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HomeMy WebLinkAbout0278 GOSNOLD STREET - Health 77, ®vvi�€i�;<<StI'eCt �yaI1Z11S f7 o f '� ���� 9, �r�• t".�'s �i,�Fi t � -�a Massachusetts Department of Environmental Protection `t Bureau of Resource Protection Well Completion Reports Well Driller Please specify work performed: Address at well location: N2 New Well Street Number: Street Name: {7? 278 GOSNOLD STREET s Please specify well type: Building Lot#: Assessor's Map#: Irrigation Assessor's Lot#: ZIP Code: CA Number Of Wells: 02601 City/Town: Well Location BARNSTABLE In public right-of-way: GPS j;; Yes jn ►� North: West: 41.63895 70.28921 Su bdivision/Property/Descri ption: Mailing Address: � click here if same as well location addres Property Owner: Street Number: Street Name: CO THE GREEN CO 24 SEA MARSH ROAD City/Town: State: Engineering Firm: BARNSTABLE , MASSACHUSETTS ZIP Code: 02632 Board of health permit obtained: jn Yes jo Not Required Permit Number: Date Issued: 2016 006 03/31/2016 —� N Massachusetts Department of Environmental Protection Bureau of Resource Protection-Well Driller Program �y Well Completion Reports(General) Well Driller - General Well Form DRILLING METHOD Overburden Bedrock ........................................................ ..................._..------�_ ..... Auger ( Choose Bedrock-- WELL LOG OVERBURDEN LITHOLOGY From(ft) To(ft) Code Color Comment Drop In drill Extra fast or Loss or addition stem slow drill rate fluid r--j: 20 Fine To Coarse S ! Brown (} 5, j,� YES jn NO jn Fast jn Slow jn Loss jn Addi 20 25 Fine To Coarse S' 1 Brown ' n YES ,� NO n Fast n Slow :n Loss n Addi J J I J I J 25 30 Medium Sand Yellowish Brown: ' 6'i � 6 � F jn YES jn NO jn Fast jn Slow j,� Loss jn Addi WELL LOG BEDROCK LITHOLOGY Visible Extra From(ft) To(ft) Code Comment Drop In drill Extra fast or Loss or addition of Rust Large stem slow drill rate fluid Staining Chips Choose Code 6. 1 YES n NO n Fast n Slow n Loss n Addition Ye Ye G! I J J j J I ADDITIONAL WELL INFORMATION Developed jn Yes jn No Disinfected Yes jn No Total Well Depth 30 Depth to Bedrock I . _ Fracture Surface Seal Type INone Enhancement jn Yes j r No CASING I 6 Is Casing above ground? From To Type Thickness Diameter Driveshoe 27 Polyvinyl Chloride- ---_---_ 6 Schedule 40 -_ � 6 I 0 Ye SCREEN No Scree From To Type Slot Size Diameter 27 30 Stainless Steel Well Point 0.010 WATER-BEARING ZONES DRYWEL Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program Well Co/npletion Reports(General) From To Yield(gpm) 17 30 12 PERMANENT PUMP(IF AVAILABLE) 2 Wire Constant Speed Pump Description Horsepower Submersible 1/ Pump Intake Depth(ft) 25 Nominal Pump Capacity(gpm) 10 ANNULAR SEAL/FILTER PACK Water Batches Method Of From To Material Weight Material Weight (gal) (count) Placement Choose Material Choose Material 0 I Choose One-- [] WELL TEST DATA Date Method Yield(gpm) Time Pumped Pumping Level(ft Time To Recover Recovery(ft (HH:MM) BGS) (HH:MM) BGS) 04/08/2016 Constant Rate Pump 6;; 12 1:30 19 0:01 17 WATER LEVEL Date Static Depth BGS(ft) Flowing Rate(gpm) Measured 04/08/2016 117 —� 12 —� 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. e� Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program Well Completion Reports(General) WILLIAM Supervising Driller DESMON Driller URQUHART Registration#' 299 Monitoring[M] Signature- THOMAS, DESMOND WELL Firm DRILLING,INC. Rig Permit# 0551 Date Job Complete O4/20/2016 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. i �� °E'`� ►J.• Page: 1 Of 1 CERTIFICATE OF ANALYSIS M, Barnstable County Health Laboratory (M-MA009) Report Prepared For: Report Dated: 04/12/2016 Sally Desmond Order No.: G169240 Desmond Well Drilling 8� . P O Box 2783 "jv Orleans, MAI02653 .o Laboratory ID#: 1692408-01 Description: Water-Drinking Water ►_-► Sample#: Sample Location: 278 Gosnold St. Hyannis Coifed: 04/08/2016 i Collected by: DWD' 30717' Rece%d: 04/08/2016 Routine_M ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Nitrate as Nitrogen 2.1 mg/L 0.10 10 EPA 300.0 LAP 04/08/2016 Iron ND mg/L 0.10 0.3 SM 3111E LAP 04/12/2016 Manganese 0.068 mg/L 0.025 0.050 SM 3111B LAP 04/12/2016 pH 6,6 PH AT 25C NA 6.5-8.5 SM 4500-H-B DCB 04/08/2016 Sodium 21 mg/L 2.5 20 -SM 311113 LAP 04/12/2016 Total Coliform 0 /100ml 0 0 SM 9222E RG 04/08/2016 Conductance 220 umohs/cm 2.0 SM 2510B DCB 04/08/2016 Sodium level is above the maxium contaminant level. Those on a tow sodium diet may wish to consult a physician. Attached please find the laboratory certified parameter list. Approved By: (Lab Manager) W6 'A ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level 3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 �•i No. Fee BOARD OF HEALTH TOWN OF BARNSTABLE ZIppYication _for Vern Construction Permit Application is hereby made for a permit to Construct( ), Alter( ), or Repair( ) an individual well at: c299 �O5/�bXG -17 J !�Al*lS .:c6 /,/'/ Location-Address Assessors Map and Parcel o /$� 6� Aa Meeo O er l dress Installer-Driller Address Type of Building Dwelling Q/ Other-Type of Building No. of Persons Type of Well Z! A 4k- ' -iL" Capacity Purpose of Well Agreement: The undersigned agrees to install the afore described individual well in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation-The undersigned further agrees not to place the well in operation until a Certificat of Com li ce has been issued by the Board of Health. Signed ,31 i` Date Application Approved By Date Application Disapproved for the following reasons: Date a +) Permit No. " ` Issued Date ----------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual ell Constructed(•>� Altered( ), or Repaired( ) by � � ,o��L- Al/ � �2«�.,�s T e-- Installer at go5hold /-irn� has been installed in accordance with the provisions..Sf the Town of Barnstabl Board of ealth Private Well Protec ion Regulation as described in the application for Well Construction Permit No. ��b—6(% Dated �-3 I- I THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector W94 6 No. Fee BOARD OF HEALTH TOWN OF BARNSTABLE 2pplication _for Yell Construction Permit Application is herebymade for a permit to Construct( ), Alter( ), or Repair( an individual well at: �7� VOS/76�0 --17 11V nA1"11� ��. //' Location-Address Assessors Map and Parcel lllliiP�'o .7 �� CrOS`Ja�[ 5i //11A-WIS O ner Address Installer-Driller fAddress Type of Building Dwelling ✓ �. ' Other-Type of Building No. of Persons Type of Well Capacity Purpose of Well Agreement: The undersigned agrees to install the afore described individual well in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation-The undersigned further agrees not to place the , well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed ICJ &12i h Date Application Approved By 3-_3/ 6 Date r Application Disapproved for the following reasons: e Date I R 2 Permit No. �� Issued '- 3 I a i Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed(✓�, Altered( ), or Repaired( ) by /y—) L /,Z� tc jr;,, _ Installer at eie)nt) % qhn iS has been installed in accordance,with the provisioQsof the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. Wane k' Dated 3- 3 f- 1 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH TOWN OF BARNSTABLE Yell Con.5truction 3permit No. W�` ` w� Fee y5 Permission is hereby granted to �E�2�Or7C/ Installer to Construct(��✓), Alter( ), or Repair( an individual well at: No. 1/1 /7j,141 ZT, f j1-7h /n/ `..Street as shown on the application for a Well Construction Permit No. Dated 2 J C Date / � ' l Approved By Ju 45,50 7 5 E I\ 57.00 w 1 am � 13 Z o° can \ IV(58o 5G 25 E nog a`ti/ ._ G8 ti j APN 30G-I I I SETBACK LINE , a O 32,900±5F tS Q 4.8' G.2' 1.01 't 2G.3' 34.9' 20.O' ` I o No. 278 0 N EXISTING FOUNDATION N 24.0' 14:0' 28.0' 1' G.0' '�R�Roses j,rL.Rtc 04 1 io),.( 41 57G°54'05"W 1 79.95' - EDGE OF PAVEMENT G05NOLD (PUBLIC - 40' WIDE) 5TREET 0 0 0 I HEREBY CERTIFY THAT, TO THE BEST OF MY KNOWLEDGE, AND IN MY PROFESSIONAL OPINION, THE FOUNDATION 15 LOCATED ON THE GROUND AS SHOWN HEREON, AND I1-5 LOCATION 15 IN CONFORMANCE WITH THE HORIZONTAL SETBACK REQUIREMENTS OF THE TOWN OF BARNSTABLE FOUNDATION CERTIFICATION JN: 15129 278 G05NOFLD STREET DATE: I I AUG.15 IN SCALE: I" = 40' BARN5TABLE (NYANNI5) MA PREPARED FOR ������ OF Mgsf9� ARMAN DO PACK ECO o RICHARD rlchard j. hood, P15 No 00031 land 5urveyor5 - engineers s FC STER�� 12 settlers path - sandwich - ma 025G3 A Ph/ Fax: 508.833.7100