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Home My WebLink About0024 LAURIES LANE - Health L== 028 RIE'S LANE.. Mills — 091_ �ti of H��y�r sf CERTIFICATE OF ANALYSIS Barnstable Counfiy. Health Laboratory (N1-MA00% 'Jt•^cHvs�' -- Recipient Sally Desmond , Matrix: Water-Drinking.—Water, Desmond Well Drilling 'Sampled: 12/15/2014 15:00' P O`Box 2183 Receivetl 12%16/2014 9:55 Orleans, MA 02653: Collection Address: 24 Laur"le's Ln.Marston Mills;MA Sample Location: Order#: G148490.0: s Description. 2day-24 Laurie's Ln Lab ID'p 1484900-0.1 Datee Analyzed; 12/16/2014 @ Sample#: Analyst: yn Method; E.pA 524,.2: Dilution Factor: is Comment, Water sample meets-the recommended limitsfar drinking water ofall the:above tested parameters: _ _ _ _ EPA 524.2 Volatile Organics by GC/MS Result MCL MDL Result MCL MDL Parameter u9/L ug/L ug/L Parameter u /L 09/L ug/L _ g Diclilorodinuoromethane NO 0.50 Chloroform 1 2.: 80 0 5..0 ...................... .......... _ .._ _ Chloromethane NO: o:5o as,1,2 Dichloroethene ND 70 0.501 vinyl chloride NO Zo; 0:50 cis-1,3-Dichioropropene NO o.so - —— �.: __..... _r . Bromomethane NO o 50 Dibromochloromethane NO 0 50 1;1i,24etrachloroethane ND: 050 Dibromomethane ND I o.50 1,1;1-Trichloroethane ND 200 0;50 Ettiylbgnzene, NO ioo: oso: 1,1,2,2-Tetrachl6roethane ND: Oso Hgxachlorobutadiene ND I 6.50 i 1,1,2-Trichloroethane ND .5.6 0.50 Isopropylbenzene NO 0.50 1;1-Dichloroethane ( NO 0.50 Methylene chloride. ND 5.0: 0.5a . ....... . . 1,1-Dlchloroethen"e NO 7:0 0:50 Methyl=tert-butyl ether NO 0.50. ....... ..._ 1;1-Dichloroprooene ND 0.50' Naphthalene ND o 50 1,43-Trichlorobenzene ND q,.5o n=gutyibenzene ND 0:50: j 1,2;3-Trichloropropane NO 0:50 n-Propyibenzene NO ! Mo ....:. _... __.. . 1,2,4 Trichlorobenzene N.D 70 0.50 P.- Isopropyltoluene, ND. 0.50 1,2;4-Trimethyiben4ene ND 0:5o sec-Butylbenzene NO 0.56 1,2=Dibromo 3 cfloropropane NO 0,5o Styrene: ND 100. o;sn 1;2-Dibromoethane(EDB) ND 0.50; tert=Butyl benzene ND 0.% 1,2-Dlchlorobenzene: ND> 600 050 Tetrachloroethene 1 NO o. —` 0:5o 1,2-.Dichlor6ethane ND' 5.0' 0.50 Toluene NO o0o 0.50; --... 42-Dichloropropane ND 0 50 Total,xylenes ND 0000 0.50. 1,3,5 Trimethyibenzene ND 0 50 tt ans-1,2-Dichloroethene ND 1001 o so; . 1 �t ooan -1,3 Dichopene NO __................................................ .__ . _ ....1,3 Dichlorobenzene 6,50 1,3 Dichloropropane; ND 0.50 �Tnch.loroethene NO 5.0 0 so 1,4 Dichlorobenzene NO 5 0 0.50 1Tncj lorofluoromethane NO� o.50: - 2,2 Dichloropropane:_ NO o.5o, Surrogates %Recovered 1 QC Limits 0/0). '2 Chlorotoluene ND. 0.50 I p=BBromofluorobenzene 90�l0 70 130 4-ChloroY6luene ND. 0♦50 _ :..._ _.. . . 1,2-Dichlorobenzene d4 SO% 70 130 Benzene ND: 5.0 0.50 _.,.._. .._ ._ .___...__._.._. .... ......._ ....... - Bromobenzene ND o.so Bromoclloromethane., ND o•50 Bromodichloromethane NO _ 0.50 Bromoform ND 0.50 Carbon tetrachloride; NO, SA oao' Chiorobenzene NO 100 0.50` Chloroethane NO, 050 Attached;please find.,the laboratory certified parameter.list.. Approved B r (Lab Director) NO=None Detected: RL,= Reporting;Limit MCL.=Maximum Contaminant Level Superior Court;House, PO; Box 427,. Barnstable; MA .02630 Ph:'508-oV&6605 Page-1 of i Page: of 1 CERTIFICATE OF ANALYSIS 1 Barnstab a Counfiy Health Laboratory (M-MA009) "s��cKus Report Prepared For: Report Dated: 12/17/2014 Sally Desmond Desmond Well Drilling Order`.No.: `G148490;0. P b Box 2783 Orleans; MA 02653 T.. Laboratory ID#: 1484900-01. Description: V1/ater.-,Drinkin'g Water Sample#; Sample Location: 24 Laurie's Ln.Marstons Mills;.MA Goilected:: 12115/2014 y RecelCollected b ; vedt 1.2/16/2014 Routine M ITEM RESULT UNITS RL MCL METHOD# TESTED. Nitrate as NNitrogen 4.7 mg/L 0.10 10 EPA 300:0 12/16/2014 Lrorl ND mg/L 010 0.3 EPA,'200 8 12Jg,6/2014 IVlanga'nese 0,613 mg/L: 0.0030 0 050; EPA 200.8 12/16/2014 PH AT.25:& NA 6.&8.5 SM'.4500 H g. 1.2116/2014 SOditliti 17 mg/L 0.:10 20 EPA 200.8: 12/16/2014 Total Coliform Absent P/A Q 0 SM,9223 12/16/2014 Conducfance. 13.0 umohs/crn ZO SM 251 OB 1211,612014 Water sample rrieets°the recommended/units for d/inking water of all the.<above tested parameters. Attached please find-the laboratory'certified parameter:list. Approved By .... ' -a, (Lab. Director] 1-2U/ ND=None,Detected RL Reporting Limit MCL=M Mmurn Contaminant LeVel Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph 508 375-6605 S LMassachusetts Department of Environmental Protection Bureau of Resource Protection Well Completion Reports l Well Driller Please specify work performed: Address at well location: New Well Street Number: Street Name: 24 LAURIES LANE Please specify well type: Building Lot#: Assessor's Map#: Dm oestic 028 Assessor's Lot#: ZIP Code: Number Of Wells: 091 02648 l� City/Town: Well Location BARNSTABLE In public right-of-way: GPS r Yes r No North: West: 41.65956 70.44658 Subdivision/Property/Description: Mailing Address: click here if same as well location addres Property Owner: Street Number: Street Name: PERRY 24 LAURIES LANE �/SAS N�C� City/Town: state: Engineering Firm: E MASSACHUSETTS ZIP Code: 02648 Board of health permit obtained: @ Yes Not Required Permit Number: Date Issued: W2014 040 12/11/2014 L 2 Massachusetts Department of Environmental Protection Bureau of Resource Protection-Well Driller Program R. 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 �� 20 Fme To Coarse S Brown ' [�� l r Fast 0 Slow rJ Loss CJ Addi ......._.. _ _ •�: 20 40 Fine To Coarse S • Brown =YESr-) =Fatr-) �J Loss Addi e-_ 40 60 Fine To Coarse S •�, Brown I•; ,7,�', f j YES !J NO Q Fast 0 Slow 0 Loss G Addi 60 65 Fine To Coarse S Brown r)YES C' NO ' 0 Fast 0 Slow � Loss r Addi . ............... .... ... �_ ....__.._.. _...._._.. ._ ... ............................ _......_-...... WELL LOG BEDROCK LITHOLOGY ° Drop in drill Extra fast or Loss or addition of Visible Extra From(ft) To(ft) Code Comment Rust Large stem slow drill rate" fluid . Staining Chips _.... - ..........n is �Fast � Slow fj Loss �J Addition _Choose Code � C��YES Q NO n Ye �Ye ADDITIONAL WELL INFORMATION ................................... Developed Yes G No Disinfected G Yes No Total Well Depth 65 Depth to Bedrock Fracture Surface Seal IF None Enhancement �Yes r No _.................................................. CASING Is Casing above ground. From: 1 To: 0 From To Type Thickness Diameter Driveshoe -- 0 62 `P"o"ly'v'inyl�Chlo�ride "S'ched�ule,0� 4 ❑Ye SCREEN No Screen From To Type Slot Size Diameter 62 65 Stainless Steel Well Point E l Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program V; Well Completion Reports(General) WATER-BEARING ZONES ❑DRYWEL From To Yield(gpm) 49 65 12 - PERMANENT PUMP(IF AVAILABLE) 2 Wire Constant Speed Pump Description Horsepower Submersible Pump Intake Depth(ft) 60 Nominal Pump Capacity(gpm) 10 ANNULAR SEAL/FILTER PACK From To Material 1 Weight Material 2 Weight Water Batches Method Of (gal) (count) Placement Choose Material Choose Material + Choose One WELL TEST DATA Time Pumped Pumping Level(ft Time To Recover 'Recovery(ft Date. Method Yield(gpm) (HH:MM) BGS) (HH:MM) BGS) 12/15/14 Constant Rate Pump �) 12 1:30 50 0:01 49 WATER LEVEL Date Measured Static Depth BGS(ft) Flowing Rate(gpm) 12/15/2014 1149 1112 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 4� y Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program Well Completion Reports(General) and accurate to the best of my knowledge. DESMON RYAN Monitoring[M] Supervising Driller III, Driller WHITLATCH Registration# 764 Signature THOMAS, DESMOND WELL Firm DRILLING INC. Rig Permit# 023 Date Job Complete 12/15/14 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. No.V� — D '" Fee 17 BOARD OF HEALTH TOWN OF BARNSTABLE 01ppYication jor Vern Congtruction 3permit Application is hereby made for a permit to Construct(J), Alter( ), or Repair( an individual well at: 2� L-Aywc\ .,j L="n , s�a�ns M14 02-$�O`l I Location-Address Assessors Map and Parcel -v1,Ma �11s,UA07-64W caner Address \f4a 2783,0A�,,s VA OIC53 Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well ayy-, '"I1`(— y"SCk1LAb NC. Capacity to Purpose of Well ��'►�0•� 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 Certi cate of Compliance has been issued by the Board of Health. Signed I t Date Application Approved Date Application Disapproved for the following reasons: Date Permit No. ,7 0 y �(� Issued Date -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed( ), Altered( ), or Repaired( ) by Installer at has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector No.WZ Fee BOARD OF HEALTH TOWN OF BARNSTABLE 2pprication _for Ivell Construction Permit Application is hereby made for a permit to Construct V), Alter( ), or Repair( an individual well at: Location-Address Assessors Map and Parcel I IQ��Tt, PfAT%\ . Laci&,.r, ;11( JAA OZ6LI 'er Address - ) •6�t)y, 21-1R30r�pr� I M 0215_3 Installer-Driller Address Type of Building Dwelling ✓ Other-Type of Building No. of Persons Type of Well F�)w,,�-i c