361 Site Reviews I
PERCOLATION TESTIS)
Time: Time:
Observation Hole #1 Observation Hole #2
Depth of Perc z Depth of Perc
7s
.Start Pre-soak s L,+- Start Pre-soak
End Pre-soak - End Pre-soak
1/- Time all-2; S Time at 12"
Time ate:" c 1 / I .� Time at 9'
Time ale' l . , J Time at 6'
Time(9'-6") - Time(9'-6')
//
Rate Min./Inch I I. / Rate Min./Inch
3'minimum of I percolation test must be perfomied in both the primary area AND reserve area.
• • ' ior • • ' - . " - •
Performed b af,; r L_1ee.,p Performed b
Witnessed by , 1n9 � / q Witnessed by
Comments:
•
On-Site Review
tionAddress or Lot
Date
Engineering Firm
,ntity on Site Plan
Land Use
Vegetation
lyV__ n'
Owner
S-iP.rP c. t})
Address
Weather
?pth from
ice(Inches)
Soil
</
Time
FNr
Soil Mottling
Engineer or Sanitarian
pi �" ,_
ir"
�t
Slope%
Surface Stones
Landform
on on Landscape
/pen Water Body
ossible Wet Area
feet
feet
DIstanfes from:
Drinking Water Well
Drainage Way
feet
eet
Property Line:
Other
fee
fee
p Hole#:
DEEP OBSERVATION HOLE LOG*
*MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
DEEP OBSERVATION HOLE LOG*
MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
:pth from
ce(Inches)
?pth from
ice(Inches)
Soil
Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil Mottling
Other
(Structure.Stones, Boulders,Consistency.%Gravel)
I
-
Ell-2 7
r
" 1, ,7l
It Material(geologic)
l -
_
- -
r to groundwater. Standing Water in the Hole
Weeping from Pit Face I _.
it Material(geologic)
Depth to Bedrock
h to groundwater. Standing Water in the Hole
Weeping from Pit Face [ _�1
<—s'--
Estimated Seasonal High Ground Water
_,
p Hole #:
DEEP OBSERVATION HOLE LOG*
*MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
:pth from
ce(Inches)
Soil Horizon
Soil Texture
(USDA)
i-- __-)
�v
Soil Color
(Munsell)
1t
Soil Mottling
Other
(Structure,Stones,Boulders,Consistency, oh.Gravel)
'
___
It Material(geologic)
Depth to Bed pelt
r to groundwater. Standing Water in the Hole
Weeping from Pit Face I _.
Estimated Seasonal High Ground Water
PERCOLATION TEST(S)
Time:
Time:
Observation Hole
#1
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
percolation test must be performed in both the primary area AND reserve area.
Performed by
Witnessed by
Comments:
IPerformed by I
Witnessed by
I
/4
n
- Title 5 - Site Review
Address or Lot ft C r Owner 5 !p� —,,
-t i
Time
f
Owner's
Address _
3 & I I
(l/
/ ' oi g
--5-// '
from
Soil Har¢on
Weather -
Phone ti
Use
Soil Texture
(USDA)
di
%Slope
Surface Stones
L
I l) `∎:'
1O
id
/y
V station ,,,r ,._ .0 Start Time CI/30 4--
idform
mon Landscape(sketch
rater Body
on the bark)
feet
Distances
Drinking Water Well
Stop Time
feet Property Line
feet
e Wet Area
feet
Drainage Way
feet Other
feet
41
I Weeping from N Fare
DEEP
ole#: *MINIMUM OF
—0-4- ca-- DEEP
e#: I — I 'MINIMUM OF
OBSERVATION
TWO HOLES REQUIRED AT
Sod Color
(Munsell)
HOLE LOG*
EVERY PROPOSED DISPOSAL
Soil
Mottling
AREA
from
Soil Har¢on
Other
(Structure,Stones,Boulders.Constency,%Gravel)
MI
ewes)
Sun Horton
Soil Texture
(USDA)
" I
C12
�i
L
50-144
S
L
I l) `∎:'
1O
1> ) c7' C
/y
3
I Dephto Bedrada
I
I
Standing Water m the Hole
I Depth to Bedrock I
Weeping from Pit Face
- ater
Seasonal HO Ground Water
Mabial(geologic)
Standing Water in the Hole
41
I Weeping from N Fare
I
/r/O /.I K'
anti.'to groundwater.
Estnated Seasonal High
Ground Water
T 2) ,.
