350 Septic Perc Tests 1995 Determination for Seasonal High War 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
Percolation Test
Date: _..../J./ Sin— Time: .._JO- OD
Observation Hole #
Depth of Perc
3 6 ' '
Start Pre
/0 - 0 Sr-
-soak
End Pre-soak
/D ". 2/
Time at 12"
/ 0 ( Z/
Time at 9"
/0 , ZS
Time at 6"
/U ' 3 /
Time (9"-6")
4.
Rate Min./Inch
2 yh14 4n di
Site Suitability Assessment: Site Passed LI Site Failed ❑
Additional Testing Needed.
Performed By r k 7
Witnessed By: ..P l4 211)494'7.r
Comments. ...
Certification Number. ‘. 88
On-site Review
Deep Hole Number 1 Date. if/14"/96- Time./°: CC Weather
Location (identify on site plan)
Land Use ds-ht,,Le Slope (%) 51 Surface Stones 21 Crud-
Vegetation A wit
Landform ti
Position on landscape (sketch on the back)
Distances from:
Open Water Body 2-er' 1‘ feet Drainageway feet
Possible Wet Area 2-` ffeet Property Line feet
feet Other
Drinking Water Well
i PS. her),
DEEP OBSERVATION HOLE LOG
Depth from Surface
(Inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munson)
Soil Mottling
Other
(Structure, Stones. Boulders.
Consistencv. % Gravel)
0 - 1(
0 - 113
23 - 47
4 7 7c
76 - / ay
A
C i
Cz
J
50_ L a
G Caal
lo catc/
ft 046,zi.
5-6
Parent Material (geo ogic) Depth to Bedrock:
Depth to Groundwater: Standing Water in the Hole: ...-...- Weeping from Pit Face:
Estimated Seasonal High Ground Water: 56
On-site Review
Deep Hole Number - Date. 5 Time: ie.el Weather
Location (identify on site plan)
Land Use Slope (%) Surface Stones
Vegetation _._14-r--_-
Landform
Position on landscape (sketch on the back)
Distances from:
Open Water Body feet Drainageway feet
Possible Wet Area feet Property Line feet
Drinking Water Well feet Other
DEEP OBSERVATION HOLE LOG
Depth from.Surfece
(Inches)
Soil Horizon
Soil Texture
(USDA)
Soil Calor
(Munn 11)
Soil Mottling
Other
IStructure.Stones. Boulders.
Consistent,/ %Greven
ii - Iv
i .
2o - 3
32 /0 I i
C
C7_
r'SI-
c.. feu)
ZO ail
1,-1-n off
3911
L e er-d-
r I I n-t
Hctici
Lalgr
Parent Material (geologic) --- Depth to Bedrock:
Fhpitti tn Groundwater. Standing Water in the Hole: ..... Weeping from Pit Face: ...
Estimated Seasonal High Ground Water: ..371
Date N1/45195-
Commonwealth of Massachusetts
, Massachusetts
Site Suitability Assessment for On-site Sewage Disposal
Performed By: (ft lies
Certification Number: 4
Witnessed By: &) r fif.C. (Lk/al
Location Address or Lot No.
3CC Celt kietibood kA.
ci4cp4i Aft etc 6,0
Own•r's Name, Addreas and Tat.
S ( , // JI&'. PoLV
3 se C/e5 mead du: Rd
NtA ». fl '7' At,
New Construction
Office Review
Published Soil Survey Available:
12.7 Repair
No 0 Yes Er-
Year Published Publication Scale Soil Map Unit
Drainage Class Soil Limitations
Surficial Geologic Report Available: No 0 Yes 0
Year Published Publication Scale
Geologic Material (Map Unit)
Landform
Flood Insurance Rate Map:
Above 500 year flood boundary No 0
Within 500 year flood boundary No 0
Within 100 year flood boundary No 0
Wetland Area:
National Wetland Inventory Map (map unit) _
Wetlands Conservancy Program Map (map unit)
Current Water Resource Conditions (USGS):
Range : Above Normal 0
Other References Reviewed:
Yes
Yes
Yes
Month
Normal 0 Below Normal 0
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
Percolation Test
Date: /l./ /S/ql Time: 10.; 0
Observation Hole #
Depth of Perc
.3 6 '
•
Start Pre-soak
/0 : 0C
End Pre-soak
/0 : 2/
Time at 12"
/ 0 • 1 /
Timeat9"
/0 ; 2S-
Time at 6"
/U ; 3 /
Time (9"-6")
Rate Min./Inch
a num /n,1,
Site Suitability Assessment: Site Passed 1Z7 Site Failed ❑ _
Additional Testing Needed•
Performed By i /% 7i a
Witnessed By:_..._.._..._P._ �� El Pad;,x.__..._
Comments:
Certification Number