HomeMy WebLinkAbout0221 NYES NECK ROAD - Health (3) aal k)qea\YUeck
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FORM 11 - SOIL EVALUATOR FORAI
Pa ge 'l of 3
No. 21t VCS ;AEC.k L A1 VE :Date: L1'/9 IOti0
Commonwealth of Massachusetts
r.:Massachusetts
"Soil Suitability Assessment for On .site Sewage Disposal
Performed B M«AEA- P i '1"�I f . ... .. .....: ........ Date: 1114 1 q q
y:
Witnessed By: po r1NA . N1►:o�..RNO 1.: .
2:z o r+> AA99G FT M �Z l N
La Addtns.aid.
r!t� 221 N YE S I�ELK L:/�N�
LJ
G' BA STAB , M
New.Construction Repair
Office Review
Published Soil Survey:Available: No ❑ Yes ®'
ear Published 1010, 3. Publication Scale :I 7M.5 2e 0 'Soil Map Unit CC 8: .
Drainage Class ,. ........... Soil'Limitations ................... .... :. ... ....
Surficial,Geologic Report Available:-No `� Yes
Year P.ulilished:: _. Publication Scale
Geologic Material (Map Unit) _._. _ _ .. _. _ ._ ....... .........................._.__..._
I:andfonn __..; ...._. _ _.. —
Flood Insurance Rate Map: 5
0DD .:opp_SL .. A�GuST- .►� , I�aSW
Above:500 year flood:boundary No ❑Yes
Within 500 year.flood boundary No' ®Yes ❑'
Within'1.00;year flood.boundary No. .Yes
Wetland:Area:
:National`Wetland Inventory Map (map unit) - -••- •..............
- --- - -
Wetlands Conservancy Program`Iviap (map unit) -. - - -
Current`Water Resource Conditions (USES)- Month
Range.:Above Normal [INormal E]Below Normal. .[I
;Other `References Reviewed:
DFP A"ROVID FORM-12197/95
FORM 11 - SOIL EVALUATOR F
ORhi
Page 2 of 3
Location Addressor Lot No. Z21 11� :D EX-+~
On-site Review
Deep Hole'Number 'rP-1 Date. ►:I'Iq I `` 7ime: .8 3� Weather,$�j
Location;(identify.on site plan)
-Land:Use
Slope t%) Surface Stones.
Ve6etation ?A�?5
s rLandform
slboci=•on landscape (sketch on the back)
ces orn:
" n $Vater Body feet Drainage.way feet
e Vlet Area feet Property Line feet
r
rng Water Well feet "Other
DE-EP OBSERVATION HOLE LOG`
'Depth from :Soil Horizon . Soil Texture .Soil Color ' Soil :Other
Surface'.Alnchesl (USDA) (Munsell) Mottling .structure,Stones,Boulders, Consistency, 96
Gravel)
D Z F:1L
2?~ � A, SAY 2, Y3j: _ Npfi�E '� FtU4 ;
L`
'Parent.Material'(peologicl; U'ru1�5''tf. Deptf:aAedroek:
Demh to Groundwater: Standing'Water in the Hole �( Weeping from Pit Face:
-Estimated Seasonal High Ground Water. 1506
DFs APPROVED FORM-LVD719S
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot'No: 221 NYI N �� LA►t ="
Determinati On far ,Seasonal ,figh Water Table
Method'Used: _.
Depth observed-standing In.observation hole ....°11 inches
Depth weeping from aide of observation hole °s' `inches
0 Depth to soil mottles S inches
K.Ground water adjustment ... feet SET $Y TD;W A :@ ELEV, 3 0
Ind:ex`.WeII Number........ ........ 'Reading Date :...::.:..... Index we(I level :...............
Adjustment factor ................ Adjusted ground water level ..::...: :........:........:....., _
Depth.of Naturally Occur6no Pervious Material
Does at :least four `feet of >naturally occurring .pervious material. exist in all areas
iobserved throughout'the area proposed for th.e soil absorption system? YES
If not, .What the depth of naturally:occurring pervious material?
Certification
1 'certify ,that bn . b.Ta . (date) l`hay.e:passed the soil-evaluator examination
apprcived'by the:DeP artme-nt.of Environmental Protection and:that the,,above:analysis
was.performed by me,consistent°with.the required.training, expertise and.expe.rience
;bescribed n 310 CMR 15:0.17.
Si gnature 'aZ 6 � Date �II9�°t0%
DEP AMOVED FORIM-12/07/95
FORM 12 - PERCOLATIOi\ TEST
Location.Address or Lot No. _Z�
COMMONWEALTH. OF MASSACHUSETTS
Massachusetts
Percolation Test*
Date: !I 14 �� Time 61
O.bser�ation Hole
-r.P. A
Depth of Pe'rc $� ►1.
Start Pre-soak
.End Pre-soak i 2
Time at 12,, kl. rN l 5 M Irl 2 �?
Tirne-at_9...
Time �at �6"
Time (9,, 6'`)
.:Rate Min./Inh
2 Mtr► -/- [ rl
* Minimum o#� 1 percolation test:must be performed in both the primary area.AND
reserve ;area:
Site 'Passed 0 Site Failed ❑
Performed,By. A"Al Kk
AEt, T .[.
Witnessed By. po N N MID BAN D 1
........
r - ..
DFF APPROVED FORM-LU,07/95
LcxtSTIN& S14ED
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AYES
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