101 Soil Eval Form 1998 No.
FORM 11 - SOIL EVALUATOR FORI
Page 1 or
Date: <511$1-
_
Commonwealth of Massachusetts
k-K5)TT lafi"'PtC3/ ! Massachusetts
Soil Suitability Assessment for On-site Sewage Dispouti
h
Performed By:
Witnessed By:
Imon AYp1 or
tat
Ric
New Construction 0 Repair ❑
Office Review
Published Soil Survey Available: No ❑ Yes ❑
Year Published Publication Scale
Drainage Class Soil Limitations
Date:
(a/fl/g8.
o .,....J eM Hufchinvo
• ."" 5FhLYv' C4inSt
Tt"bm t A JCA 141 CL/PriP to ith4 o/O,,,U
586-t-[‘:,(03 A 1s
Soil Map Unit
Surtiicial Geologic Report Available: No 0 Yes ❑
Year Published -- Publication Scale
Geologic Material (Map Unit)
Landform _.
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 ❑
Wetland Ara:
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. I2l07r5
kJ
FORM 11 • SOIL EVALUATOR FORA.
Page 2of ;
Location Address or Lot No Par.); h Jj, Rd.
1Onj-site Review I
Deep Hole Number A,I. Date:. oJf(/90 Time:. �1!Yf Weather b
Location (identify on site plan) 5-e-k. 111JJ1
Land Use _
q� d Slope (%) a-5 Surface Stones ty-Car-
Vegetation ,. .c JJ'Q
Position on landscape (sketch on the back)
Distances from:
Open Water Body >1CU feet
Possible Wet Area F IOC feet
Drinking Water Well}/90 feet
Drainage way > SO feet
Property Line >a0 feet
Parent Materiel(geologic)
peoth to Groundwater: Standin RI
Estimated Seasonal High Ground Water: 3(7" 50 "
lac ; \\ DaptMaBSdrocTi.9c)/ 7' /0 "
g Water in the Holey y' LI /r /o(J ii Weeping from Pit Face:C-10a J 4.
DEP APPROVED FOMI-11/07115
DEEP OBSERVATION HOLE LOG.
Depth from
Surface(Inches)
Soil Horizon
Soil Texture
(USDA(
Soil Color
lMurrasil
Soil
Mottling
Other
(Structure.Stones.Boulders,Consistency. %
OreS)
o' \w"
16"-30"
30„_ 95;,
O' \U" ---
14"-asr'
08"-6v"
66„/a”
A
?)
C
-Pi
6
C,
Ca
SZ.
L
5 L
5L
3C.
51_
5 L
rove143
iba.elib
/Dyectla
wyR 43
/0yl2YJ3
Jovv/a
7sykt
n
&tso
ao4G
ioVis/8
M
xs14--
n-ti)L2
ao%Ray
7.S6 1'q
6�
as was
V
tcp lL
swb ,(.
- s --- -- -
atbsot L
�� r.,+
• MIMaSI WI Or, unite terns Mme r...nw..,
Parent Materiel(geologic)
peoth to Groundwater: Standin RI
Estimated Seasonal High Ground Water: 3(7" 50 "
lac ; \\ DaptMaBSdrocTi.9c)/ 7' /0 "
g Water in the Holey y' LI /r /o(J ii Weeping from Pit Face:C-10a J 4.
DEP APPROVED FOMI-11/07115
Location Address or Lot No.
FORM 11 - SOIL EVALUATOR FOP
Page 3 o
Determination for Seasonal High Water Table
Method Used:
❑ Depth observed standing in observation hole inches
❑ Depth weeping from sid, of opservation hole inches
epth to soil-mottlea ?T.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 area
observed throughout the area proposed for the soil absorption system? ; RCl
If not, what is the depth of naturally occurring pervious materiel?
Certification
I certify that on (date) I have passed the soil evaluator examinatio
approved by the epartment of Environmental Protection and that the above anelysi
was performed by me consistent with the required training, expertise and experienc
described in 310 CMR 15.017.
