468 Perc 9-27-19 City of Northampton Board of Health 2019
212 Main Street
t { Northampton, MA 01060
413-587-1214
Fee Collected.
Perc Test Dat : 1 I ` d� .
APPLICATION MUST BE SUB TTED_10 BUSINESS D PRIOR TO THE SCHEDULING OF A PERC TEST
pplication for Percolation ("Perc") Test
Date of Application: go rd, 0 9 v2 a/S-
Home
S I II
Home Owner Name: a ra �e�e r a +6 t, - CJ/es m�rzd o tJ o ner4 c E L C C
Address: N es nA dow' DIZI RG r
City/Town/State/Zip Code:. o 0? O
SOIL EVALUATOR LICENSE NUMBER:
R.S.❑ Engineer❑
ADDRESS
on-lDe' S+• Ash (
G Cc_ 0I33c
PHONE /3 ' 7 6,X'
E-MAIL :
EXCAVATOR
.(back-hoe operator) Q r r'
ADDRESS a Q 5 ?` >✓� dl 3Q
PHONE
1771
PLEASE MAKE,ALL CHECKS PAYABLE.TO THE CITY OYNORTHAMPTON
CHECK LIST
❑ New Construction
P�Repair/Upgrade
***Number of Los to be Perc Tested New Construction only- Give Lot Numbers***
❑ Dig Safe Sign-Off: Gas/Electrical
❑ Trench Permit/Info Sign Off from DPW
------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------
For Board of Health Use Only
CITY of NORTHAMPTON
PUBLIC HEALTH DEPARTMENT
' BOARD :Donna Salloom, Chair—Joanne Levin,MD—Suzanne Smith,MD
map
STAFF. Me rri nth O'Leary,RS,Director—Daniel Wasiuk,Inspector—Edmund Smith,Inspector—Jennifer Brown,RN,Nurse
September 6, 2019
Kim Goggins
79 King Street
Northampton,MA. 01060
RE: Sewage Disposal System Inspection
(System Failure)
Dear Ms. Goggins:
The Northampton Board of Health is in receipt of a report on the Subsurface Sewage Disposal System
Inspection conducted by M rcus Millett&Tom Leue at your property and/or the property that you
represent,468 Coles Meadow Road,on 8/29/2019.That inspection report indicates that your
subsurface sewage disposal system fails to protect the public health and the environment as defined in
Section 15.303 of CMR 15.000,State Environmental Code,Title S.
Therefore,in accordance with the provisions of 310 CMR 15.000 of the State Environmental Code,Title 5,
and-under authority of Massachusetts General Laws,Chapter 21A,Section 13,you (or the subsequent
owner of the property) are hereby ordered to repair the subsurface sewage disposal system at 468 Coles
Meadow Road,within two years of the date of the original inspection, (8/29/2019).If further
degradation of the sewage isposal system occurs (e.g.sewage flowing to the surface of the ground),you
may be required to comple a the repairs sooner.
All work to repair/upgradeyour subsurface sewage disposal system must be performed by a licensed
sewage disposal system intaller,in accordance with the requirements of 310 CMR 15.000,and with plans
approved by the Northampton Board of Health.
Please be advised that you are entitled to a hearing on this order to upgrade your subsurface sewage
disposal system,provided that you file a written petition requesting such a hearing in the Board of
health office within seven 7)days of the receipt of this notice.
Please feel free to contact the Board of Health office,at 587-1214,if you have any questions concerning
this matter.
Thank you for your anticip ted cooperation in this matter.
Sincerely,
Marcus Gabrieli
Health Inspector
City of Northampton
Certified Mail# 7016 3560 00001918 6489
212 Main Street,Northampton,MA 01060
Ph(413)587-1214 Fax(413)587-1221
Commonwealth of Massachusetts
Cityffowp of Northampton
Percolation Test
Form 12
Important:when wing Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage
out forms on the Disposal. DEP f,as provided this form for use by local Boards of Health. Other forms may be used,
computer,use only the but the informat on must be substantially the same as that provided here. Before using this form,
tab key to move your check with the 1 cal Board of Health to determine the form they use.
