Lot 2 Soil Tests Lot- 2
Li �a.a;ra� w� rJo,+�aw.��H •
Massachusetts Department of Environmental Protection y '
Bureau of Resource Protection—Wastewater Permitting Program
Site Address or Map/Lot Number
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (minimum of two holes required at every proposed disposal area)
Deep Observation Hole: Date: 6/9/04 Time: 1;1 Weather. 5vi^y ?Os
1. Deep Hole Number 2A Location (Identify on Plan ):
2. Land Use:
C1w..<I Wools Surface Stones. c.v., Slope(NI Z=3 Vegetation. Wets
(e.g.woodland,agncukural fiek,vacant Id.etc
Landfonm. Csr, Mwaiaix Position on landscape.
3. Distances from. Open Water Body 2o?4- ft. Drainage Way 107' ft. Possible Wet Area soo±ft.
Property Line _ft. Drinking Water Well _ft. Other ft.
4. Parent Material: Ablcrlon ;11 Unsuitable Materials Present: Yes❑ No Q'
if Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s)❑ Weathered/Fractured Rock ❑ Bedrock ❑
5. Groundwater Observed: Yes d No ❑
If Yes: Depth Weeping from Pit L Depth Standing Water in Hole lo? Estimated Depth to High Groundwater: 38'
Redoximorphic Features Coarse Fragments
l Soil Matrix: (mottles) %by Volume
Depth Horizon/ Soil Texture Color-Mast Depth Color Percent Gravel Cobbles Soil Structure Soil Consistence other Layer (USDA) (Munsell) &Stones (Moist)
0-5" A Cs (o\iR3/2 v,,.,,Ja leosc
5- l5" 3N 1.-S (0 VR5/6 5X, manwm- }rrable-
Iorp.sfB la 10% IOjo vnasstve 4,-alcla-
13116° G LS oHRb/2 38° loyRVI
I
Additional Notes
DEP Form 17 Soil Suitability Assessment for On-Site Sewage Disposal•Page 3 of 4
U Massachusetts Department of Environmental Protection CUrolino Vic/ N�+}ytaw,Q4-0v,
Bureau of Resource Protection —Wastewater Permitting Program Site Address or Map/Lot Number
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
A. Facility Information r
�+
Owner Name' W2u+eI< F I y Ir✓s� HILL TOWN ENVIRONMENTAL CONSULTING
P. O. BOX 226
Street Address. P.0. Box 1039 Map/Lot: NORTH HATFIELD, MA 01066
A (413) 247—5464
cny Emskh arphr, State. M A Zip Code: 01027
B. Site Information l
1 (Check one) New Construction Q• Upgrade ❑ Repair ❑ •
2. Published Soil Survey available? Yes [] No ❑ If yes, 1 181 I 15640 AmB /nios{n.nn •
•
Year Published Publication Scale Soil Map Unit Soil Name
Soil limitations We1.1E54 peres siresIy
3. Surficial Geological Report available? Yes ❑ No ❑ If yes.
Year Published Publication Scale Map Unit
Geologic Material Landform
4. Flood Rate Insurance Map.
Above the 500 year flood boundary? Yes [,ll_f No ❑ Within the 100 year flood boundary? Yes ❑ No Er
Within the 500 year flood boundary? Yes ❑ No [r 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) (104 Range: Above Normal ❑ Normal LD Below Normal ❑
Mr.th!Y*ar
7. Other references reviewed:
DEP Fomt 11 Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 4
/^(,o z
� Massachusetts Department of Environmental Protection Covclinal Way, No++kaw.f}pyA
Bureau of Resource Protection—Wastewater Permitting Program sae Address or Mawtot Number
\ Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
D. Determination of High Groundwater Elevation ZA 13
1 Method used: ❑ Depth observed standing water in observation hole A. B. _
0 Depth weeping from side of observation hole A. B.
( Depth to soil redoximorphic features (mottles) A. 38 B. 40'1
❑ Groundwater adjustment(USGS methodology) A. B.
