 5-7 SABK Friable 26"-44" C1 2.5Y 5/2 LS 5-7 SABK Friable 44"-72" C2 5Y 4/2 54" 75 6R 5% LS 2-3 SABK Friable Additional Notes: t5forml t-1.tloc•rev. 1/10 Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 • Commonwealth of Massachusetts City/Town of Northampton IL Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 2 11/21/2011 10:30am sunny 60 _. Date Time Weather 1. Location Ground Elevation at Surface of Hole: Location (identify on plan): -- ------ -- -- 2. Land Use Woodland Yes 6-7% (e-g-,woodland,agricultural field,vacant lot,eta) Surface Stones Slope eA) Wooded Drumilin Side slope Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body >200 -. Drainage Way >50 - Possible Wet Area >100 feet feet feet Property Line -428 Drinking Water Well N/A Other — - feet feet feet Glacial Till 4 Parent Material: -- - -------- Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes ---- -- - -- - Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 66"_ inches elevation t5form11-1 doc•rev. 1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 .&' . Commonwealth of Massachusetts km _ City/Town of Northampton fin' Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 2 11/21/2011 10:3Oam sunny 60 Date Time Weather 1. Location Ground Elevation at Surface of Hole: - 567 Location (identify on plan): — ----- ---- --- 2. Land Use Woodland Yes 6-7% (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) Wooded Drumilin Side slope Vegetation Landform Position on Landscape(attach sheet) >200 >50 >100 3. Distances from: Open Water Body -feel -- Drainage Way feet Possible Wet Area feet Property Line 428-- Drinking Water Well N/A Other —-- feet feet feet Glacial Till 4. Parent Material: - ------- ---- - - Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: --- ---i --- tan —t- Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 66" inches elevation t5form11-1.doc•rev.1/10 Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 14 Commonwealth of Massachusetts City/Town of Northampton Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal r C. On-Site Review (continued) Deep Observation Hole Number: -2 - Redoximorphic Features Coarse Fragments Soil HorizoJr Soil Matrix:Color (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Layer Moist(Munsell) (USDA) Cobbles& Structure Consistence Other Depth Color Percent Gravel (Moist) Stones A 10YR 3/2 LS SABK v. friable 2"-28" B 10Th 4/4 LS 4-6 SABK Friable 28"-66" C1 2.5Y 4/1 LS 4-6 SARK Friable 66"-96" C2 2.5Y 4/1 66" 7.5YR 5/E 5% LS 2-4 SABK Firm 1 i i _ i i I Additional Notes: • t5form11-1.doc•rev. 1/10 Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts - City/Town of Northampton -� Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: ® Depth observed standing water in observation hole n in inches N/A N/A nches B. ® Depth weeping from side of observation hole _A NsA in ch esA inches N/A ® Depth to soil redoximorphic features (mottles) inches es _ _ inches es inches inches ❑ Groundwater adjustment(USGS methodology) in inches inches 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ® Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: --oches -- - Lower boundary: 96hes -- t5forml 1-1.doc•rev.1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 6 Commonwealth of Massachusetts City/Town of Northampton :111 r 1144 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Certification I certify that lam currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. I further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form, are accurate and in accordance with 310 CMR 15.100 through 15.107. 121 [get] Signature of Soil Ev lua or Date ` ' Rlt— t`1w- / .% L2II�I_ 7/4 $ Typed or Printed Name of Soil Evaluator/License# Date o Soi Evaluator Exam E 5"1 1.4 __ 7 t Nr PR1/. Name of Board of Health Witness Bo r of Health Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and to the designer and the property owner with Percolation Test Form 12. t5forml l-2.doc•rev.1/10 Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 13 _ . Commonwealth of Massachusetts City/Town of Northampton ""' Form 11 - Soil Suitabilit Assessment for On-Site Sewage Disposal ,- Y 9 p Field Diagrams Use this sheet for field diagrams: t5form11-1.tloc•rev.1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8 Commonwealth of Massachusetts City/Town of Northampton Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal A. Facility Information Patrick Melnik Owner Name 308 Chesterfield Road Street Address Map/Lot# Northampton MA 01060 City State Zip Code B. Site Information 1. (Check one) N New Construction ❑ Upgrade ❑ Repair 2. Published Soil Survey Available? 