Lot 2 & Lot 7 Perc Test 5-3-19 C114)-City of Northam P ton Board of Health 2017 4" ‘"1
212 Main Street
raTNINorthampton, MA 01060
413-587-1214
PERC TEST WITNESS FEE
$200.00 per 3 hours
Permit Number:
4.75.00 per hours after 3 hours
Fee Collected: WO 64) E'S ARE NON-REFUND -- -
Pere
.,_. -
Perc Test Date:
APPLICATION MUST BE SUBMITTED 10 BUSINESS DAYS PRIOR TO THE SCHEDULING OF A PERC TEST IAA.a
Application for Percolation ("Perc") Test
Date of Application: q/igI 19
Home Owner Name:
�JO AI tdet5.5 NCO 't(1. 1347,c(ctrr.P Dios/r/
Address: C L 12 Cm re-Z cLd . �} , Lb 7--
City/Town/State/Zip Code:
SOIL EVALUATOR LICENSE NUMBER:
R.S./ Engineero 3 3
ADDRESS -- ., - .-. ... „�,. r�*--•-was_
PHONE 1111111011=M114 41116._ 1111
E-MAILINIMEMIleffargiierv.„R,„.- - I
EXCAVATOR
lack-hoe operator
ADDRESS 111,
11111.11111111111111
PHONE 41111111.11
CHECK LIST
Id/New Construction
❑ Repair/Upgrade
***Number of Lots to be Perc Tested—New Construction only-Give Lot Numbers***
0 Dig Safe Sign-Off: Gas/Electrical
0 Trench Permit/Info Sign Off from DPW (413) 587-1570
0 Conservation Commission/Planning Department Review
Contact the Planning Department(413)587-1266 for the Conservation,Preservation&Historic Planner
Prior to the Perc Test for review any possible conservation commission issues relating to Perc Test.
0 Conservation Sign-Off
For Board of llcahh Use Only
r he
.� Berkshire
Design
Group.Inc.
• PARkJIJC• AREA (IG hPAC.Pfi) �/419
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LAT a 1 i • (I)CALL TowE.jZ Lor 174 402E5
(34-,2405F) l •(I)Gci.f•NOL.E j
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(�1. ice. /i \�-'----,______._..\.\ C� / Pine Grove Golf Course
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y , ,- ! VERNAL POOL
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ZONING TABLE
City of Northampton Board of Health
t 212 Main Street i l 7 19
:�
�'- Northampton, MA 01060 o d WI( Sbr ("La
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� 413-587-1214
Lgdjcttem4 +0 G utb housc.)
Percolation Test Results
Pere I-I Time Measurement Pere 1-2 Time Measurement
Begin Begin a$ $ „
(�u
Saturation 3 U/ Saturation _f '
End Saturation
'1 . s 6i ,& noa-
Saturation
9"depth 9"depth
p
Measurement f • 3 Li Measurement 'O, (j 50 a k
6" depth 6"depth
q: Liii
Measurement Measurement
Elapsed Time Elapsed i
9"to 6" I0r`n Time
9"to 6"
Percolation Rage Weriadile - 3, 3 meq prt Percolation Rate: Lai- 'n I'^
Bottom of Percolation Test Hole: Bottom of Percolation Test Hole:
Determination for Seasonal High Water Table
Method Used: Depth observed standing on observation hole> n..eepth weeping from side of observation
hole 3 io inches
ml-Depth to soil mottles 30 inches ❑ Ground water adjustment inches
Index Well Number Reading Date Index well level
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area
proposed for the soil absorption system? 1413
If yes, what is the depth of naturally occurring pervious material?
If not, what is the depth of naturally occurring pervious material?
On-Site Review
Deep Hole Number: Date: si17j19 Time: clam Weather: Cool & Overcast ✓
Location (identify on site plan):ae IQ tit 'FO (tut b how{
Land Use/Vegetation: Lawn/grass - ply' Cp,CS(, Slope (%) Surface Stones: none v'Landform: �J
Position of Landscape:
Distance from:
Open Water Body Feet Drainageway Feet
Possible Wet Area Feet Property Line Feet
Drinking Water Well Feet Other Feet
DEEP OBSERVATION HOLE LOG
Depth from Soil Soil Texture Soil Color Soil Other Structure, Stones,
Surface Horizon (USDA) (Munsell) Mottling Boulders, Consistency,%
(Inches) Gravel)
(} - q AI rSL 107e. 3/i
q - de 6 r5 to 'it C/to
`3,°— (I0 Cd 5 10 V 14no 30
SAPS e 3to°
DEEP OBSERVATION HOLE LOG
Depth from Soil Soil Texture Soil Color Soil Other Structure, Stones,
Surface Horizon (USDA) (Munsell) Mottling Boulders,Consistency, %
(Inches) Gravel)
0—IO " r r5L IDYL 312
(o -30 6 Gs ioytCito 30"
? o - I 0 C S -1.5 SI'6 se-cis e34,0
Board of Health Inspector: �jC l £(li 54-ett(l
Witness: MO uu l U
pm
o City of Northampton Board of Health
t 212 Main Street
`• Northampton, MA 01060 5Ii-i1t'
-,, ,,,..9.,",-!2 413-587-1214 Ota LA, ; \.Son C3
i-rmA(( of -ReidPercolation Test Results
Pere I-I Time Measurement Perc 1-2 Time Measurement
Begin Begin
S.Saturation �� 3o Saturation
End Saturation End
1� o Saturation
9"depth '1 9"depth
Measurement w VUG Measurement
6"depth 6"depth
Measurement Measurement
Elapsed Time \ \ Elapsed
9"to 6" Time
9"to 6"
Percolation Rage <2 min./in. Percolation Rate:
Bottom of Percolation Test Hole: Bottom of Percolation Test Hole:
Determination for Seasonal High Water Table
Method Used: Depth observed standing on observation hole> o Depth weeping from side of observation
hole 3ia0 inches
1Septh to soil mottles I CO inches o Ground water adjustment inches
Index Well Number Reading Date Index well level
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area
proposed for the soil absorption system?ii1 S
If yes, what is the depth of naturally occurring pervious material?
If not, what is the depth of naturally occurring pervious material?
On-Site Review
Deep Hole Number: Date: clo I19 Time: $.3YXim Weather: Cool &Overcast V'
Location (identify on site plan):
Land Use/Vegetation: Lawn/grass.- a01 t^ (Om S{ Slope (%)trugirngl Surface Stones: none ✓
Landform:
Position of Landscape:
Distance from:
Open Water Body Feet Drainageway Feet
Possible Wet Area L 92° Feet Property Line Feet
Drinking Water Well Feet Other Feet
DEEP OBSERVATION HOLE LOG
Depth from Soil Soil Texture Soil Color Soil Other Structure, Stones,
Surface Horizon (USDA) (Munsell) Mottling Boulders,Consistency, %
(Inches) I1 Q Gravel)
0— l0 i,}+8mix r---3L love 3/a
10'- 10 ) C, F.SL a art ill, iv r%
g. 0 mi,
-frs 1 rla seep e as ,t
DEEP OBSERVATION HOLE LOG
Depth from Soil Soil Texture Soil Color Soil Other Structure, Stones,
Surface Horizon (USDA) (Munsell) Mottling Boulders,Consistency,%
(Inches) Gravel)
a-13 flt6rolx 1%S1-- 10 Y2 3)2
3 -tzo C . FSS Q S / Y JI rsrla
Ito"
, >'Y4Il1 5 , e,, lel*
i. 5? Iq
Board of Health Inspector: Br €t CtiSiaL d-i
Witness: MA11 weiSs