Lot5 Perc Test 2002 FORM 11 - SOIL EVALUATOR FORM
Page 1of3
No. Date:
Commonwealth of Massachusetts
, Massachusetts
Soil Suitability Assessment for On-site Sewage Disposal
Performed By: Melo ° SO"
Date: /414 c6
� . 2a>. 2aZ
6
Witnessed By: ./ e f cr M` ..-rla/vl
l.otalion Address of c Owners Name. / a r-/k rL Va (/e�/
La/ �rop€ -the_ norf � Or nd
Tekplme f Zo7 J y l VEST¢+ R.04,4
20-1 Sylvatfcr- RaQo{ Frorancc. /4/1 0(062.
yew Construction Q'Repair 0 3-86 - 3771
Office Review ,--,/
Published Soil Survey Available: No 0 Yes Er
Year Published 19x( Publication Scale : 15840 Soil Map Unit 6-x-33 (-i
Drainage Class FxcGsswe). , Soil Limitations Pooe. F 1+e✓
Surficial Geologic Report Available: No 0 Yes 0
Year Published Publication Scale
....... ..... ........... . .
Geologic Material (Map Unit)
Landform
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑Yes E
Within 500 year flood boundary No . EYes ❑
Within 100 year flood boundary No ErYes ❑
Wetland Area:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map (map unit)
Current Water Resource Conditions (USGS): Month Re(, , 2002__.
Range :Above Normal ❑Normal ❑Below Normal Er
Other References Reviewed:
H/LLTOWN ENVIRONMENTAL CONSULTING
DTI (413) Z-96 -4-4-99 -
DEP APPROVED FORM- 12/07/95
l-E 11 fow„�nv;re.iryte.44-f4.(e. Ma;l 6*n
•
FORM) 11 - SOIL EVALUATOR FORM
Page 2 of 3
La�r� +o nor-1-k oc
Location Address or Lot No. Z07 Syfdes•4ef• Road
On-site Review
Deep Hole Number -5 Date: M"'e!('`. 2-°)240.1- Time: /0%JD Weather Clow 30
Location (identify on site plan)
Land Use ICi e.Id Slope (%) Z-3 Surface Stones Matey -89 u(de rS
Vegetation ..r.ccSSe-. , R ne , Oa k.
Landform Qy* $ .. �(^"^
Position on landscape (sketch on the back)
Distances from:
Open Water Body 200-t" feet Drainage way + feet
Possible Wet Area 2c k feet Property Line TO 6¢.Sof feet
Drinking Water Well ?IA"' . feet Other
DEEP OBSERVATION HOLE LOG*
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, %
Gravel)
o -9 .r A (5L lOYQ3/2. None er,...-.befbrtib4"
Z4-rr Mont to - ZOpo y I
ravL
24 -IZO " G 3 s l°YR513 °Ne IoOSG, 51 n91e 'rain
5a/ 9ravel eo6tie5 1'
6o�(dc✓s
• t • e • a ■e • ell • I • • •• '•••111P a •e • A• • .
•
Parent Material(geologic) O(+wc.S L Depthto8edrock: Nome` r
Depth to Groundwater: Standing Water in the Hole: 1�✓\e. Weeping horn Pit Face: 1�a INC.
Estimated Seasonal High Ground Water: 120„+ _ ---
��1
D f F DEP APPROVED FORM-12107/9S
FIILLTOWN ENVIRONMENTAL CONSULTING
r .
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
1 L
La.,4l 0 +1,c_ 00(+1A oc
Location Address or Lot No. Z07 Syl jeske.t Road
On-site Review
Deep Hole Number IP- 6 Date: M"FtL i01/tot Time: //: /.5 Weather S o(...), 30
Location (identify on site plan)
Land Use Re- lei . . Slope (%) Z-3 Surface Stones Mari/ -6ou(de-1-5
Vegetation Grc ss c c , Pine- , 04 k
Landform .0id'}w0.S�.. PI�,-r, • .
Position on landscape (sketch on the back)
Distances from:
Open Water Body 200+" feet Drainage way 2o0 + feet
Possible Wet Area 202 k feet Property Line To Be-Set feet
Drinking Water Well 2e°+ feet Other
DEEP OBSERVATION HOLE LOG'
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, %
Gravel) f
0 --7 If c5L IDYR3/Z None. -CrieMee✓ ..w
. ,i /gt�rut b�
- 2 1 /r 'L/ SL 10'1 A.5 A done �✓iA b(e, / IO- Zo% y rave-
Z1 - IZD11 9 s I0YR5/3 N)DPW_
iooSe. n
, Singe 9ra�
50 x gave.( cob4/c s cl
✓ bo�ldcrs
WI , . •a - •I • 0 I. t ..-• "0'0 1 •a
.
Parent Material(geologic) 0.4 o.S L 1 DepthtoBedrock: N0Yt
w
Depth to Groundwater: Standing Water in the Hole: I lon4- Weeping Iron)Pit Face: 1v a nC
• 120 r,+
•
Estimated Seasonal High Ground Water: — -
G ' C DEP APPROVED FORM- 12/07/95
JIILLTOWN ENVIR011t>lfENTAL CONSULTIN
•
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Lana 'lv nor+k o f 207 .5ylvts+er PA.
Location Address or Lot No.