y" Sclt\LID Nc, Capacity /0 F°yP�►- 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 (21 /c / Date Application Approved By �I t-zoj Date Application Disapproved for the following reasons: ,� ll Date W Permit No. � Cq Issued Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed( ), Altered( ), or Repaired( ) by Installer at has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. Dated 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 I Yell �Con5truction Permit J No. A) ` O�0 Fee f Permission is hereby granted to�p� ,�,,� ��Q OT,y��. Installer to Construct e), Alter( ), or Repair( ) an individual well at: No. Z`1 hut•\e�S L� , �a�sfohs MM, Street as shown on the application for a Well Construction Permit No W?,o1 H-0 q 0 P-atied Date (7 {(( 1-2a 1 I Approved By - Ci i •! v �. irk ., 4-0 « k s s F �}ppy 4 Y 4 ' n LnIf 3 _ SO- y ( ' : z r _ < riha if YAe .� 1 (Ap4 t ,!;1 7 n.S �+ :;, Y" JR .v`s £• - 5 rl..,. > T-3 ✓ LO CAI ION SEWAGI PERMIT NO. YIL ' AGE INSTALLER'S RAZE A ADQRESS I d$ UIL0 4 OR OWNER v RATE PERMIT DATE COMPLIANCE ISSUED �'� 8l V�� f✓` �G�c � . ;�,,,,� 0 S q L �y i n?3� 1--- �' ................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH '.. i fi ....................OF...... ..........................--------- ---_..._. ................. tiratiou for Disyuial Worko Tomitrurtinn prnti Application is hereby made for a. Permit o Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .. ...................................... ---.............................................. Location-Address or Lot No. s, ..... n&loll .......................................................... ......t'�ez.�E��'.t� P = ..: •� Ow Address...._ Insta.0 Address Type of Building Size Lot...2j,.o.��_✓--.-_..Sq. feet Dwelling—No. of Bedrooms........... . ......................Expansion.Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ Noe of persons---------------------------- Showers ( ) — Cafeteria ( ) Otherfixtures F......---•-----••-•---------------------------------••--•-••••------•-----------------........................ W Design,Flow•-` 1.0................................gallons per person per day. Total daily flow__._...�...3--- ........................gallons. 9 Septic Tank—Liquid capacity_/4!...gallons Length___.•_-_•___-•-• Width................ Diameter................ Depth................ x; Disposal Trench—No..................... Width.................... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No....../........... Diameter...... ........... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ry ,, Percolation Test Results Performed by --_.................................................:--------------------------------------------- Date. ...0..'r..........----•-•-----------. a Y:. Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-----------------....... (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth.to ground water........................ R+' ......................................................-.............................................................................................. 0 Description of Soil...............................................................-......................................................................................................... x U W ........................................................................................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable................................................................................................ g ------------------------ ------•----.............---------•-------------------.._.....-•--•-•----------•------------------------------------------------------------------------------.._...-----_----- Agreemenf ,`. «: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System'lb-acgordance with + tl e`provisions of iITI L 5 of the State Sanitary Code—The undersigned further agrees not to place t e system in - p ration until a Certificate of Compliance has been;issued b the boar of 1 ealtheefo!1owi_ng g d.....� ..� .... , ApplicationApproved B ------------••-........-----•----•-----------..................-----.•. a --....•• te Application Disapproved reasons-------------------------------------------------------------------------------------------------------..--...... ..............•-----•-----------------._...-------------------•----•-----------------=--•-.....