275 Soil Eval Form & Site Review FORM II•SOO.EVALUATOR Foul
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FORM U-500 EVALUATOR FORM
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FORM 11.5011.EVALUATOR FORII
Page 3 of
Z75 *lieu rr
Determination for Seasonot High Water Tate
Soh observed lbnding N obseIvatpr hope te.rats
Depth weeping from side of observe:or hole Inches
Depth to soil mottles )Tp"+rzhes
Ground weer adjustment lee:
I Number
o rotor
Reeding Doe Indee well lever el
Adjusted grand waver love; ?/fe
Ni•uralle Dc01'nn0 Pe'viou MA•e21
et at least out feel cf naturally occurring Devious meteraI ease a eYy artei
amid throughout the wea proposed for the sod ebsorptan system' l ere
io1.what 4 the depth of naturally ecarcng pev ous mater!DP
ign
or
Miff that on Jul 7,5 Idet)1 hays eased the sod Nalmlor enema}on
proved by the e»rtmentol Eiwironmentil Protection andMM the above analysis
Is performed by me consistentwith the«oerzd Wing,nperVse and etpenence
scribed 0 310 CMR 15.017.
Signature
leflertarlaotri Nis
Dale -it- t
Location Address or Lel No.
FORM 13•PERCOLATION 7eST
Z7r bSov«a C
COMMONWEALTH OF MASSACHUSETTS
Nd2Tfr` iv r p/✓ ,Mssnchuutts
Percolation Test'
Cate: ?.., r.....01, Ta
Ob:ee:alron Hole I
Depth of Poe
5c to
Stan Pinola
Qr O
I
End Prrsoie
Time it l7•
Z7 64t
Tdnae r
lA/ 10 my,/
Time a S'
M'tk Nei /A714
vine?...
Time IS•B•I
ftele ada.flnth
Z M94/1
•Mono of 1 percolation test mull be pmlo mad n both the;limy■n AND
num meal
Site Passed LI1' 5de Failed 0
PNIond ay: n- CAFfa4
Wdnesled Br , e r t a /E"e/Pt LA
Commis:
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Lift addlgrLot )
Date
Q75 }-o- ^--
ti � 16�6 � 1
PERCOLATION TESTIS)
Time:
Time:
J
Observation Hole
#1
Observation Hole
#2
Depth of Pere
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 percolation test must be performed
in both the primary area AND resew area.
SITE
PASSED
SITE
SITE -
PASSED
SITE
FAILED
FAILED —
—
Performed by
1 Performed by
Witnessed by
Witnessed by
Comments: