Lot #1 & #2 (to be one lot) Site Suitability 2013 4-
Adjustment factor
Adjusted ground water level
De.th of Naturall Occurin• Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the sc
absorption system?
If yes,what is the depth of naturally occurring pervious material?
If not,what is the depth of naturally occurring pervious material?
Deep Hole Number. R Date:
Location(identify on site plan):
Land UseNegetation:Lava*. rasreatil
Land form:
Position of Landscape:
Distance from:
Open Water Body
Possible Wet Area
Drinking Water Well
On-Site Review
Time: ,a�AM Wea
Slope(%):
Feet
Feet
Feet
Drainageway
Property Line
Other
Surface Stones: none
T.P. 1-1
Feet
Feet
Feet
DEEP OBSERVATION HOLE LOG
Depth from
Surface
(Inches)
Soil
Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
Mottling
Other(Structure,Stones,Bo
Consistency, %Gravel
d —}I
17--30
30"iCLI
Pr
C Z
ib7r2,51
1vrisl�
toy r 1 .1
iy� q,3
/LOrse��o
s I
r5„
fir.
= 56
-city
,537/7-2
- ->9
t
_sldo,n
ON
12.-36
Li
Pt
Cl
t . 5
v
vt
—, erpwcf so, /
�o—
- epNy
3/a a 5y6tAn
Parent Material(geologic)
DDe th to Groundwater: Standing Water in the Hole:
Estimated Se�sonal High Ground Water: > l�
# o n s( Cbr reC (ca»
G /�W
Cl /fled
l 3dtr� 5
4fri 64.
Depth to Bedrock: >
We •ing from Pit Face:
B
_ e GI 04 60
Ltt-tOr CA-
1
IARD OF HEALTH
MEMBERS
:ITMAN,M.D.,ACTING CHAIR
IUZANNE SMITH,M.D.
DONNA C.SALLOOM
CTOR OF PUBLIC HEALTH
SCRIMGEOUR,MHEd,CHES, BOARD OF HEALTH
CITY OF NORTHAMPTON
MASSACHUSETTS 01060
OFFICE OF THE
(413)587-1214
FAX(413)587-1221
Site Suitability for On-Site Sewage Disposal
Number: re to-) 5rrO C)
led by:1; M,
Inspector D U k
1 Site Address C
Ok( We CSO.-�C?cct
New Construction
Date: 32.6 113
Equipme Operator:
T.P.• 1-1
212 MAIN STREET
NORTHAMPTON,MA 01060
Client Name&Address
Repair
Office Review
:d Soil Survey Available: No ❑ Yes 0
r Published Publication Scale Soil Map Unit
I Geologic Report Available: No 0 Yes ❑
r Published Publication Scale Geologic Material(Map Unit) Landform
ssurance Rate Map:
ve 500 year flood boundary❑ Within 500 year flood boundary ❑ Within 100 year flood boundary ❑
Drainage Class Soil Limitations
I Area:
onal Wetland Invetory Map(Map Unit)
Water Resource Conditions(USGS):
ge: Above Normal ❑
eferences Reviewed: _
e- Ne
Wetlands Conservacy Program Map(Map Unit)
Month
Normal 0 Below Normal 0
/.✓
54950/ ht057- PGA%�✓v-F+�/!)
Percolation Test Results
I
Time5
Measurement
Time
Measurement
aturation
Begin Saturation
/210/ ell
6
uration
/�Q,�r
End Saturation
/.1:/7 /
1
iment
//12tC/♦49%
9"depth
Measurement
D tat%M
sment
I/.✓�0
depth
Measurement
q
ii 'L/?e/%
Time
Elapsed Time
9"to 6"
[ion Rate <2 mm.
of Percolation Test Hole:
PercoMhon Rate:
Bottom of Percolation Test Hole:
-Determination for Seasonal Diet Wat.. Table
Used
tth observed standing on observation hole> ❑ Depth weeping from side of observation hole_inches
ith to soil mottles inches ❑ Ground water adjustment inches.
/ell Number
Reading Date
Index well level
30ARD OF HEALTH CITY OF NORTHAMPTON
--MEMBERS
FLEITMAN,M.D.,ACTING CHAIR
SUZANNE SMITH,M.D.
DONNA C.SALLOOM
[RECTOR OF PUBLIC HEALTH
fHl SCRIMGEOUR,MHEd,CHES, BOARD OF HEALTH
MASSACHUSETTS 01060
OFFICE OF THE
(413)587-1214
FAX(413)587-1221
Site Suitability for On-Site Sewage Disposal
act Number: Vet'`) CO^IS
armed by:1 t M,
th Inspector 11
D. LAJ 4 U
Site Address
-ltd— kac 1ssric)C\?� e
New Construction
Date: 3176 133
Equipme Operator:
T.P.# 1-1
212 MAIN STREET
NORTHAMPTON,MA 01060
Client Name&Address
Repair
Office Review
Yes ❑ /
Soil Map Unit
Yes 0
Geologic Material(Map Unit) Landform
shed Soil Survey Available: No O
ear Published Publication Scale
:ial Geologic Report Available: No O
ear Published Publication Scale
I Insurance Rate Map:
bove 500 year flood boundary O
and Area:
ational Wetland Invetory Map(Map Unit)
nt Water Resource Conditions(USGS):
ange: Above Normal O
Drainage Class Soil Limitations
Within 500 year flood boundary 0
References Reviewed:
Within 100 year flood boundary ❑
Wetlands Conservacy Program Map(Map Unit)
Month
Normal O Below Normal ❑
ov
Percolation Test Results
I-1
Time
Measurement
Time
Measurement
.Saturation
Begin Saturation
1.210/r/
Q
aturation
%fa
End Saturation
J.Zr/%
?tb_
arement
j/1210
__ -
.9„deptL
Measurement
_.. _.
/l td-7rM
nh
iiement
J»50 __
6"depth
Measurement - -
- ]/ n 44
��
d Time
5"
Elapsed Time
9"to 6"
l
lation Rate <2 cam./in
n of Percolation Test Hole:
Percolation Rate:
Bottom of Percolation Test Hole:
DetenoinatiorrforSeasonal High Wale. Table
<I Used
epth observed standing on observation hole> ❑ Depth weeping from side of observation hole_inches
epth to soil mottles inches
Well Number Reading Date
❑ Ground water adjustment inches.
Index well level