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198 Soil Eval Form 2015
FORM 11 - SOLL EVALUATOR FORM Pagel of 3 Date: )7, Commonwealth of Massachusetts , Massachusetts Soil SuitOility Assessment for 07i-site Sewage Disposal n 6/ve rmed By: 5/4 Date: :ssed By: ____,4241(2—ia./4S.1.2../ .46/4 /C13724) -A-- rcie ytturesk r- - construction d Repair 0 4104/7 Review ' /1//25.5 bed Soil Survey Airailable: No 0 ' Yes Published Publication Scale age Class Soil Limitations Sal Geologic Report vailable: No 0 Yes a------r- Piahli.shed -- Publication Scale — 'sic Material(Map Unit) Corm I Insurance Rate Map: re 506 year flood boundary No Oyes in 500 year flood boundary No 01; 0 in 100 year flood b4undary No E(1es and Arta ma!Wetland Inventry Map(map unit) ands Conservancy P gram Map (map-unit) ant Water Resource ondi ' (USGS): Month m :Above Normal Normal OBelow Normal 0 i; r Refercoors Revievkd: N przic e/i-3-1/ /3 rA 'cis- 0u+, » 0, 4-i .P—i9 no it) CC /2_E- tic, ,P753-7 Soil Map Unit rei-c 7./ ? Y66 /5- 76 ?' 7 (6,6 7c73 DAixEP OVED TORM•13Th7M$ ) 4( xi XIS C �o �rrorti .,.,., /37 ?n0 Ping 0 10 LW / - /h e FS /a a' / / ao f 3Lulr-v/ 1 - ' / n/ a t/ s . n?/J 96/ g� /p : and Jo n0T]a301 t/OF/ -,//,''st/ ryb/Of : neu] rn tLC/r2/y/S_!' (.it//-,-7 /rY/ : Jaaui8u;7 S •�N �z/10 >rPcri // Cl %Ifir 17 / f 2/21e70 _ .X8. ?3�--J�.—_—_— --- l `d al90 -)1/_L -unT ]d i 00 I A72(1( 5.61 taiga," -ta]eH I TII T S Foetus, 'naTB Dunns /JP 1' 'Ilion • A9T3___ y]daa Aaoapau ___, naTB O yadau •naTa y]daa aa]anpunoJ0 d? 7q y oa / ill an iii Ta' Taan uoTioTiooa(1 TTos ij ]aal a /]Tl lea,) naan a(o __�,_,�,, ��- aloll 30 y.l loll IA_ff. - _.._ • A ' nala Inutnap '01011 • oJai y?nT/oIW Q' d/ yauT uTW1d/7/ CV /' _ . s���1�- (nil�l sT) ( uyu 51 ) unjaurna05 _ 9 9 _. esJ am T.1. awTS,__ Elul lwall t L OH 1a8,1. //1 e . Thai iinTieTCYl as .3,tsN/s1-71 /YJOscJ/epcf/�z /tJ. —Cf/. Patel P3 (l !a�cT�l /Yytrj� � <a•n Addimxl✓f.Na 4./ 9 ! /44.6C s5•/ 'riC. /�'O L?°' Aedm:or fa Na /UO/ On site Revjety c L�, r/i 2. shy/204r c 'oo w. t •Su,'✓/tu7 / „'t(/'Y 51."1 4 / Dail Iliga ;S`/7n.w xw.xwa._ - .,,P xon xame.. aat• n�._._ w..uW g,S� w w t v l.D%! /= [4..j% ter i...sc.. - S O ti ,c' NO 4 il I n d wry.m.0 eP_•x. .4I— i 0 .surf Sum. .� ,rt^! a •auewl Qbt-47- X I-ttU LL-44-/.4./ v.au L.mlmm /it/r/(-I 4-6/ 12.02./.014 YCI 1J MI I .. dO 7./.,/-/ L/f(/ ....f PeviloP nna.um lama. N an - yl 'dMon.I OAdP..P.4k ttltm the bkckl - - ont 1 no V ,�tT el 1 me. OP W Nr B0 I..t 01610•00 W1Y l'. ,�� at xfN , .4-/9/2- CI —�r��f-I.at w.P•m u.. ,�/l,..t Alln_- oPUiW.tw best a..Mw•x+:v n•! Possible WtAn�LCi /Dt�S.WHIM ✓V In 0th., In met DtNtNOw.utWW�--• I.N o1..i N NW;WtivW.L /.. ..Iwt Other --J-; / / i 74- ' -• - DEEP Oas lYATLON HOLE LOG a._ L)EP.O85ERYA710R HOLE tOG• .• y�y MMMwn. WN.. - Ina"..••••∎"•Mi+•.w.•. r.♦ Yi.b M+i M twW q...y.i.r�. Cr.i..