DEEP
ole#: *MINIMUM OF
OBSERVATION
TWO HOLES REQUIRED AT
Soil Color
(Munsell)
HOLE LOG*
EVERY PROPOSED DISPOSAL
Sol
Molding
AREA
Other
(Structure,Stones,Boulders,Consistehcy,%Gravel)
from
Soil Har¢on
Sot Texture
(USDA)
Indies)
117
"qto)
I Dephto Bedrada
I
I
Standing Water m the Hole
I
Weeping from Pit Face
- ater
Seasonal HO Ground Water
/
1 :s
PERCOLATION TESTIS)
Time: Time: —
Observation Hole #1 Observation Hole
V 51 #2
Depth of Perc
��.,,pp /,f Depth of Perc
Jw! d Start Pre-soak 1 f 9 Start Pre-soak
1
,k� End Pre-soak
L End Pre-soak
3 Time atric
I/ ; I r Time at 12"
D d
Time at •'
/) 3 i Time at 9"
Time at 6" p 5 1 Time at 6"
Time(9"—6")
/Uj z Time(9"-6^)
Rate Min./Inch Rate Min./Inch
'minimum of 1 percolation test must be performed in both the prima area AND reserve area.
• • • •
Performed b
Witnessed by Performed by
Witnessed by
Comments:
dress or lot N
NORTHAMPTON BOARD of HEALTH- Title 5 - Site Review
Time
Owner's
Address
Owner
Weather Phone
Use
form
ta Slope
Surface Stones
station
landscape(sketch on the
ter Body
Wet Area
feet
fee
Distances
Drinking Water Well
Drainage Way
Stet Time
Stop Time
30 4-
feet Property Line
feet Other
feet
fee
L
V
Soil Horizon
y
DEEP OBSERVATION HOLE LOG*
'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Soil Texture Sod Color
(USDA) (Munsete
)C„j_.
I
(SWdure,Stones,Boulders,Consistency,%Grovel)
afria (geobgic) I
Ph to gmun&Rater. Sanding Wader in the Hole
Estimated Seasonal High Ground Water
LI
Deppto Bedrock
Weeping from Pd Face
Ill
le#:
DEEP OBSERVATION HOLE LOG*
*MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
om
aches)
dTe are
(USDA)
l)
Mo
Other
(SW Wre,Stones,Boulders.GorStency %Gravel)
t Matta!(geoldgk) I
Depth to groundwater Standing Water in the
Estimated Seasonal Hqh Ground Water
Depth Bedrak I
weeping from Pit Face
K�o2
!IC7a iitii, ,v rhz , e otr. :) IMEMMINEENWRIMI
PERCOLATION TEST(S)
Time: Time: —
Observation Hole
Observation Hole #2
Depth of Perc 56 ,i Depth of Perc
Start Pre-soak
End Pre-soak !
®illiall Ende at 12' II :3 Y
Time at 12'
® Time at 9' �
Time
Time at 6' iii
Time(S'-6') �� i G
Time (9'-6 )
® M
Rate Min/Inch
—�.....•.uue
Performed b
Witnessed by ® Performed b
Witnessed by
Comments:
■
TON BOARD of HEALTH- Title 5- Site Review
dress or Lot#
I7D��� r r a Owner
9 ///,,,
��� I�� '
Time
a
owners
Address
-� N..� , L ,
r, ,,
r' /
-.).2247. �..
,
•
Sod Tetbre
(USDA)
Weather
Phone#
I Use
NJ"5'S ,f,,j,-
7.Slope
Surface Stones
i
form
51 LII2
V station Start Time
on Landscape(sketch
en the back)
Distances
Drinking Water Well
Stop Time ; 6
feet Property Line
feet
ter Body
feet
Wet Area
I feet
Drainage Way
feet Other
feet
M bbl iidwalex.I Water In the Hde
Estimated SeasaW High time
eff.
�2—
dies)
Sod Horton
DEEP OBSERVATION HOLE LOG*
*MHRMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Sol Tarim Sal Color
(USDA) (Mosel))
Sd
(Seucire,Stones.Bouloess Conaatency,%Gravel)
ply
(q is) I
pth to groundwater. Standing Water in the
Estimated Seasonal High Ground Water
Depth to Bedmd I
Weepbg from Pe Face
DEEP OBSERVATION HOLE LOG*
#. I •MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Soi HOrimn
Sod Tetbre
(USDA)
Soi Color
)Mundt)
Sal
Mottling
Otlier
(Structure,Stones,Beuldere.Cons. Gravel)
es)
)
A
i'A
i
/
51 LII2
) 5 p
ti
DapN b Bedrock
I
M bbl iidwalex.I Water In the Hde
L,
Wee::i:from Pit Face
I
/t0_0
Estimated SeasaW High time
eff.
�2—
dies)
Sod Horton
DEEP OBSERVATION HOLE LOG*
*MHRMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Sol Tarim Sal Color
(USDA) (Mosel))
Sd
(Seucire,Stones.Bouloess Conaatency,%Gravel)
ply
(q is) I
pth to groundwater. Standing Water in the
Estimated Seasonal High Ground Water
Depth to Bedmd I
Weepbg from Pe Face