38 Site Suitability 2009 On-Site Review
T.P.#
Deep Hole Number: ft i Date: 4—,71-—o% Time: m Weather: 5 „'h;2.
Location(identify on site plan):
Land Use:
Laodform:
Distance from:
TP1
Vegetation:
Position of Landscape:
Open Water Body
Possible Wet Area
Drinking Water Well
Slope(%):
Surface Stones:
Feet Drainageway
Feet Property Line
Feet Other
Feet
Feet
Feet
I
Depth from
Surface
(Inches)
Soil
Horizon
Soil Texture
(USDA)
Sot?Color
(Mansell)
v Soil V
Mottling
Other(Structure,Stones,Bou
Consistency, % Gravel)
Other(Structure,Stones, Bo
Consistency, % Gravel
D — IC ''
to -non
2.l ''
L / - l�
,q
73 Lt.
Li
Ca
5/(,
45
y5
3,t,o) IED
�o .,2sE
iorZ
V - 3
«1112.
5_1
,�
NaNe
iii..
5 .1
Ic% 6ea;M
� 33 ( 6tss
MASS✓E
F21.tALr
Parent Material(geologic)
Depth to Groundwater. Standing Water in the Hole:
Estimated Seasonal High Ground Water. Weeping from Pit Face:
Depth to Bedrock
TP
Depth from
Surface
(Inches)
Soil
Horizon
Soil Texture
(USDA)
Soil Color
(Monsen)
Soil
Mottling
Other(Structure,Stones,Bou
Consistency, % Gravel)
7
CANF
; 2 111 /trio ,\ 1
. / 51
Parent Material(geologic)
Depth to Groundwater: Standing Water in the Hole:
Estimated Seasonal High Ground Water
Certification: I certify that in I passed the soil evaluator examination approved by the Department of
Enviromnental Protection and that the above analysis was performed by me consistent with the required training expertise and
experience described in 310 CMR 15.017. SE Certification if
Depth to Bedrock:
Weeping from Pit Fact
Signature:
Date:
t Number:,
red by:
a Inspector:
NORTHAMPTON BOARD OF HEALTH
212 MAIN ST., NORTHAMPTON, MA 01060
TEL; 413-587-1213
Site Suitability for On-Site Sewage Disposal
rLy sic2v
£ueN �Or , Not
//,� Site Address
A,V1Y +0 '. DV 7— V��1i
3B MM'cc= �-'
JN okTN-4v"el-oN .i�4 New Construction n
O/O bD
T.P.# -
3—y r1
44 1 4
-t
Date: —2 7 —0
Equipment Operator: $; Lt, 5 ,
Client Name&Address
7/9,)76
Office Review
shed Soil Survey Available: No n
ear Published Publication Scale
alai Geologic Report Available: No rz
'ear Published Publication Scale
I Insurance Rate Map:
hove 500 year flood boundary it
and Area:
lational Wetland Invetory Map(Map Unit)
ent Water Resource Conditions(USGS):
'ange: Above Normal a Normal s
r References Reviewed:
Yes a
Soil Map Unit
Yes n
Geologic Material(Map Unit) Landform
Within 500 year flood boundary it Within 100 year flood boundary n
Wetlands Conservacy Program Map(Map Unit)
Month
Below Normal it
Drainage Class Soil Limitations
Perco a o
:olation Rate a..0 ynvf onGN Bottom of Percolation Test Hole:
:om of Percolation Test Hole: (5-,).."
Determination for Seasonal High Water Table c/,/
hod Used o 7 inches
Depth observed standing on observation hole,inches ❑ Depth weeping from side of observation hole_
Depth to soil mottles inches ❑ Ground water adjustment inches.
:x Well Number Reading Date Index well level
ustment factor Adjusted ground water level
nh of Naturally Occurinp Pervious Material
6M b / ,t vet_
:s at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil
option system? TP#
es,what is the depth of naturally occurring pervious material? TP# '
ot,what is the depth of naturally occurring pervious material? TP# TP#
rercotanon
lcaaa —
Time
Measurement
Time
Measurement
�y�l
Begin Saturation
Sattuurationn
End Saturation
epth
&
9 depth
Measurement
surement
J S�
6"depth
Measurement
surement cement
'sed Time
3',5-
Elapsed Time
9"to 6"
ti n Rate'
Perco a o
:olation Rate a..0 ynvf onGN Bottom of Percolation Test Hole:
:om of Percolation Test Hole: (5-,).."
Determination for Seasonal High Water Table c/,/
hod Used o 7 inches
Depth observed standing on observation hole,inches ❑ Depth weeping from side of observation hole_
Depth to soil mottles inches ❑ Ground water adjustment inches.
:x Well Number Reading Date Index well level
ustment factor Adjusted ground water level
nh of Naturally Occurinp Pervious Material
6M b / ,t vet_
:s at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil
option system? TP#
es,what is the depth of naturally occurring pervious material? TP# '
ot,what is the depth of naturally occurring pervious material? TP# TP#