Pursuant to The Board of Health, City Of Haverhill, Percolation & Deep Hole Regulation as amended on January 28, 1997, in accordance with and under the authority granted by Section 31, of Chapter III of the Massachusetts General Laws.

All percolation and deep hole tests conducted in the City of Haverhill shall be conducted between March 1st and June 15th.

The application deadline for requesting these tests must be filed with the Haverhill Health Department on or before April 15th. Scheduling will be assigned on a first come first serve basis. Exceptions may be made for isolated lots if time is available.

No Applications will be accepted without payment.

If appointments for percolation tests and deep holes are cancelled by anyone other than the Board of Health, the Board is under no obligation to refund or reschedule the percolation or deep hole tests.

APPLICATION FOR WITNESSING PERCOLATION AND OBSERVATION HOLE TESTING
THE FEE FOR WITNESSING OBSERVATION HOLES AND PERCOLATION TESTS BY A BOARD OF HEALTH INSPECTOR IS $150.00 FOR EACH LOT. (NEW CONSTRUCTION & UPGRADE)

ADDITIONAL TESTS ON A LOT ARE $100.00 EACH FOR A SET OF TWO OBSERVATION HOLES AND ONE PERCOLATION TEST.

THE FEE MUST BE PAID PRIOR TO TESTING.  INSPECTORS WILL NOT WITNESS TESTS THAT HAVE NOT BEEN PAID FOR.

OWNER:________________________________TELEPHONE #_____________________

ADDRESS:______________________________________________________________

LOCATION OF SITE:__________________________M#______B#______L#_________

AUTHORIZED SOIL EVALUATOR  AS APPROVED BY 310CMR510(3):

NAME:_________________________________TELEPHONE #:____________________

ADDRESS:______________________________________________________________

DATE OF TEST:_________________________TIME:___________________________

# OF TEST(S) PAID FOR______ (@ $150.00/LOT, ADD’L TESTS $100.00 ea)

INSPECTOR ASSIGNED:___________________________________________________