Site Reviews iI( fos--7. rzi
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PERCOLATION TEST(S)
Observation Observation Hole
Depth of Pero ® Depth of Perc
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SITE FAIL 4 %■ SIT • .
PASSE4. �. : FAILEn E` ."31TE' : .;,.:..
Performed b PASSED b f .FAI�.EF14
Witnessed b - Performed b
Witnessed b -
NORTHAMPTON BOARD of HEALTH— Title 5—Site Review
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DEEP OBSERVATION HOLE LOG*
IIT:1flUil OF Ti'.O HOLES REQUIRED AT EVERY PROPOSED❑ISFOSEL ARE
ISpUSDA re A®
u / 4
1afedat(9eabgic) '-
a groundwater.Standing Water in the
Aunated Seasonal High Ground Water
Hole S:
th torn
e Inchhhes)
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DEEP OBSERVATION HOLE LOG*
*MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPO�
So l TexWre
USDA �®
Location Address or Lot,#`
Date more clam.=
PERCOLATION TESTIS)
Observation
® Observation Hole
Depth of Perc ® Depth of Perc
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SITE .. _ . . . . . _ .
PASSED �i SITE. ■ SITE PASSED ■
SITE
ED PASSED • �- SITE
FAILED
Performed b
Witnessed Witnessed b
b -
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NORTHAMPTON BOARD of HEALTH- Title 5- Site Review
e#:
DEEP OBSERVATION HOLE LOG*
9d1NIL.Ur1 OF WiO HOLES REQUIRED AT EVERY PROPOSED Q15PCSAL
1,USDA
Texture �® _•. ,_
Depth to Bedrock
weeping from pit Face
AREA
Aateriai(geologic)
'groundwater. S
Sated Sea
Hole#:
th from
e(Inches)
a
D
rdleg
S
nt Mate (geol°g'c),
to grourdwa ter
n$.
Estmated:Seauraat
w
el
DEEP OBSERVATION HOLE LOG*
IN IMUId OF MO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA OMer
USDA
Soil Color Structure.5tones,BouOthe,Consistent ,%Gavel
Soil Munsell
USDA
[>epNto, , lrerk ..
Weep ebn Pit Face
On-Site Review
idress or Lot# �A '2: •—f--
—, 7,. ..l 1 { C/
Date _I
raring Firm 1-1-g,o r�'6rM-
on Slte Plan
nd Use
gelation
rndform
n Landscape
Ownera
c Eng' or Sanitarian
c—
Time
Slope%
Address
Weathe
T Surface Stones
Distances from:
Water Body
ole Wet Area
Drainage Way
tole
from
iche
DEEP OBSERVATION HOLE LOG*
'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Soil Horizon Soil Texture
'USDA)
Material(geologic)
1 to groundwater. Standing Water in the Hole?
Estimated Seasonal High Ground Water
Soil Color
(MUnselp -
11 crI3'y
2S7 �� '�
f /ootayd ,.
Soil Mottling
Other
Stones. Boulders C ns sencY '- Grassi, �II
'1s r I
p Hole#
gtn from
nchesl__
I �
ert
C
/71 -rte !,
I Depth to Bedrock
Weeping from Pit Face
n
DEEP OBSERVATION HOLE LOG*
'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Other
Soil Color Soil Mottling
(Monselll _ _ ' (Structure.Stones Boulders Consistent %Gravo)
Sail H Soil Texture
(USDA)_
� c5
L
dent Material(geologic)
apih to groundwater. Standing Water in the Hole
Estimated Seasonal High Ground Water
i err
57 V(
1 y(-) >YyL i Y.
Depth to Bedrock
Weeping from Pit Face
-r _ 7,71/1/
On-Site Review
Owner \
-- - Address
Locat ooA Date or LOt# 3,- �-y 1- --— W afher / f
Dale Time �Q f. ', --el'e. •,
-+ Engineer or$antanan
Engineering Firm �6W.,, 11 IU('. r -- - -
Identity on Site Plan C. - - -- - - - - ---
- 1 t Slope% I rSudace Stones l
Land Use
Vegetation
Landform —_— ___ - __ -_ --
[PostonOnLandscape
Distances from ___
_ I feel Property Line
I Open WaterBrea fl feet I Drinking Water Way - feel Other 1i
Possible Wet Area I feet I Drainage Way
DEEP OBSERVATION HOLE LOG* -I Deep Hole #: 'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA •
Morning Ogler
-
J'011Irom Soil'legion Soil Tenure Soil Color Sod IS, ciuleSIOnn 13 Id.rs r.onSe ' ^-'
Inc ur U Unit,:SDAI ueu r
d - .) R L 1 O 3/3
: , ^ — Y ef--
2 - 0 0•
i L , 1 Li/••v / SJ _— -! � '
I
Li 1 It Parent Material(geologic) Depth to fieoch,__ I
Weeping from Pit Face
I, Depth to groundwater. Standing Water in the Hole I I �-� _ -
9... l%�
Estimated Seasonal Hi h Ground Water, �
DEEP OBSERVATION HOLE LOG*
Deep Hole#: MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Sod Horizon Soil Texture Colo. Soil Mottling
other
n (USDA} (Mug 'ill
(Structure. Stones Boulders.COnsslevr,
\ I ` DePlli toBWeeP 91 our PS Face —_
gig later In the Bole
standing ( —_-
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