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 naturallllypcurring pervious material exist in all areas observed throughout the area proposed for the
soil absorption system? Yes I�' No❑
b. If yes, at what depth was it observed? Upper boundary: 15" lower boundary: 120
F. Certification •
I certify that I have passed the soil evaluator examination' approved by the Department of Environmental Protection and that the
above analysis analysis was performed by me consistent with the required training. expertise and experience described in 310 CMR 15.017.
a1 ee �o 2�-
Sign ureot Soil D
Typed or Printed Name or Soil Evaluator 'Date of Soil Evaluator Exam
Er„ac4 KA-le id to No+i-korxrdr+orJ \
Ayca I
Name of Board al Health Witness Board at Health l 11
Note: This form must be submitted to the approving authority with Percolation Test Form 12
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 4 of 4
La-1 G
0 Massachusetts Department of Environmental Protection Ca`°`t V`A1 WCY/ \erkL ,pip
Bureau of Resource Protection-Wastewater Permitting Program site Address or man/Lot Number
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (minimum of two holes required at every proposed disposal area)
Deep Observation Hole: Date: 6 -9-04 Time: I13 0 Weather: SCr n y '70%
1 Deep Hole Number 25 Location (Identify on Plan ): _- `'
2. Land Use: Cleared Woodc Surface Stones: 1'ew Slope (%): 2-3 vegetation `MtJs
(e.g. woodland, agricultural field,vacant lot,ole
Landform: Cr. MO ra;At Position on landscape:
3. Distances from: Open Water Body 100k ft. Drainage Way 150r ft. Possible Wet Area loot ft
Property Line _ft. Drinking Water Well I504 ft. Other_ft.
4. Parent Material: 41,1,,.1-0K-1,11 Unsuitable Materials Present: Yes❑ No❑
If yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s)❑ Weathered/Fractured Rock ❑ Bedrock ❑
. 5. Groundwater Observed: Yes Eti No ❑ ii
If Yes: Depth Weeping from Pit 50" Depth Standing Water in Hole II 101I Estimated Depth to High Groundwater. 40
RedoximorpNc Features Coarse Fragments
Soil Soil Matrix: (mottles) V.by Volume
Depth Horizon/ Soil Texture Color-Moist Depth Color Percent Gravel Cobbles Soil Structure Soil Consistence
(In.) Layer (USDA) (Munsell) 8 Stones (Moist) Other
0-5" A c5L— IavR311 c,,w.b (001e
5- 15' "BW Ls iirm5/6 5% °59.>a- ;,,LL
ibvesm
G o% to
�_I�" (,S IOYR6�L 40' ov2,�l 10% I /> Wiest or e- cvie ble_
, Additional Notes
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal • Page 3 of 4
L{42
•
Massachusetts Department of Environmental Protection Cnvplknpl Wuy N°4ow p+°'^
•
Bureau of Resource Protection -Wastewater Permitting Program Sae Address or Map/Lot Number
Form 12 - Percolation Test
A. Facility Information
1. Facility Information
\.f.Izar�L h IyT
Owner Name
Q'° '?X 1039 Map/Lot
Street s Addre
Eas+s �pbr Mf4 0IO2-7
City State Zip Code
Percolation Test
Date:
Observation Hole # P-z A 9- 2B
Depth Of Perc 41" 44"
Start Pre-soak 5:24 3 :40
End Pre-soak 3 59 3',SS
Time at 12" 3 41 3 55
Time at 9" 3 49 4 03
Time at 6" 4'.07_ 4;15
Time (9"-6") 13 Mir-1 12 ■ u-)
Rate - Min/Inch S MirJJlr1 4 MrN/1r-1
�,'Minimum of I Percolation test must be performed in both the primary area AND reserve area
Site Passed Ly Site Failed El
Performed By, M T
Mar K I 71er,-.fset,\
Witnessed B9. ". ._s t �,.l l:_° --
Comments
DEP Form 12 Percolation Test • Page 1 of 1