�at. - Wn M�1 c -fl' 4-v !y a6 s z,)-77 iuG/, 2 el w 2•SJ /-4°4V CG.i4' Lv5 a l07 - f«[J f 1 5 C 7e . 1 i_oas ///G/1 4 // / aG • S L S-�ov� • SAN ° mwwi egUr ff4 j s..a.a 0 N/ n - .•..,■.wi.-w.w /#.12 /¢y /-:•, w.wt-art/U/4 . f:w,y w vww.aw , 'wr.r.• h•°1 .. ...—......-......a ma u.a w...- . . . . 2 f -b/.i> ' //A/7 /tetajlra /4472-4 (,5 779 FORM 12 - PERCOLATION TEST • /98 5//06541-1-1)An )cation.Addr-ess or Lot No. at s 4 ,1-i . • id fil4 COMMONWEALTH OF MASSACHUSETTS 706/2-77-moi , Massachusetts • Percolation Test' Date: - V )c/ _I" Time: SI1111111111111 1111S111111111111111 SIM I . MININS INS Observation Hole te / 7 / 0 _35- SI 111111110ES z, 0 Rate Min./Inch • Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed [IV- Site Failed 0 Performed By: g_c_athA J fikae-4-1 /71 5 Witnessed By: .94 /(-1 he145tti/0 Ic &Ai A6'get.) r Comments: , DEP APPROVED FORM.11107115 -Address or Le( No 05.1W 11 VALUATO g e /v 9?Zt 84- S� 30 /90 sy U/ 5 /2- R o NO, - 1//1-/14 / tJ ` J ftl!fl Dete �,.th observed standing in observation hole_...__,— inches , 40-71)-f . th weeping from side of observation-hole inches !7 `7 le-/f m'1— Depth to soil mottles.,__—_._inches • /20 " Ground water adjustment —_ feet Reading Data Index well level iertt factor. • Adjusted ground water level — »--,--"-- �f Natucc urrin )oes at least four feet of naturally occurring tbs.erved throughout the area proposed for the f not, what is the•depth of naturally occurring Pervious Material pervious material exist in all. ar 'soil absorption system? pervious material? T/g Q /5-- cer ify that on 7//7 (date) I have passed the sail evaluator examination epproved by the 0epartmentof rivironmental Prote ion:and that the'ebove analysis Nas performed by me consistent with t aqui Sing, expertise and experience described in 310 OMR 15.0 Li . . _ Date aG /y /41 ` )-0/5— - . - 4n 99S WMINTYO6 1PM7/1S911MU . g / (It $ /ve7✓eti i- 1 y _ _ , _ F4 q T C WO 51,,,,,..E.-A. Imo.H w SMht$ 1 .m �� fI i�iov�i f � ` © cwwwn lma �wJ..4y /.rby, WAR W MO N NORTHAMPTON, MASSACHUSETTS • _._._. • MEMO RA "I � _. 1 ARMAND R. k ROSEL A. L&PALME i PIr, , - HWQ Y+q must VW i r a _- O) _ \�% -._.I � xmanl.ulOMMO LIMD OIR{Md1H l 1 ---' m nusYnts µxPnar-MuRwnRem ._._• 2578 ACRESt \\\\ HmmR./H.WE, i HET u e _.�wA9.^N_._. `._._ aMPRM RIMIm A\\5.IOTA M LIMY a AMMO It MD RO .A -" yam` t_MML, n113EPAL]!! 4,'.'M-..-�, / \\♦ • I \ \ • HaHwnmrxnn WEAL Myolo.! �{`�1,4I y, \\\ lI xj,(rdpl YM0 COMIMMM IYT MYXIPOT jll� J A>. \ ➢[RMTW VIg1 YMMY 4HCI.wK iro] \\ MIRM�YyLMIR M pRpMMMNI ,_.a.t M to VMW I \\ MRM..WYeRITIMICIW . ' r NRCWIIDRMIT+V WRO•WIW . In•r�„/ 1 4 ,1 CIS S:' MA ME MEMO 000111 TO TCo ma ono PWUROrMI1a I �`I� SAUEY II 1 � - - SE?Mx it. 1 1 swat H/inM KR 15-5/111005 RD Tv ME lI vM/M I IOMI THAT HO NMI MS BEd PROMS w GOdMtt fin MOM tl wi wr/A wvunw<^° " .• q. T I OWE 945-14 4 PRyWROxu WMEnna