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CONTEN"1 '
C.rtifi.dFib.rSourcing pOST.CONSUMER
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�t Massachusetts Department of Environmental Protection MID 1 9 L-oO3 j�Xo 7 �T
Bureau of Resource Protection
Well Completion Reports
Well Driller C
0
I.*
Please specify work performed: Address at well location: p,o
. ...............__..._.._.
New Well Street Number: Street Name:
0 SERVICE ROAD I-e-i-Cry r-M 2
Please specify well type: Building Lot#: Assessor's Map#: Xr
Monitoring tl�
Assessor's Lot#: ZIP Code: K
Number Of Wells: 02668
2
City/Town:
Well Location BARNSTABLE
In public right-of-way: GPS (GPS for the deepest well)
f Yes f"No North: West:
41.70606 70.40516
Subdivision/Property/Description:
WEST BARNSTABLE SHOOTING RANGE Mailing Address:
click here if same as well location address 1:
_......._._._.._..__....__... __ _........_....._..._._..._.._._......__...._
Property Owner: Street Number: Street Name:
TOWN OF BARNSTABLE 382 FALMOUTH ROAD
City/Town: State:
Engineering Finn: BARNSTABLE MASSACHUSETTS
EAST COAST ENGINEERING ZIP Code:
02601
Board of health permit obtained:
C Yes to Not Required
Permit Number: Date Issued:
_.........._...........-...-........_......__....................
r
f
- '; Massachusetts Department of Environmental Protection
Bureau of Resource Protection-Well Driller Program
' Well Completion Reports(Monitoring)
Well Driller- Monitoring Form
DRILLING METHOD
Overburden uger �edrock Choose Bedrock WELL LOG OVERBURDEN LITHOLOGY
_._____..____.______.._______-----------From(ft) TOM Code Color Comment
Drop in drill Extra fast or Loss or addition
stem slow drill rate offlufd
F ne 0 120 i To Coarse San Brown
I................_._. 1 4......................_.....I I.._..�................._.....T -
.............. ! I......................................................_ YES NO Fast Slow Loss Addition
............................._....I .........................I........._..... ................................__.............
r r
j
r r =�dditin
=40 Fine To Coarse San BrownYES NOFast Slow..... .._.........................._............................. _. .__......_....._.___...-_............_..._.... ............._..__......................_.._..._.. .:......._....._............_......_..__._..
" ......... ....
41.
r.. r r
40 I60 Fine To Coarse San Brown
II
L� L------- ��—— -----� YES NO ? Fast Slow Loss Addition
I
80 .._.__. t r r r r
60 I Fine To Coarse San �.j Brown
____........I (. .. . II .. YES NO ! Fast Slow Loss Addition
j .....................................................
�_ ('
80 100 Fine To Coarse San Brown
� �- YES ND Fast Slow Loss Addition
.__......_..............._......... ._.... .._.._._. _--- - ........._....._
I
100 120 Silty Sand Brown +::
I_ �:. � r r r Sl r t
Fast Slow Loss Addition
.............._..........
Silly Sand....._...._.................�j II..Brown......_.........................._ )
�..... I......._... ........... .._YES.NO �..Fast..._Sl...... ..� ....Loss...._Addilion.................._.
i
=YESNO
r r r r
I Silty Sand j�Brown ) Fast Slow Loss Addition
II
._._..___......_ ._..---- - {--.... _.......................... — ....................__.._........__._.__....._ -
60 L=17O.8 1Silly Sand i Brown �4-W--�
- YES NO Fast Slow Loss Adddion
PERMIT INFORMATION
DEP 21E RTN# DEP Groundwater Discharge#
ADDITIONAL WELL INFORMATION
�LC�oncreterea
.Develo ed re these wells nested? i rYes C No
Surface Seal Type a of group(sq.ft) 6000
Total Well Depth 170.8 Depth to Bedrock
......................
CASING Is From:2To:0
From To 17re- Thickness Diameter Casing
..................................................................._......._................. ..................._............._...................._....................._........._........____....._.._............._.._................_......................................................_.........................._.........................__.........._........................ above
I0 7 150.8 Polyvinyl Chloride Schedule 40 �! 2 ground?
... _._............1 I............_..........�
SCREEN No Screen
From"> To Type Slot Size I Diameter
150 8 170 8 I Continuous Wire PVC 0 010 2
_..........._ ..... ........__.
L ....:_.............1 I............. l ...................................... . I I _ :T T1 I :::_._ _
....................._........................................................................................................................................................... .... ..................................1..........................
WATER-BEARING ZONES
From To Yield(gpm)
152 i170� 8
l
Massachusetts Department of Environmental Protection
Bureau of Resource Protection—Well Driller Program
L7j Well Completion Reports(Monitoring)
ANNULAR SEAL I FILTER PACK
Water
From To Material 1"5 Weight Material 2 Weight (gal) Batches Method Of Placement
- ------_._.........._....-_...._.....__._........:: . ::.:-.___i..__....___....._.-___..... ...............:.- �- �_.._.... ��_._-..:::.:.::::::::::.-:. ::::'_:.`::.:::'.::::....:.::.:..;::::::::':'
_
72 75 I Bentonite Chi s/Pellets 3 -Choose Material — �� - _ Gravity !Jj
P �s i- _.._._._...__.._ __._.._..__..... __._
158 170.8 Sand- - �Io L Choose Material Graviy
WATER LEVEL
Date Measured Static Depth BGS(ft) Flowing Rate(gpm)
F�4/13/2017 �152 1E'�`�- - E
.........................................._..._...._.._.......................__.__._................................................
_.�.
COMMENTS
WELL DRILLERS STATEMENT
This well was drilled or altered under my direct supervision,according to the applicable rules and regulations,and this report is complete and
accurate to the best of my knowledge.
DESMOND
THOMAS E Monitoring(M] Supervising Driller Signature III,
DrillerDESMOND III Registration# 764 THOMAS,E
DESMOND WELL
Firm DRILLING INC. Rig Permit# 023 Date Job Complete 04/14I2017
NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion.
Massachusetts Department of Environmental Protection
Bureau of Resource Protection—Well Driller Program
", Well Completion Reports(Addendum)
Well Driller - Addendum Form
WELL COMPLETION ADDENDUM FORM MONITORING WELLS
Well ID Well Depth Screen Interval FROM Screen Interval TO GPS Coordinates(WGS 1984)Degree Decimals
North West:70.40516
ECE5 . 170 8_ _ 150 8.._ . 170 8 _. 41.70606_.
ECE4 166 3 146 3 166 3 North 41.70828 West:70.40986
NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion.