296 Soil Eval Form 2003 FORM Il - SOIL L•VALUATOO age Oo
Lesko P.orr4y
a6ad
Location Address or Lot No. L_ -
Determination or S •asonal Hi!h Water T1 de
Metho�ed
❑ Depth observed standing in observation hole inches
E � in • s
epth weeping from side of observation
inches TP' f a 1/6
Grpuh to soil adjustment feet TP 2 !? [OO„
❑ Ground water adjustment Index well level
Index Well Number -
Reading Date
Adjustment factor Adjusted ground water level
De th of Natural) Occurrin Pervious Material
Does at least four feet of naturally ring pert ervious material exist
xm?in II areas xist
observed throughout the area proposed pervious material? _---
If not, what is the depth of naturally occurring p
Certify ion
I certify that he a"ate nt of(date) Protection and that the above analysis
was
approved by the y me consistent with the required training, expertise and experience
was performed by
described in 310 CMR 15.017.
Date 11 2003
Signature
® DER APPROVED FORM 11,01,95 HHyTOWN ENVIDOON ENT1b CONSULTING BOX P.
NORTH HAWSLD,NA 01066
(413)147.5464
I
flILLTOWN ENVIRONMENTAL
CONSULTING
P. O. BOX 226
FORM 11 - SOIL EVALUATOR FO
NORTH HA TF/ELD, MA 01066 .. Page 1
(413)247-5464
No. Date:
Commonwealth of Massachusetts
Narfha.n,,ION , Massachusetts
Soil Suitability Assessment for On-site Sewage Disposal
Performed By: 1 CJs?,I< o ofort --.--.. Date: /"lay OS,2
Witnessed By: e ev c r ain
Laafloe Mtn a r DnenNan . 4d4n-i Les-ko
t^, /:21534 /,lcree. Let Aokat..as 21 C& 34,1vt /eel-
sy(Veiler " ° d
11-Dame/ "11 " f-/al-fir A4,4 of 073
New construction L� Repair ❑ 247-0217
Office Review
Published Soil Survey Available: No ❑ Yes '-
Year Published I95 I Publication Scale I. 1S64° Soil Map Unit 6 x$ G40
Drainage Class gXcess.�ely_ Soil Limitations Poor F t}cr
Surficial Geologic Report Available: No ❑ Yes ❑
Year Published Publication Scale
Geologic Material (Map Unit) _.... . _ _...
Landform
Flood Insurance Rate Map:
Above 500 year flood boundary No 0��-YeYYe��/es
Within 500 year flood boundary No 9es ❑
Within 100 year flood boundary No Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit) - - -Wetlands Conservancy Program Map (map unit) ,t -- - --
Current Water Resource Conditions(USG)): Month Mal 2003
Range :Above Normal ❑Normal gBelow Normal ❑
Other References Reviewed: - --
® HILLTOWN ENVIRONMENTAL CONSU
P. O. BOX 226
DEP APPROVED FORM-13/07195 NORTH HATFIELD, MA 01066
(413) 247-5464
•
��jj FORM 12 - PERCOLATION TEST
Liske Prate+
Location Address or Lot No. �7l✓e9kv Roan(
COMMONWEALTH OF MASSACHUSETTS
Nor��a n �D` , Massachusetts
Percolation Test'
Date: May z8, 20o3 Time:,
Observation Hole # P / p_ Z
Depth of Perc 43 " 41"
Start Pre-soak f1 •.o3 l0 2 5
End Pre-soak 11 •• 18 l o :40
4
Time at 12" 11 .. 15 0 ; 40
Time at 9" ( '. 19 10 ',4q-
Time at 6" 1 1 '.1,0 10:4,
Time (9"-6") 1 Min) 5 r4,�
Rate Min./Inch < Z MiN/rA < 2 nsNbr-1
Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed ❑ Site Failed ❑
Mark_Performed By: ' - ar k noo pson
Witnessed By: peke✓ MLErla,n
Comments: .__ ... ..._.. _.._.
DEP APPROVED FORM-12/01H5
MILLTOWN ENVIRONMENTAL CONSULTING
P. O.BOX 226
• NORTH HATFIELD,MA 01066
(413)247-5464
On-Site Review
On-Site Review On-Site 10: 5�
�? Date: S 28 03 Time 10 ;Do Deep Hole Number�Z_ Date: s/ze/o3 Time •
Deep Hole Number I Weather Ou..vc..s�' or �. ; n
Weather vc• + 0 i Location (identify on site plan) _ i -p
Location (Aentify qn site plan) bee. es% �^ i Slope(%)
Land Use r 1 d Slope (%) 1•-L Land Use
Vegeceon: n\ Vegetation:
Vegetation: Grasses teals
6.vassts etch Landfonn:
Landform:
Position on Landscape(sketch on back)
Position on Landscape(sketch on back) Distances from: I oe+ feet
Distances Open Open Water Body 2•oi- feet DrainagewaY j! - feet
Pos i Water Body Luia feet Drainageway 100r feet Possible Wet Ares%+ feet Property Line__
Property Line__feel Drinking Water Well feet Other�---
PossiDle Wet Ares_Luis_feet Other
Drinking Water Well o� feet
D P 0:S RVATION HOLE OG
D P OBS RVATION HOLE LOG godson n aou nation •�(USDA) soil ngAfnp (*Wort.Manna Waders)
sodAss depth from 'oil wrtrm au I--- /11th
NI {'.r.61., cr....L 0- IL" Ap GSL IevR z/z N,... fr;4L(. , c•,.•"6
�-IZ�� f1 ESL I•YRZ/a. � .�;•bk
1Z-Z4e 3„ r.
gZ-�.Sn� Z.5Y5i6 ® t •ne - ,rn+,SA4:vier..I
24-CO G, LS z 5Y T/3 N
G' 4. LS z.sv ,/3 N•r.e
1a� . 1 40-IZ0n CZ q S IovRS�3 �'"` 30%':wsl,n6Ao
`6 'nQ° Intsyg.S/3 N°^� w6Ll•y I 9 •1 b>.I/wc
30% yva.•.(,
Parent Material(geol ic) 01.14"WAS�'
Parent Material(geologic) . ----•tl" Depth •
to Bedrock on•-
Depth to Bedrock Nona- Depth to Groundwater
Depth to Groundwater : Standing Water in the Hole ba"
Standing Water in the Hole III ,i•r 1nSla Weeping Estimated iron Pit Face lob"
*Weeping from Pit Face 6_ rt Estimated Seasonal High Water Yoh,_ ,_ _ c Cu