------. Da� PermitNo......................................................... Issued....................................................... Pate No. -- ..... Fxs..-�? ?................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...... ..... ...................OF.....-..-.......-..--.-..-.-.-....:..... Appliration for Uiipoual Workii Tunutrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �»- rr -••40 " -- ...........................r1 ¢ tt; ;css................:................•-------. .5 r ----------...................................... Location-Address or Lot No. a 16�J{. �'r'a� 11.10 i�.. !�!. _ ..._e �c.! /2 ..... R E is�Z n.................... ,/ * Ow "Address aW ;/-V0- --" ---- -----------------•-•-----. - ................................................Address... ------____-------__•_•_--- Insta r VType of Building Size Lot__ .3y. _u.......Sq. feet 1-1 Dwelling—No. of Bedrooms.___.__.____.2___________________________Expansion Attic ( ) Garbage Grinder ( ) a " Other—Type of Building ____________________________ No. of ersons__.._..__._.____._.__.______ Showers p ( ) — Cafeteria ( ) d Other fixtures ......................... ------•---•--------------••---------•-----------------------__.................. •---------- ......---- W Design Flow...1_�:0......_.........................gallons per person per day. Total daily flow.._.__.3...3_ __._.________-_-........gallons. WSeptic Tank—Liquid capacity_l!? ,'__gallons Length................ Width................ Diameter................ Depth................ Disposal'Trench—No..................... Width.................... Total Length...... _;........_._. Total leaching area....................sq. ft. Seepage Pit No------/----------- Diameter'`...... _.......... Depth below inlet____________________ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 4 Test Pit No. 1.........._.....minutes per inch Depth of Test Pit.______..____._..__. Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil.................................................................................-------------------------------•------•--------------------------------....--•------•-- V ............................................................................................................--------------•------------•-•-----•--------------..._..__...------•••-...---••-•---•------ W UNature of Repairs or Alterations—Answer when applicable................................................................................................ ...-----•-....-----•-•-------------------------------------------------------------------------------••-----------•••-••.... -------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the boaroof 1 alth. igned_- 14fR�- _------ ..._. Application Approved By...... _ «�* -----------------------------••....----•--•-••----- Da t e Application Disapproved f r, lie following reasons:................................................................................................................ ... •----•-•••--•-------•----------•------••---•------------•--•-•--•••--------•-------------•-------... ----•---••---- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... (9rdifirat e of ft�- plianrr TH-S'IS TO CERTIF t the Individual Sew Disposal System constructed (*-)—or Repaired ( ) by.... .:. __...._ ----1'1 :._A.--•---= ------------------------------------------------------------------------ ., � Installer �^v' has been installed in accordance with the provisions of TITS 5�fhe State Sanitary Co as de Bribed in the application for Disposal Works Construction Permit No...._��_�_"___ ___________________ dated__�__..�r��.y?___._..__.____.____ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® A GUARANTEE THAT THE SYSTEM WIL F CTION SATISFACTORY. DATEZ,71 _ .................................................. Inspector... -------------- -'THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................................OF..-...........-........ . .. .............................................................. FEE---......__. No. ............ �i ou l o !�� ion rruti Permission is hereby granted...... '"�._.... ...... :: to Construct (""I" ee it ( an IndividualeSeewage Disposal�System - Street as shown on the application for Disposal Works Construction Permit No............_,:,.Dated .__z.._ ...................... ........................................... �� Boa�f Health DATE---...........--��------ -----------._....------------•--.. i FORN 1255 HOBBS & WARREN. INC.. 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