Signature.... Date 6 /
DEP APPROVED FORM- I1I47195
FORM 12 - PERCOLATION TES'
K � Rd
Location Address or Lot No. O� luJ a 9
COMMONWEALTH OF MASSACHUSETTS
Iw rl ' apny Massachusetts
Percolation Test.
Date: 67///969 Time:. la/MS
Observation Hole #
P l
'> - g
Depth of Pere
38 /l
3 A,, "
Start Pre-soak
l 1 j /_
)a-'la
End Pre-soak
/./ 3v/i
)/O3
Time at 12"
/ -‘ 3.),S----
/110
Timeat9"
/ : SO
)' AO
Time at 6"
a: 22
/ ;3 y
Time (9"-6")
32-
/ i
Rate Min./inch
//
S'
Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
M Site Passed �' Site Failed ❑
Performed By:
Witnessed By:
Comments: _.
Ai)
Yfl fA\ftYm
POT APPROVED FORM-ILCYaS
Soil Evaluator; Michael Unripe SYSTEM PROFILE v.t.s, serves
Witless: Peat McErlaa -...r au
Date: love 11.1999 ...i.,.o.._..j + • # ...o.-w. �. y 1
Hwe Name:IA mwv.lcm.n F i__ _ > ENVIRONMENTAL Lasts
a,. ,L mm ; `m,,, e _ ;: _ ulyyl 'lyrrYrrrr, DESIGN,INC.us= Axle
warn .x,.e. 6\` w e.,J l 1„' . 3`%'y ""' ep�,
room r asvialu.aw a%Intl
_ y 101 OLD FERRY ROAD
13 —30 — T —5 y _ _ NORTNAMPIVN,MA 01060 lag
Hate N.m TM 6entlar l050 tint ` •. •. PHONE (413)59$.520
�int" PAIL(413))590501
44,2V A IL lOYPAR XS
71,07 CI IL IOWA MO
107-101" C2 IL M
eas tram.Sm.a m
m#wieTes a> SEWAGE DISPOSAL
SYSTEM
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CONRTROCCION NOTES NONamptan,MA 01060
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4'!NC IATIOAL&I•401,•CC.CadillOWS•rtni am MI m MOMS Chriemplter&Kevin Hutchins
0▪AVID t a� �'°�avYSUMn NoMemptm,MA 01060 446 Bridge Road
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IIIPKIIMED AM}Amami apnea SEM=Ill WM M1.10 WO,=MOM 7{10112e.
a 110 DESIGN REFERENCES
MAT 24 MAD TOWS.MOM LOW AI0 arrtante UM roma ,
it,WATER AufltY WI TOMIOCATIID AT WIT VI Mil ANY MAC OEM mot SITE SIGN E
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' LEGEND SCAnyris"1:717
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Peall APPROVALS&REVISIONS
`l, 110 aromR.4 a•448 am . ,. . w e.,�e _.... ,a-eiw w /
Desiptaily w/ 50% -640 @9 men. 1
nese
nee Pee mrwean.maDal.awm1 PARK HILL ROAD IS
efaalwmPm A,m.m.le-laoss.n ew. .ma Neiteal
TAP-(Cls2 Soa 1]M k.R e 0.160Pe26.R-706 0N
121j
OTNEE LAID OF
IAJPESTMELIT PAETAJEE IAJC --
APPEOYED BY AJOETNAMPTOA/ PIAA/LIAL6 BORED OAl2
MAY 9,1990.
AIM!34 -41'E_
233 10
41Co1o5 TOTAL
&AO Oa'
44,56'
(147J 7035=131V 122.94'
5666-34'-4i"W 379.84' TOTAL ` g -L
PARK HILL LOAD , A 66' WIDE CITY WAY EDGE PAYE —
EDGE PAVE -
/no, e PCCCGCNPF . ,SEE DEED TO
I REPORT THAT THIS PLAN AND