cursor-do not use the
return key. A. Site Infdrmation
Owner Name: Coles Meadow Properties LLC
Street Address or Lot* 468 Coles Meadow Road Book 13181 Page 10
Citylrown: Northampton State: MA Zip Code: 01060
Contact person if different from owner)
Telephone Nu nI
ber 413-575-7581 Homestead Inc.* 809
B. Test Results 9/27/19 9/27/19
Date Date
9:00 AM
Time Time
Observation H le# 1 2
Depth of Perc 55 inches
Start Pre-soak 10:01 AM
End Pre-soak 10:16 AM
Time at 12" 10:16 AM
Time at 9" 10:20 AM
Time at 6" 10:26 AM
Time (9" - 6") 0:06:30
Average Rate per Inch 2.0
Test Passed Test Passed:
Test Failed: Test Failed: ❑
Test Performed By: Thomas S. Leue. Homestead Inc.
Witnessed B : Bri Eichstaedt, Northampton
Comments:
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Commonwealth of Massachusetts
Cityrrown of Northampton
i;
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
Cf Site Address: 468 Coles Meadow Road, Northampton
Homestead Inc. #: 809
DEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but the information must
be substantially the same as provided here. Before using this form, check with your local Board of Health to determine the form they use.
A. Facility Information
1. Facility Information
Coles Meadow Properties LLC
Owner Name
468 Coles Meadow Road Book 13181 Page 10
Street Address Map/Lot
Northampton MA 01060
B. Site Information
1. (Check one) New Construction Upgrade . Repair ❑
2. Published Soil Survey available? X Yes _ No If yes: 1980 15580 10
Year Published Publication Scale Soil Map Unit
CnC Charlton fine sandy loam slight limitations:
Soil Name Soil limitations
Comment: _
3. Superficial Geological Report available? X Yes _ No If yes: 1980 1: 190, 080
Year Published Publication Scale Map Unit
glacial outwash kame terrace
Geologic Material Landform
4. Flood Rate Insurance Map:
Above the 500 yearo0 pun ary. es o Wi h�in� Ike 100year fpod-boundary?-=Yes- X—No--
Within the 500 year flood boundary? X Yes — No Within a Velocity Zone? _Yes X No
5. Wetland Area: National Wetland Inventory Map
Map Unit Name
Wetlands Conservancy Program Map
Map Unit Name
6. Current Water Resource Conditions (USGS) Range: Above Normal X Normal _ Below Norm
Month/Year
7. Other references reviewed:
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 1 of 4
Commonwealth of Massachusetts
City/Town of Northampton
a
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
Site Address: 468 Coles Meadow Road, Northampton
Homestead Inc. #: 809
C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area)
1 Deep Observation Hole Number L 9/27/19 10:30 AM Clear
Perc date Time Weather
2 Land Use: lawn Surface Stones: YES 5%
(e.g. woodland, agricultural field, vacant lot, etc.) Slope (%)
Vegetation grass Landform kame terrace
Latitude:
Longitude: Position on landscape (attach sketch)
3 Distances from: Open Water Body 100 Drainage Way 100 Possible Wet Area: 100
Property Line 70 Drinking Water Well >150 Other:
feet feet feet
4 Parent Material: glacial outwash Unsuitable Materials Present: No
If Yes: Disturbed Soil Fill Material Impervious Layer(s) Weathered/Fractured Rob Bedrock
5 Groundwater Observed: Y e s
If Yes: Depth Weeping from Pit _ inches Depth Standing Water in Hole _ inches-
Estimated Depth to High Groundwater: 44 inches
Depth Soil Soil Matrix Redoximorphic Features Soil Texture Coarse Fragments Soil Soil Other
(In.) Horizon Color-Moist mottles (USDA) Cobbles Structure Consistency
/
Laver Munsell Depth Color Percent Gravel & Stones Moist
fine sandy
12 - 22 A 10YR 5/6 loam 20%
fine sand
22 - 33 BW 7.5YR 6/4 10% blocky friable plant roots
7.5YR 5/4 sand
_33 - 44 C 1 7.5YR 6/3 44 7.5YR 6/1 >5% 0% 0% blockv friable
sand
44 - 105 C 2 17.5YR 5/3 1 1 10% 5% 1 block friable I refusal
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-Page 2 of 4
