254 Lot 1 Perc 2019 Commonwealth of Massachusetts
City/Town of Northampton
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
A. Facility Information
Pine Grove Golf Course Toward Maintenance Building first Site 10.8.2019
Owner Name
254 Old Wilson Road Site 1 Lot 1 See Map.
Street Address Map/Lot#
Northampton MA 01060
city State Zip Code
B. Site Information
1. (Check one) ® New Construction ❑ Upgrade ® Repair
2. Soil Survey Available? ® Yes ❑ No If yes: Cal web USDA 311c
Source Soil Map Unit
Woodbridge Fine Sandy Loam moderatey well Drained
Soil Name Soil Limitations-
3. Surricial Geological Report Available? ❑ Yes ❑ NO If yes: USGS current gisYear Published/Source Publication Scale Map Unit
Lodgement Till, Kame Terrace Moraines, Drumlins Terraces
Geologic/Parent Material Landform
4. Flood Rate Insurance Map
Above the 500-year flood-boundary? ® Yes ❑ No Within the 100-year flood boundary? ❑ Yes ® No
Within the 500-year flood boundary? ❑ Yes ® No Within a velocity zone? ❑ Yes ® No
5. Wetland Area: Wetlands Conservancy Program Map Map Unit Name
6. Current Water Resource Conditions (USGS): Month/Year Range: ® Above Normal ❑ Normal ❑ Below Normal
7. Other references reviewed:
Pine Grave Lot 1 soil evaluation by Maint building site 1, Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8
10.08.2019.doc•rev.3/13
Commonwealth of Massachusetts
City/Town of Northampton
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area)
Deep Observation Hole Number: 1 &2 10.08.2019 1600 -
Date Time Weather
1. Location
Ground-Elevation-at Surface-of-Hole: shown --Location-(identify on plan)---
2.
lan):-2. Land Use Golft.field Edge of woodland no 2
(e.g.,woodland,agricultural field-,vacant lot,etc.) Surface Stones Slope(%)
Grasses terrace shown
Vegetation Landform Position on Landscape(attach sheet)
3. Distances from: Open Water Body feet 100'+ Drainage Way e0t+ Possible Wet Area e0t+
Property Line 10'feet Drinking Water Well e0et + Other feet
4. Parent Material: Kame Terrace _ Unsuitable Materials Present: El Yes No
If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock
5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole
Estimated Depth to High Groundwater: 50
inches elevation
Pine Grave Lot 1 soil evaluation by Maint building site 1, Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8
10.08.2019.doc•rev.3/13
�__ Commonwealth of Massachusetts
City/Town of Northampton
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (continued)
Deep Observation Hole Number: 1 and 2 (Lot 1, Site 1 BY
MAINT. BUILDING
Redoximorphic Features Coarse Fragments
Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil
Depth(in.) Layer Moist(Munsell) (USDA) Consistence Other
Cobbles 8• Structure (Moist)
- - - - - - - - Depth Color Percent - - -- Gravel. Cobbles
- --- - (-Mo ) --- - - -
0-7" A 10 YR 3.2 FILL Mix Friable
7-16" B 10 yr 4.6 FS
16-96" C1 2.5 y 5.3 30" 7.5 yr 5.8 10% F-CS 5 s grain Granular
0-7" A 10 yr3.2 FSL Friable
7-18" B 10 yr 4.6 FS
18-98" C1 2.5 y 5.3 30" 7.5 yr 5.8 10% F-CS 5 s grain Granular
Additional Notes:
Pine Grave Lot 1 soil evaluation by Maint building site 1, Form 11-Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8
10.08.2019.doc•rev.3/13
Commonwealth of Massachusetts
City/Town of Northampton
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
D. Determination of High Groundwater Elevation
1. Method Used:
® Depth observed standing water in observation hole A. B.
inches inches
- - - A.- B.-
Depth-weeping from side of observation hole -- —inches - -" -- -inches --
Z Depth to soil redoximorphic features (mottles) A. 112" B. 112"
inches inches
El Groundwater B.Groundwater adjustment(USGS methodology) inches inches
2.
Index Well Number Reading Date Index Well Level
Adjustment Factor Adjusted Groundwater Level
E. Depth of Pervious Material
1. Depth of Naturally Occurring Pervious Material
a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil
absorption system?
E Yes ❑ No
b. If yes, at what depth was it observed? Upper boundary: 16-18 Lower boundary. 96- 98
chesPine Grave Lot 1 soil evaluation by Maint building site 1, Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8
10.08.2019.doc•rev.3/13
Commonwealth of Massachusetts
lugCity/Town of Northampton
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
F. Certification
\ I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil
evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience
described in 310 CMR 15.017. 1 further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form,
are accurate and in accordance with 310 CMR 15.100 through 15.107.
10/8/2019
Signature of Soil Evaluator Date -
ALAN WEISS, RS#933, SE#2568, Cold Spring Env. Inc. 6/1995
Typed or Printed Name of Soil Evaluator/License# Date of Soil Evaluator Exam
B, Eichstaed Northampton
Name of Board of Health Witness Board,of Health
Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and
to the designer and the property owner with Percolation Test Form 12.
Pine Grave Lot 1 soil evaluation by Maint building site 1, Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 8
10.08.2019.doc•rev.3/13
Commonwealth of"Massachusetts
City/Town:of Northampton
Percolation Test
VVI .S
Form 12
Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage
Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but
the information must be substantially the same as that provided here. ;Before using this form, check with
the local Board of Health to determine the form they use.
Important:When
filling out forms A. Site Information
on the computer,
use only the tab Pine Grove Golf Course: Location 1 on 10.8.20.19
key to move your Owner Name
cursor-do not 254 Old Wilson Road
use the return
key.
Street Address or Lot#
raa� Northampton MA 01060
V=11 City/Town State Zip Code
C/O Jeff Squires , BDG
Contact Person(if different from Owner) Telephone Number
B. Test Results.
10.08.2019 1600 10.08.2019 1600
Date Time Date Time
Observation Hole# P1 P2
Depth of Pert 40 38
Start Pre-Soak 1401 1430
End Pre-Soak 1416 1436
i
Time at 12" 1416 Can't
Time at 9" 1437 Hold
Time at 6" 1500 Soak
Time(9%6") 23 <2
Rate(Min./Inch)
8 <2
Test Passed: ® Test Passed:
Test Failed: ❑ Test Failed: ❑
A WEISS, RS , SE, Cold Spring Environmental Consultants, Inc.,
Test Performed By:
B Eichstaed, BOH
Witnessed By.-
Comments:
y:Comments:
I
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