HomeMy WebLinkAbout0278 GOSNOLD STREET - Health 77,
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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
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13
Z
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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