Loading...
HomeMy WebLinkAbout0011 APOLLO DRIVE - Health �.l1 Apollo Drive WrBarnstable f Massachusetts Department of Environmental Protection Bureau of Resource Protection Well Completion Reports Well Driller rya rat Please specify work performed: Address at well location: New Well - _— `� Street Number: Street Name: FQ n�a 11 APOLLO DRIVE 0 Please specify well type: Building Lot#: Assessor's Map#: P [Domestic � 131 Assessor's Lot#: ZIP Code: 0 Number Of Wells: 49 02668 City/Town: Well Location BARNSTABLE In public right-of-way: GPS C`Yes r No North: West: 41.70679 70.38712 Subdivision/Property/Description: Mailing Address: IFF click here if same as well location address Property Owner: Street Number: Street Name: ELAINE GRACE 11 APOLLO DRIVE City/Town: State: Engineering Firm: BARNSTABLE MASSACHUSETTS ZIP Code: 02668 Board of health permit obtained: f%Yes r Not Required Permit Number: Date Issued: W2017 025 09/19/2017 �� i L Massachusetts Department of Environmental Protection °a Bureau of Resource Protection—Well Driller Program t Well Completion Reports(General) Well Driller - General Well Form DRILLING METHOD Overburden Bedrock uger Choose Bedrock— r WELL LOG OVERBURDEN LITHOLOGY Drop in drill Extra fast or slow Loss or addition �rn (ft) To(ft) Code Color Comment stem I drill rate of fluid �0 10 Silty Sand ( Brown ! r I f'Fast r Slow Loss Addition YES NO 10 20 Fine To Coarse S Brown ��r Fast.r.Slow Loss Addition 20 30 Fine To Coarse S j3 - Brown • rl Fast r Slow T— YES NO Loss Addition WELL LOG BEDROCK LITHOLOGY Drop in Extra fast or Loss or Visible Rust Extra From(ft) To(ft) Code Comment addition of Large drill stem slow drill rate fluid Staining Chips P �� f W Choose Code °► Yes r Yes Loss Addition ADDITIONAL WELL INFORMATION Developed Go Yes_(— fe(—No Disinfected Yes r No Total Well Depth 30 Depth to Bedrock III Surface Seal Type lNone �racture Enhancement f`Yes No CASING 1 Is Casing above ground? From: 1 To. 0 From To Type Thickness Diameter Driveshoe 27 Polyvinyl Chloride m� s+ Schedule 40 =J L Yes SCREEN II No Screen Fr�m To Type Slot Size Diameter 27 30 Stainless Steel Well Pointe V 0.012 L WATER$EARING ZONES DRY WEL From T To Yield(gpm) PERMANENT PUMP(IF AVAILABLE) 2 Wire Constant Speed Pump Description Horsepower Submersible Pump Intake Depth(ft) 25 Nominal Pump Capacity(gpm) 10 i i Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program ' Well Completion Reports(General) 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 ......_.v.__._.--- Time Pumped Pumping Level(ft Time To Recover Recovery(ft [Date Method Yield(gpm) (HH:MM) BGS) (HH:MM) BGS) 09/19/2017 Constant Rate Pump j: [�12 7:: 1:3D _— 9 0:01 Y 6 WATER LEVEL Date Measured Static Depth BGS(ft) Flowing Rate(gpm) 09/19/2ot716 _ 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. WILLIAM Supervising Driller DESMOND, DrillerURQUHART Registration# 877 Monitoring[M] Signature PATRICK, DESMOND WELL _ Firm DRILLING INC. Rig Permit# 024 Date Job Complete 09/21/2017 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. FI'A��Jr CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009) y�iCENSt^� I Recipient: Sally Desmond Matrix: Water-Drinking Water Desmond Well Drilling Sampled: 09/19/2017 14:30 P 0 Box 2783 Received: 09/19/2017 15:35 Orleans, MA 02553 Collection Address: 11 Apollo Dr.W.Barnstable,MA Sample Location: Order#: G17103391 Description- 2 Day Rush-11 Apollo Dr RE Kit Lab ID: 17103391-01 Date Analyzed: 9/20/2017 @ 10:53 I i Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Sodium level.is above the maxlum contaminant level.Those on a low sodium diet may wish to consult a physician. EPA 524.2- Volatile Organics by GC/MS -- - _......... .Result- MCI. .-M Result 1�� MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroform 2.9 BO 0.50 Chloromethane ND ` 0.50 cis-1,2-Dichloroethene ND 7D 0.50 - - ND 0.5 ide ND 2.0 o.s0 cis-1,3-Dichloropropene _ - -- - Viny c or _.... eromometlhane ND 0.50 - Dibromochloromethane ND 0.50 _. _ 1,1,_1_,2-Te_trachloroethane ND 0.50 Dlbromomethane NDt70�'O� 0.50 _ 0.50 ND 200 o.so Ethylbenzene ND1,1,1-Trichioroethane 0.50 Hexachlorobutadlene ND1,1,2,2-Tetrachloroethane ND -1,1,2 Trlchloroethane ND5.o D.50 Isopropylbenzeneo.5- ._...1,1-Dichloroethane ND - o.SD Methylene chloride ND - ---- ...:__" 7.o D.5D Methyl-tent-butyl ether ND 0.50 1,1-Dichloroethene ND _ - 1,1-Dichloropropene ND - 0.50 Naphthalene ND - 0.50 - "-- 0.50 Ln-Butyllbenzene ND 0.50 123-Tdchlorobenzene ND 1,2,3-Tdchloropropane ND o.50 nzene 1,2,4-Trichlorobenzene ND 70 0.50 ltoluene ND o.50 1,2,4-Tdmethobenzene ND 0.5o enzene ND 0.50 1,2 Dibromo-3-chioropropane ND 0.50 Styrene ND -100 0.50 1,2-Dibromoethane(EDB) ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dichlorobenzene _ ND 600 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dlchloroethane ND 5.0. 