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HomeMy WebLinkAbout0006 STONEY CLIFF ROAD - Health (3) CL 2.64 ,6�Aew�i IRCI /019 C _ OIL EV UATOR FORM �rs 117 . FORM 11 s Page 1 or 3 Dater lS�i No. �� /U.oU AW S Commonwealth of Massachusetts Massachusetts ita � • e n r / Date: Performed By: .......................... �►.sue,G......no+ -fl.....oF..:.. ' ......................... c`A •. :.:....g .......... ............. Witnessed By: w ....0.4.° o�v 4156�5 S 1� TckphM I 1'?�v�o 11/tA►� �i 1' 89- of9 �s-�- y� , yor+ M A-o 21 ew Construction- Repair ❑ 0 f'tjc�e ew Y. esd Published Soil Su rvey Available: No � ZSV G� oi1 Map Unit Pl . ll�t 3.., Publication Scale ................... S year bished ........... : ; G o1 C- �z..... �..�..�,�— ................................................ Drainage Class 5 E0--e V....... Soil Limitations ., ' Avail# e: No ❑ Sw{cial Geologic Report _ Yes Publication Scale •-... Year Published v .......... 0......................... , Geologic Material (Map it F ............ '�1 '!..��......... ..................................�...... `,.`5...1.............................................. dform .........i �"••.-"'................. Lan Flood Insurance Rate Map: f Above 500 year flood boundary No []yes [� Within 500 year flood boundary No ElYes ❑ ear flood boundary No lK� ❑ Within 100 y Wetland Area: �a. +.., .r.. .eo...a.!.:.�3.:: Mo..• , National Wetland Inventory Map(map unit) ....gyp nnlw n,!! s...A��!...�P. ..., .. ............. ............. Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(USGS): Month s Dw - 252 Range:Above Normal ❑Normal ❑BelCW Normal Othcer References Reviewed: V-5 Gs .�1� DEP APPROVED FORM-12/07/9S FORM 11 .SOIL EVALUATOR a FORM 3 ^ g Location Address or Lot No. I PPI t°t �, s-ro�.,e-r c��r-F R o• cam+-� R,-� �u r� o�i �3 �- On-site Review s 4,0. .. 3e V11@eth@r ca,D1l T e :.I �,L . Time:.:. 1:0:...-.:. . :.::. Date:;.j�hl 19('o Deep Hole Number' ...-.I .::......::.:::::.::::.:. .::.. .... ... p 3 Surface Stones ,._Hqt A_.0( Location (identify on site plan) �.w v::.,: Slope 136) .. .-:. . Land Use Vegetation ....If... :::. .....: . . .::..... Position on landscape (sketch on the back) Distances from: �o feet`; Open Water Body ''�� feet Drainage Way. '► - 30 I 7-H Possible Wet Area .. Igo!.: feet Property Line ..::....:......:. feet 45' Z_ r+ z Drinking Water Well :..rw,,,2. feet Other ...:.:.,.. DEEP OBSERVATION HOLE LOG* other Depth from Soil'Horizon Soil Texture Mu Color.gl . Soil Gravel) Surface(inches) (USDA) Mottling (Structure,Stones,Boulders, Consistency, -TjjI - �� Moa aaO POYCD _ ORl�++IG AAA o - „_ oe LOAM-1 10`/R 4�4 NpM6. 5�C &0A,4M1.• No M Z 5 ']e C�QAv E L STD C S Tv 3 „ Ito" - 31 tipNG C (� �1►aDY LOAM Al SI" ,ta, 51 io �/4- Locss - . ,4.• o � AA I -• —.22" SAME Sf�M E Stu 6 GQo�..O wise c I I ,L (�atlQrrSrt+tin+ �'�^�*~ PLAl+4 OaPthloBadrOck: 30� Parent Material(9e01091 from Pit Face' c _ 9, ;8„ Weeping Depth to Groundwater: Standing Water in the Hole: Estimated Seasonal High Ground Water. 4- 3•�i UEP APPROVED FORM'12/07/95 FORM 11 - SOIL LVALUATOR FORM Page 3 of 3 Location Address or Lot No. G�1,►rr4,4/0-e , N+h . De e in ' n r a n H' hWtrT le Method Used: ❑ Depth observed standing in observation hole.....U!- inches ❑ Depth weeping from side of observation hole.....N.A..... inches ❑ Depth to soil mottles,,-,WA.,.::: inches 3 Ground water adjustment feet Index Well Number ;P , s L Reading Date .... .f Index well level ...477-s3... 'L4• 'I _._.._... Adjustment factor ....3 ..... Adjusted ground water level ........................................... Depth of Naturally Occurrin^ Pervio s Material Does at least four feet of naturally occurring pervious ate ial exast m?in awls areas observed throughout the area proposed for the soilabsorption If not, what is the depth of naturally occurring pervious material? /a Certification I certify that on O5 09 (date) I have passed the soil evaluator examination approved by the Deptrtment of Environmental Protection fmin e expertise and experience nd that the above analysis was performed-by me consistent with the required9 described in 310 CMR 15.017. Date Signature 3 ►°� a DEP APPROVED FORM-12/07/9S 1 F3ets,,., 40 PERK T-4 #2 V� 0 o � , D o \/.I�TL^-u -ly MAP 1 591 Pe-L. 10, Cl l—x / -1 Ce C I C *-AA FORM 12 - PERCOLATION TEST 1 Location Address or Lot No. I b9 / �`+ (4 cL_j r-,P Q-c�"'° MA COMMONWEALTH OF MASSACHUSETTS p- ¢,,.,s,-tr .Lz— , Massachusetts Percolation Test* Date: ::..:oe, i Time:. :...::::i.©.::.4- Observation Hole # Depth of Perc s „ Start Pre-soak End Pre-soak Time at 12" Time at 9" Time at 6" Time W-6"1 Rate Min./inch 2MiH/1$.4 2sc.A� Minimum of 1 percolation is t rust be-prarformed n bath the primary area AND reserve area. Site Passed Site Failed ❑ Performed By: L L t Witnessed By: Eo"rt-" Comments: .......�...w:.���.�.:.N..�.�.,�,.....w.,M.�........_.��v..�.v.�......vr......�..�..,. ..v.. ..w......w...�....�........�....,,..........�.�,....�......�.��.�...�-....�............. DEP APPROVED FORM-W07/95