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271 (Girl Scouts) Soil Suitability Assessments No. FO VALUATOR FORM Page 1 of 3 Date: Commonwealth of Massachusetts Poe-ntAniPme , Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed By: 8, ezi-utx.)Assoc / c Witnessed By: Pent. I1cee44 tk) Date: 31251/C Laa has a jig/lit La 6 -Z.or 1/4 Vew Construction 0 Repair Ei °min ilimkataPiet q-TOO, /9 4 A.1,92i0 / ;=::271 assaisahALLe kb Noerna manio, 414 T/3 --1-8 I/S6 Office Review Published Soil Survey Available: No 0 Yes Year Published /97f Publication Scale 7:2 Stan Soil Map Unit Drainage Class Soil Limitations Surficial Geologic Report Available: No I Yes 0 Year Published ----- Geologic Material (Map Unit) Landform Flood Insurance Rate Map: Above 500 year flood boundary No OYes E Within 500 year flood boundary No ElYcs 0 Publication Scale Within 100 year flood boundary No 12 Yes 0 Wetland Area. National Wetland Inventory Map(map unit) Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(USGS): Month Range :Above Normal ONormal El Below Normal 0 Other References Reviewed: DEP APPROVED FORtA•1211171$ FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. ,Z7/ /19>t edutfiLee NoP--M4m.7a,i MA On-site Review Deep Hole Number I.?. _ Date:52'11k I Location (identify on site plan) Land Use .17I(4 of Vegetation Landform DRQAL1jAj SLoM. Position on landscape (sketch on the back) Distances from: Open Water Body /Dp+ feet Possible Wet Area /O°* feet Drinking Water Well /0 7 feet Slope (%) I Time:. . ..__ Weather&OULV/GLNT SNOwceJ Surface Stones /00/0 ..-. Drainage way l/"t_. feet Property Line .3Y..-_ feet Other _ DEEP OBSERVATION HOLE LOG' Depth from Surface(Inches) Soil Hatton Soil Texture (USDA) Sad Cdor (Mooned) Soil Mottling Other (Structure.Stones.Boulders.Consistency,% Grano 0 -6 t ,L2- a- /S IS'/Z 4 A FILL Q w G -St SL LS 1oye913 2.s will 2 Sy5%V .5%-I-0 a" 7SyeS/6 tumor /uree_FACG un)ccneACreb Jo IL.. STa&ff/ .bcoL6£e s C3 CoEflLelr.P,ewti Ch SofL /S w£T SOIL SmcgeS MINIMUM OF 2 HOLES RkUUINtU AT kVENY PRUPDSED DISPOSAL AREA Parent Materiel(geobpic) -54A-)IS Dyd.aOeSWS > /.Z ri e Devthte Gra.dwater. Standing Watet in the Hole: /19 weeping from Pk Face: Esdmeud Saasaret High Ground Water. /2' S DEP APPROVED FORM-12./V MS FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. 2 I HaYbanist.u. r7Dr .clanfig slAroafAM Determination for Seasonal High Water Table Method Used: IrS Depth observed standing in observation hole HI inches ® Depth weeping from side of observation hole 33 _ inches Depth to soil mottles /21 .. 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? Ye- If not, what is the depth of naturally occurring pervious material? Certification I certify that on Sl-Y 1f99 (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 DEP APPROVED FORM- 1y07l95 otc Id Date S,.2c//o I PERCOLATION TEST(S) Time: 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") lime(9"—6") Rate Min/Inch Rate Min./Inch 'minimum of 1 percolation test must be performed in both the primary area AND reserve area. • _ •• III ■ Performed by I Performed by Witnessed by Witnessed by Comments: NORTHAMPTON BOARD of HEALTH- Title 5-Site Review Location Address or Lot# Owner Date iv Time ���5� Owner's Address 7, Engineer I •1.9 Weather Other (Stuchure,Stones,Boulders.Consistency.%Gavel) Phone Land Use ft 4...r--- %Slope ,(7 o).S) Surface Stones s1I: eel- Ya " `S/6A ,1,2, r-1 Landform Ve•etation Start Time Posi&o on Landscape(skemr on the bald Distances Stop Time Open Water Body feet Drinking Water Well feet Property Line feet Possible Wet Area feet Drainage Way feet Other feet DEEP OBSERVATION HOLE LOG* Deep Hole#: % 'UIMMUMOF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Depth from Surface(Inches) Sal Horizon Soil Texture (USDA) Sod Color (Munsell) Sal Mottling Other (Structure,Stones,Boulders,Consisten y,%Gavel) Other (Stuchure,Stones,Boulders.Consistency.