0.50 Toluene ND 1000 0.50 -� 1,2-Dichloropropane ND 0.50 Total xylenes ND 10000 0.50 1,3,5-Tdmethylbenzene ND 0.50 trans-1,2-Dichloroethene ND 100 o.So 1,3-Dichlorobenzene ND 0.50 trans-1,3-Dichloropropene ND 0.so - - 1,3-Dichloropropane ND 0.50 Trichloroethene ND 5.0 0.50 1,4-Dichlorobenzene ND S.D 0.50 Trichloronuoromethane ND 0.50 2,2-Dichloroprop_ane ND 0.50 Surrogates %Recovered QC Limits(%) 2-Chlorotoluene ND 0.50 p Bromofiuorobenzene 850/ 70 130 4-Chlorotoluene ND o,50 1,2-Dichlorobenzene-d4 101%.. 70 L30 ._ - - Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochlorometh_ane ND - 0.50 Brichiorometha omod ne ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0.50 Chloroethane ND 0.50 Approved By: -- Attached please find the laboratory certified parameter list. (Lab Director) C, ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level � 3195 Main Street, PO: Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 1 of 1 U vs t -�A "^ °sr CERTIFICATE OF ANALYSIS Page: 1 of 1 Barnstable County Health Laboratory (M-MA009) "f1�,r.rUSY��J Report Prepared For: Report Dated: 9/21/2017 Sally Desmond Desmond Well Drilling Order No.: G17103391 P O Box 2783 'Orleans, MA 02553 Laboratory .ID#: 17103391-01 Description:. Water-Drinking Water Sample#: Sample Location: 11 Apollo Dr.W. Barnstable,MA Collected: 09/19/2017 Collected by: DWD Received: 09/19/2017 Routine M ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE I Nitrate as Nitrogen 0.71 mg/L 0,10 10 EPA 300.0 LAP 9/19/2017 Iron ND mg/L 0.10 0.3 SM 3111E LAP 9/21/2017 Manganese . 0.055 mg/L 0.025 0.050 SM 3111B LAP 9121/2017 pH 7.3 PH AT 25C NA 6.5-8.5 SM 4500-H-8 DCB 9/20/2017 Sodium 26 mg/L 2.5 20 SM 3111B LAP 9/21/2017 Total Coliform Absent P/A 0 0 SM 9223. •RG 9/19/2017 Conductance 260 umohs/cm 2.0 SM 2510B DCB 9/20/2017 Sodium level is above the maxium contaminant level. Those on a low sodium diet may wish to consult a physician. i Attached please find the laboratory certified parameter list. Approved By.— (Lab Director) • a 1 X / i 3 i a a 's { s s : 'r s i i - i I ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level i i 3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508.375-6605 i No. [ 7 Fee S BOARD OF HEALTH TOWN OF BARNSTABLE TippYication -for Yell Cougtructiou permit Application is hereby made for a permit to Construct(✓), Alter( ), or Repair( ) an individual well at: pip Bl'rY,�"j.►_ n( Location-Address' Assessors Map and Parcel Cccac-a_ kk A no\10 1 fit'. 1,W AS i11- tA ozca Owner Address innvff4 %jo\k i�a,�w� P-o 2c183, 0&�ns DM o2653 Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons Type of We11 4„ S C*-qb (P VC_ Capacity 0 Purpose of Well J(-' 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 Cert' cate of Compliance has been issued by the Board of Health. Signe �,� Shin Date l Application Approved h ( l Date Application Disapproved for the following reasons: Q Date Permit No. Q,�P)�2 Issued Q 1 "l 1 Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of (Eommpliartce THIS IS TO CERTIFY,that the individual well . Constructed(4), Altered( ), or Repaired( ) by Desr-y.QjA \tjQ_jt tI>,_� Installer at '` A P o"o ox,staoy- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private We Prot cti n Regulation as described in the application for Well Construction Permit No.Q, l �p�5 Dated 9 � 9 1 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector � f F No. i 7 3 s Fee BOARD OF HEALTH TOWN OF BARNSTABLE 01 ppricatiou for Yell Construction Permit Application is hereby made for a permit to Construct(✓), Alter( ), or Repair( ) an individual well at: 1 i �01�0 �c��e. :1�11r 1Iay.A ( 31 oLAq Location-Address Assessors Map and Parcel c<aco ll A�nllt, 6tnskc,LAp Owner Address %10\1 ;1\:nR o`�� �.Cy�c 2"1 3 