Determination for Seasonal High Water Table
Method Used:
❑ Depth observed standing in observation hole inches
"Depth weeping from side of observation hole ......2o t inches
ED/Depth to soil mottles ..> °.:+.. inches
•
❑ :Ground water adjustment feet
Index Well Number Reading Date Index well level
Adjustment factor Adjusted ground water level
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas
observed throughout the area proposed for the soil absorption system? Yes
If not, what is the depth of naturally occurring pervious materia!?
Certification
I certify that on 4-29-g7 (date) I have passed the soil evaluator examination
approved by the Department of Environmental Protection and that the above analysis
was performed by me consistent with the required training, expertise and experience
described in 310 CMR 15.017.
Signature.% / Date 3-20—o2
D E P DEP APPROVED FORM-12/07/95
HILLTOWN ENVIRONMENTAL CONSULTING
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FORM 12 - PERCOLATION TEST
Lard -fhtMr+t, of
Location Address or Lot No. Zo-7 Sy(ve s fer Road
COMMONWEALTH OF MASSACHUSETTS
/vvrl-hamp fbr , Massachusetts
Percolation Test*
Date: r e—c—k Time:,
Observation Hole # p_ I P.2 P-3 I P-4 p-5
Depth of Perc 40 42. " 4.0 42" 45 " 43 "
Start Pre-soak 9: 37 9:S5 10;1( 10;32 Hol- (t - H
End Pre-soak 9:52 10:10 10;36
I0;47 WIT ( 1 :24)
Time at 12"
,;52. to:to 10 ; 6 10,47 /( ; 19 Ia)3
Time at 9" 19;5-7 I Io113 Io :4o 1o ; 50 I ( ;23 II '3o
Time at 6" Io ;ol 10'.l& 10:46 10 ;54 11 ;27 11 ;35
Time (9"-6") M irk S MrrJ G MIN/ 4 m,,,/ 4 MIK' 5 M IN
Rate Min./Inch < Z < Z 2 < 2 < Z < Z
Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed O Site Failed ❑
Performed By: Murk I howl p s c`,
Witnessed By: P"e�Q+- M C E ,r lath
Comments: ..Deco w v `-fr* +k.w.. VSA o r. l 4.:E%vL: ,...... D
reAPPN
,p DEP APPROVED FORM-12/07/95
HILLTOWN ENVIROJIMENTAL CONSULTING
NORTHAMPTON BOARD of HEALTH_
Location Title 5-
Address or Lot# Site
Date �.t. nr � ., Owner wilawilmiRSV%e
11111m owr,g�s Engineer 7� AddressLand Use � ��i-r..r ilimmsviiiim,Vvriswe
e .
Vegetation
Position on landscape Slope°/, Phone#
Surface Stones
(Sketch on back) Landform
ill
End Time:
Open Water Body Distances from: -- -
Possible Wet AreaaliftmDrinking
g Water Wellimminga
Drainage Way Property Line
Other
1111111111111
Dee. Hole#: ( DEEP OBSERVATION HOLE LOG*
'MINIMUM OFT /O HOLES RE
Depth from Soil Horizon REQUIRED AT EVERY PROPOSED DISPOSAL AREA
er
Surface Inches Soil Texture
41
USDA Murp Soil Mowing
- _ �- a -� ` Structure,Stones,Boulders,Oonsisten ,%Gra'
7, l i,
.._•
� 6i, - - - - - - _ _.
/13
‘tr,g-v-- 1° 1 3- 41.6ii, ArteeAioAtk
/ _
_._ _ _ _ _ _ _._ _..
i _.,,,,,, _
. • _ _ _ _ _.,. . .
Parent Material(geologic) _ _ _ _
Depth to groundwater. Standing Water in the Hole Depth to Bedrock
Estimated Seasonal High Ground Water
' Weeping from Pit Face --5 /—
Dee• Hole#: DEEP OBSERVATION
'MINIMUP.4 OF TWO HOLES REQUIREDHOLE LOG*
Depth�� Soil H AT
Surface from Horizon Soil Texture EVERY PROPOSED DISPOSAL AREA
USDA
Munsell re,Ston Soil Color Soil Mottling
Other
! _(r U G z Structure,
�_ / Y es.Boulders,Consisten ,%Gravel
a
._ _ _
Parent Material(geologic) _....5._
DePth to groundwater. Standen -
Est
Estimated Seasons!Standing
g Water in the Hole P ?,to Bedrock
9 Ground Water • _
• Weeping from Pit Pace
•
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Location Address or Lot#
Date •
PERCOLATION TEST(S)
Observation Hole
Observation Hole
11. 1
/
Depth of Perc INNII
Depth of Perc MINI
\/
Start Pre-soak 4 '
-I 4
Start Pre-soak '
ty End Pre-soak -�
0 End Pre soak 2 ; v
r 3 3 Time at 9"
. Illiallgelgalliiilli""
G.
Time at 9" G, �02/
Time at 6" W1� �,.�
Time at 6" 5 Mal �J
Time (9"-6") Wilgal JJJ��`
Time (9"-6") Min
Rate Min.ilnch 1, �-
Rate Min./Inch Z. D ((_ %—
•minimum of 1 •ercotation test must be ••rformed in both the orima area ANSITE D reserve
serve area.
SITE SITE ED IIIISITE FAILED PASS
PASSED Performed b
Performed b IINIINIIIINIIIIIIIWitnessed b
Witnessed b
Comments:
I