%Gavel) D —i is- S A fLA) SZ SL_ ,(7 o).S) r 4/3 lily s1I: eel- Ya " `S/6A ,1,2, r-1 Depth to groundwater Standing Water in the Hole I Weeping from Pit Face I Parent Mahal(g I I Depth to Bedrock I .>S-0 Depth to groundwater. Standing Water in the Hole 1 Weeping from Pit Face I •Dirn7 Estimated Seasonal High Ground Water /a h DEEP OBSERVATION HOLE LOG* Deep Hole#: *MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Depth from Surface(Inches) Soil Horizon Sol Texture (USDA) Sal Color (Munsell) Soil Molding Other (Structure,Stones,Boulders,Consisten y,%Gavel) Parent Mahal(geologic) I I Depth to Bedrock I Depth to groundwater Standing Water in the Hole I Weeping from Pit Face I Estimated Seasonal High Ground Water PERCOLATION TEST(S) Time: Time: Observation Hole #1 Observation Hole #2 Depth of Pert Depth of Pere 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. Performed by 1 Performed by Witnessed by Witnessed by Comments: ■ I Address or Lot# NORTHAMPTON BOARD of HEALTH- Title 5- Site Review a I , 'ter c— Owner DEEP OBSERVATION HOLE LOG* Deep Hole#: 'MINIMUMOF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Time G Owner's Address Sad Texture (USDA) leer I Weather Phone# Land Use Other (Stiltorre,Stones.Boulders,Consistency,%Gavel) %Slope Surface Stones Parent Mahal(geologk) I I De 11)to Bedrock I Landform I, Ve.etation Start Time PmROn co Landscape(sketch on the bad.) Distances Slop Tirne Open Water Body feet Drinking Water Well feet Property Line feet Possible Wet Area feet Drainage Way feet Other feet DEEP OBSERVATION HOLE LOG* Deep Hole#: 'MINIMUMOF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Depth from Surface(Inches) Depth from Surface(inches) Soil Holton Sad Texture (USDA) Sal Motlfng Soil Color (Monsen) Sod Mooring Other (Stiltorre,Stones.Boulders,Consistency,%Gavel) 11 I\ I Parent Mahal(geologk) I I De 11)to Bedrock I 0 I, 1' L P 7r Parent Matrial(geologic) I I Depth to Bedrock I Depth to groundwater Standing Water in the Hole I Weeping from Pit Face I — - Estimated Seasonal High Ground Water _ DEEP OBSERVATION HOLE LOG` Deep Hole#: 'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Depth from Surface(Inches) Sod Horizon Sod Texture (USDA) Sal Color (Munsell) Sal Motlfng Other (savours,Stones.Boulders.Consistency,%Gavel) Parent Mahal(geologk) I I De 11)to Bedrock I Depth to groundwater Standing Water in the Hole I Weeping from Pit Face Estimated Seasonal High“round Water FORM II - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. 271 MAybAAXL LCL Rh Noenraltp70.0 On-site Review Deep Hole Number _ Date:.�ZIS100 Time:... .,,__ , Weather GLEAe 4lotp Location (identify on site plan) Land Use 4.441+& ... Slope (%) l-zr Surface Stones Node Vegetation la e9SS,_ _ . Landform .?*mtLIs)-S Link- Position on landscape (sketch on the back) Distances from: Open Water Body loo+ feet Drainage way /00}, feet Possible Wet Area /00# feet Property Line 6.0,.,. feet Drinking Water Well POD* feet DEEP OBSERVATION HOLE LOG' Depth from Surface(Inches) Soil Horizon Soil Texture (USDA) soil Color Soil IMunMl Mottling Oar (Structure. Stones.Soutaera.Canwtency. % GravelJ 25 - SO SL it 15 l07k th asyYi9 2.5rsl f Aty pyrt eFACt uotAMpAcr€b Sea. JT.JdS 4fofttS soic r3 ✓Eey GotT Snit- -Mina ES MINIM 11A OF 2 MOMS RECIUMPU AT Front Material(geologic) 57 N • gnat to Groundwater Stand(ng War(n the Hole: Cstrad Seasonal High Ground Weir. / II S 71" DISPObALMkA DrpatrarYUrt >80n Weeping from Mt Face: .?.rg'r DPP APPROVED FORM-ULpIAS FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. a 7/ HAybwv,1LL �.1� 4Jotm4mro?u MA Determination for Seasonal High Water Table Method Used: ® Depth observed standing in observation hole 71 inches © Depth weeping from side of observation hole 28 inches © Depth to soil mottles _.JZ-. 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? y6S If not, what is the depth of naturally occurring pervious material? Certification I certify that on Sfl-• )4?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 /2/s/oo DU APPROVED FORM-gM/%