2008 1:6,510 711E y ® Yes ❑ No If yes: — -- -- - Year Published Publication Scale Soil Map Unit Charlton-Rock outcrop-Hollis complex, steep (711E) >80'to restrictive feature, well drained, see soil report Soil Name Soil Limitations 3. Surficial Geological Report Available? ❑ Yes ❑ No If yes: 1999 1:250,000 Year Published Publication Scale Map Unit Till & Bedrock Drumlin Geologic Material Landform 4. Flood Rate Insurance Map Above the 500-year flood boundary? N Yes ❑ No Within the 100-year flood boundary? ❑ Yes N No Within the 500-year flood boundary? ❑ Yes N No Within a velocity zone? ❑ Yes N No 5. Wetland Area: National Wetland Inventory Map ---------Map Unit Name Wetlands Conservancy Program Map Map Unit -- — ------ ----- - --- -- — - Name 6. Current Water Resource Conditions(USGS): 12/2011 Range: N Above Normal ❑ Normal ❑ Below Normal Month/Year 7. Other references reviewed: ---- - -- - - - -- -- ---- -- — ----- t5forml l-2.doc•rev.1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 Commonwealth of Massachusetts kirftw.s , City/Town of Northampton Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: 3 11:00 Sunny, 60 Date Time Weather 1. Location Ground Elevation at Surface of Hole: -566 Location (identify on plan): See plan 2. Land Use Recently cleared woodland Yes 6% (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) Wooded Drumlin Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body feet Drainage Way eet0 — Possible Wet Area feet Property Line eet0 Drinking Water Well N/A-- Other feet 4. Parent Material: Glacial Till – Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: - - - - it — -- Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 60 inches elevation tbform11-2.doc•rev. 1/1n Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts City/Town of Northampton —(, Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal _ C. On-Site Review (continued) Deep Observation Hole Number: 3 - Redoximorphic Features Coarse Fragments Soil Horizor✓Soil Matrix:Color (mottles) Soil Texture %by Volume Soil Soil Depth gn.) r Consistence Other Layer Moist(Munsell) (USDA) Cobbles& Structure (Moist) Depth Color Percent Gravel Stones 0-2" A 10YR 2/2 LS V.Friable 2"-27" B 10YR 4/4 LS 4 SABK Friable 27"-37" C1 2.5Y 5/2 LS 4 SABK Friable 37"-66" C2 2.5Y 4/2 60" 10YR 6/6 5% LS 2-3 SABK Friable t I I I I Additional Notes: t5forn11-2.doc•rev. 1/10 Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts City/Town of Northampton Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 4_ 11[21/2011 11:45am sunny 60_ Date Time Weather 1. Location Ground Elevation at Surface of Hole: -564---- Location (identify on plan): - --- ------- -- 2. Land Use Woodland Yes 6-7% (e.g.,woodland,agricultural field,vacant lop etc.) Surface Stones Slope(%) Wooded Drumilin Side slope Vegetation Landform Position on Landscape(attach sheet) >100 3. Distances from: Open Water Body >200-- Drainage Way ->�'-� Possible Wet Area - feet feet feet Property Line feet Drinking Water Well -feQA-- Other feet 4. Parent Material: Glacial Till Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes:--- --- — ---- Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 51" inches elevation t5form11-2.doc•rev.1110 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 Commonwealth of Massachusetts City/Town of Northampton t Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 4 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Layer Moist(Munsell) (USDA) Structure Consistence Other Depth Color Percent Gravel Cobbles a (Moist) Stones A 10YR 2/1 LS SABK v. friable B 10YR 4/4 LS 5-7 SABK Friable 27"-53" C1 10Y 5/2 51 10YR 7/8 5% LS 5-7 SABK Friable 53"-66" C2 10Y 5/2 LS 5-74 SABK Firm t. _._ I I I I I I I I I 1 Additional Notes: t5forml 1-2.doc•rev. 1/10 Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts Illit City/Town of Northampton '— Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: ® Depth observed standing water in observation hole A. N/A in N/A inches in N/A A.Z Depth weeping from side of observation hole inches inches Z Depth to soil redoximorphic features (mottles) A 60 in 61 inches inches B. ❑ Groundwater adjustment(USGS methodology) A. in inches inches 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ® Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: 0 Lower boundary: _66„e5 inches t5form11-2.dcc•rev.1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 <. ., Commonwealth of Massachusetts k=r, City/Town of Northampton r=�, Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. I further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form, are accurate and inn aacc000rrdance with 310 CMR 15.100 through 15.107. Iq Pa laiSIL Signature of Soil Evalu for Dal L%« I'NCtaE / SE12.9M 7)! 1aoog Typed or Printed Name of Sail Evaluator/License# Date of oil valuator Exam Ccof 5i-N-N_ - Naw#Hta n Name of Board of Health Witness Board of Health lth I Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and to the designer and the property owner with Percolation Test Form 12. t5fonn11-1.doc•rev. 1/10 Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 8 Commonwealth of Massachusetts CitylTown of Northampton rt Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: t5form11-2.doc•rev. 1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8 Important: When filling out forms on the computer, use only the tab key to move your cursor-do not use the return key. Commonwealth of Massachusetts City/Town of Pittsfield Percolation Test Form 12 Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. A. Site Information Patrick Melnik Owner Name 308 CHesterfield Road Street Address or Lot# Northampton City/Town Eric Melle MA State (413)582-7000 Contact Person(if different from Owner) Telephone Number 01060 Zip Code B. Test Results t5form12.doe-06/03 Observation Hole# Depth of Perc Start Pre-Soak End Pre-Soak Time at 12" Time at 9 Time at 6" Time (9"-6") Rate (Min./Inch) 11/21/2011 Date 1 10:06 Time 11/21/2011 Date 2 40" 36" 10:35 Time 10:06 10:35 10:21 10:21 10:46 11:25 39min 13 10:50 10:50 11:10 11:30 20 6.67 Test Passed: ® Test Passed: IE Test Failed: ❑ Test Failed: ❑ Eric I. Melle S>: Ia91Y l- -✓f 4/ Test Performed By: I ici 604 PIO Teri -60 Witnessed By. / Comments: Perc Test•Page 1 of 1