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207 On Site Reviews kertatackastikgst 0 7 ct, -Ph)Ad , 1 , 1 II PERCOLATION TEST(S) I Time: I I Time: I I Observation Hole #1 Observation Hole #2 Depth of Perc Depth of Perc 5-X LI Start Pre-soak Start Pre-soak 0 End Pre-soak End Pre-soak C- ' t• -1 Time at 12" ' Li 1 Time at 12" Time at 9" Time at 9" Time at 6" Time at& /C 5,, Time (9"-6") Time(r-6") Lli Rate Min./Inch - Rate Min./Inch *minimum of 1 percolation test must be performed in both the primary area AND reserve area- Performed by I ,._, UL-t/6 (i I Performed by I .1 Witnessed by 1 -V-1 jVl--'--r:' I Witnessed by 1 Comments: I - , • -; r : lii J ,( 1 I ',,• _..." ,---------- NORTHAMPTON BOARD of HEALTH- Title 5-Site Review Owner /-5)10 Time . Soil Texture (USDA) Owner's Address Son Molding Other (Structure,Stones.Boulders.Consistency,%Gravel) Weather Phone M SO v e — 96 Slope I Surface Stones rm I Depth to Bedmd I Vegetation Chit Tr'2 Landscape(sketch on the back) Distances Drinking Water Well Stop Tvne feet Property Line feet r Body feet at Area ) pi) - feet Drainage Way feet Other feet DEEP OBSERVATION HOLE LOG* *MINIMUM OF IWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Soil Horizon Soil Texture (USDA) Sod Color (MunsdQ Son Molding Other (Structure,Stones.Boulders.Consistency,%Gravel) -�i I S L 5 v e — t0 t LI y i (geologic) I I Depth to Bedmd I 1 groundwater Standing Water in the Hole I h(D I Weeping from Pi Face I It)'3 tlmated Seasonal High Ground Water -54C1) " DEEP *MINIMUM OF OBSERVATION IWO HOLES REQUIRED AT Soil Color (Munsdq HOLE LOG* EVERY PROPOSED DISPOSAL Son Molding AREA Oher (Structure.Stones,Boulders,Consistency,%Gravel) ) Soil Horizon Soil Texture (USDA) al(geologic) I I Depth to Bedrock I to undwater Standing Water in the Hole I Weeping from Pit Face I gr slim ted Seasonal High Ground Water : E : I > 044 » \� de HIC . . ' ,,,4© jy ? /r ' \ ( / m is / § 0 •66 i \ \ \��\A : . 4 . - \ 7,� + 7 jj wfie.:.) • 22 ; « ) kE � f \ . . a ; : 2 / \ §» } 2 X26 »; a ] 666 \ \ \ . 5m . , / ` . § \ }\ « . 416 #t \ » !; « « ` i \_\ \ . ' ( - � ? . i2: § - C) a \ I � S « : - : s & e . </� i9 A 5 ,, °tee `e i A 'kJ- k? b I 4. b- o -tic-3-^7: coa/rye% �"' r et,ne5 � M.. , . PERCOLATION TEST(S) Time: Time: Observation Hole 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") Time(9"—6") Rate Min/Inch Rate Min/Inch 'minimum of 1 percolabon test must be performed in both the primary area AND reserve area • • • • Performed by I Performed by Witnessed by I I Witnessed by Comments NORTHAMPTON BOARD of HEALTH- Title 5- Site Review ddress or DEEP OBSERVATION HOLE LOG' 'MINI UM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Owner IA n / e Time /C V C Owner's Address Sad Color (Munaeld — ,-. i 2. +„ 1 '-a' YletAk H— o— ^^!--'6--N Weather IV ( Phone Use ( I%Slope I Surface Stones r Depth to Bedrock I /✓O DIM V=,station StartT me 1 Landscape(sketch on the bade Distances Stir Time timated Seasonal High Ground Water er Body feet Drinking Water Well feet Property Line feet let Area St Drainage Way feet Other feet DEEP OBSERVATION HOLE LOG* : I -- 'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA DEEP OBSERVATION HOLE LOG' 'MINI UM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Sop Harmon Sal Texture (USDA) I San Horizon Sad Texture (USDA) Sad Color (Munaeld Safi Mottling Other (SWclure,Stales.Boulders,Consistency,%Gavel) the l j to Bedrock IV ( Amsted Seasonal High Ground Water I(Geologi) I r Depth to Bedrock I /✓O s groundwater. Standing Water in the Hole I Weeping from Pd Face I /'.' timated Seasonal High Ground Water DEEP OBSERVATION HOLE LOG* : I -- 'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA it Sop Harmon Sal Texture (USDA) Sd Color (Munsell) Soil Mottling Other (Swclu Sb<ms,Boulders,Consistency,%Gave) icgto_NEL lo groundwater j to Bedrock Standing Water in the Hole Weeping from N Faa Amsted Seasonal High Ground Water