Commonwealth of Massachusetts
City/Town of Northampton
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
Site Address: 468 Coles Meadow Road, Northampton
Homestead Inc. #: 809
C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area)
1 Deep Observation Hole Number 1 9/27/19 10:30 AM Clear
Perc date Time Weather
2 Land Use: lawn Surface Stones: YES 50/0
(e.g. woodland, agricultural field, vacant lot, etc.) Slope
Vegetation grass Landform kame terrace
Latitude:
Longitude: Position on landscape (attach sketch)
3 Distances from: Open Water Body 100 Drainage Way 100 Possible Wet Area: 100
Property Line 70 Drinking Water Well >150 Other:
feet feet feet
4 Parent Material: glacial outwash Unsuitable Materials Present: NO
If Yes: Disturbed Soil Fill Material Impervious Layer(s) Weathered/Fractured Rocl, Bedrock
5 Groundwater Observed: Yes
If Yes: Depth Weeping from Pit — inches Depth Standing Water in Hole inches
Estimated Depth to Hiah Groundwater: 54 inches
Depth Soil Soil Matrix Redoximorphic Features Soil Texture Coarse Fragments Soil Soil Other
(In.) Horizon Color-Moist (mottles) (USDA) Cobbles Structure Consistency
Laver (Munsell) Depth Color Percent Gravel & Stones (Moist_ _ fine sandy )
0 - 15 A 1 OYR 3/6 loam 20%
fine sand
15 - 32 Bwl 7.5YR 5/6 10% blocky friable plant,roots
sand
32 - 39 Bw2 7.5YR 6/4 0% 0% blocky friable
7.5YR 5/4 sand
39 - 54 C 1 7.5YR 6/3 1 54 17.5YR 6/1 >5% 1 10% 5% blocky friable refusal
sand
54 - 90 C2 7.5YR- 5/3 10% 5% blocky friable refusal
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-Page 3 of 4
Commonwealth of Massachusetts
Cityfrown of Northampton
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
Site Address: 468 Coles Meadow Road, Northampton
Homestead Inc. #: 809
D. Determination of High Groundwater Elevation
1. Method used: Depth observed standing water in observation hole A. ® inches B. m inches
Depth weeping from side of observation hole A. a inches B. inches
X Depth to soil redoximorphic features (mottles) A. 44 inches B. 105 inches
Groundwater adjustment (USGS methodology) A. o inches B. Q 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 s
absorption system? Yes
b. If yes, at what depth was it observed? Upper boundary: 2 2 Min. inches Lower boundary: 8 8 Max. inches
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
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
Boit-evaluation-,as-rrdicated-in-the-attached-Soil-Evaluation-Forrrr,are-accurate-end-in-accordance-with-310-CMR45:1D0-through-15.x07
9/27/19
Signature of Soil Evaluator Date
Thomas S. Leue SE 1368 June 1995
Typed or Printed Name of Soil Evaluator/License Numbe Date of Soil Evaluator Exam
Bri Eichstaedt Town of 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
property owner with Percolation Test Form 12.
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 4 of 4
CITY Of NORTHAMPTON
PUBLIC HEALTH DEPARTMENT
Public Health Director—Merridith O'Leary
'A Munic pal Building—212 Main Street—Northampton, MA 01060
Phone (413)587-1215—Fax(413)587-1221
http://www.northamptonma.gov/245/Health
Peer°c Test/Soil Evaluation Form
Property Address: 0�
Owner's Name: 16C r
0�
Date: �71 1 � tg,
Performed by: TO 7 Vert
Witnessed by:
No. of Bedrooms: 04,
Garbage Grinder? Ye _�No3
Fee Paid? Yes No Sketch of propertyand,location of deep holes/pere(s)
Percolation Test x f L
Pere Hole# 1 2 3 4
Elev: Elev Elev: Elev:
a
k
Start pre-soak 1
End pre-soak ,r
ZEN ff
:Time @ 12''
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Time @9
4
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9"-6"
Rate (min/in)
Deep Hole Observation Log
Depth From Soil Horizon ex ure SeiLC-04"r- Mottling
Surface (inches)
Lam,®r 4e-�ckA-<, (inches)
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