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254 Perc Lot 4 2019 CITY of NORTHAMPTON (-o+ PUBLIC HEALTH DEPARTMENT Public Health Director-Merridith O'Leary A Municipal Building-212 Main Street-Northampton, MA 01060 Phone (413)587-1215-Fax(413)587-1221 http://www.northamptonma.gov/245/Health Perc Test/Soil Evaluation Form Property Address: o`� IISB Owner's Name: Date: Performed by: 0411". t �L Witnessed by: 96 {� f F y C V No. of Bedrooms: <�n �w� Y lot' Garbage Grinder? Yes F'Notr f Fee Paid? Yes No Sketch`of propertyA andil`ocation of deep holes/perc(s) �r Percolation Test 77F Perc Hole# 3 4 Elev: Elev: Elev:! Elev: Start pre-soak . -� l 3 End pre-soak H 3 Time @9" �. ,. �.° � ��•.� � � '€ i 4+� s ' Time @ 6" C �Y/�� -� 3? i s x 0 5 ey-IT 7� ��tJ�' 1 � ��� � li � � �-. �. •s � �}'.a' ; €. y t a {: Elapsed==time "` U o L ; . .i'.. 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