C�cLcA,r�� YY1A o2653 Installer-Driller a Address Type of Building Dwelling Other-Type of Building No. of Persons ` Type of Well L� S G P Qc— Capacity )V Purpose of Well c4c:N i 0nm J 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 Daatte Application Approved 'ry �� 1 Date Application Disapproved for the following reasons: �^ Q a Date Permit No. � -3 Issued 1 1 \ )I Date -------- O--------------- ----------------- deem°------------------------------ BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed(d), Altered( ), or Repaired( ) by Dd\�rN!1 , k,'_ //�� Installer at. I \ A 1 o �r�_V has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Prot' cti n Regulation as described in the application for Well Construction Permit NO.\A) 1? a�5 Dated 9 Il 9 !7 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 Very Construction Permit No. ^©aD-. Fee Permission is hereby granted to 1�.e._Sm�, VQAk 6 YsA \iNC Installer I to Construct(�, Alter( ), or Repair( an individual well at: Street as shown on the application for a Well Construction Permit No. V Dated Date `` 1 '"\ ! Approved aLegend Parcels -< - Town Boundary Railroad Tracks f, Buildings 131041 Painted Lines .Jf ~`ti #123 f'u+` 131022 Parking Lots F/' j24 Paved Unpaved 131040 f' \ Driveways #10 r , f ill Paved Unpaved 13t043 Roads C3 Paved Road 8 M1 Y1 4!r. r \w Unpaved Road lc ; f 41 Bddge Paved Median f `•. r' ,;, Streams �t4 �' Marsh 131039 13 Water Bodies 131g044 fF • ~1 #LIB s� h , i 1 i030 131045 ,. #40 #€ 131048 #23 h 131037� ��� ! 68 �� �, 131047 #39 �131"051 f 131020 x; Map printed on: 9/19/2017 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026oi 0 y 83 167 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: 1 inch = 83 feet 0 cartographic errors or omissions. gis@town.barnstable.ma.us (� N OF BARNSTABLE h0000f LOCATION 0,°- SEWAGE # 3 2/i/ VILLAGE b`�/`Z4-4 ,ASSESSOR'S MAP & LOT 3 INSTALLER'S NAME & PHONE NO. A & B C qCO 775-6264 SEPTIC TANK CAPACITY /o- -0 LEACHING FACILITY:(type) cP--- (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC,WATER w, BUILDER OR OWNER ' DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED:9 -/�?--Y VARIANCE GRANTED: Yes No v i n 'you \�.. n �� -/� � 'o � ¢ � J �,;�.. �— �. � ,1 . � c c� = t.; "ARICEL NO.. 131 -0 No.......... __ ...� Fps.._..-.a .l........_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ........... wn...............oF7;'.W+1_K?ea................................................ .._.._. ApplirFation for Dhip i al Works Tnnitrnrtinn Vamit V101 Application is hereby made for a Permit to Construct ( ) or Repair (*) an Individual Sewage Disposal System at: �. -••,------------ --- t--a- l-�--------•--•--....--•---•--•••--...---•- Location Address rLo .---------••---------------------------------------------- ..4 Q,L o ------------•-••----------- Owner .................. . _ll/.r10 _ :..Cs�.r.-- --------------- Installer Address d Type of Building Size Lot----------------------------Sq. feet V Dwelling—No. of Bedrooms________________________________ _____Expansion Attic ( ) Garbage Grinder ( ) _______________ No. of ersons._._______..____________.___ Showers — Cafeteria p`�-, Other—Type of Building _____________ p ( ) ( ) Q' Other fixtures _______________________________ _ _ W Design Flow......._....................................gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacity............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.....................------•••-••-•••- ,� 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........................ P4 •--•---------••-----•---•---•••---•-••••--•--••-•---•••.................•-------•-•----•----•••••••.......................................................... . 0 Description of Soil........................................................................................................................................................................ x W UNature of Repairs or Alterati ns—Answer when applicable._ -nSi ._�OG�?__� yi-_�Qfi��l: w1______________. ---- nc�_ zs-_r.— .—Answer - -•- --•---------•----- --------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i T:t.. 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 by the board of iealth. Signed..... !- u ----•-•----•-----------•- .2G'8.1......... Date ApplicationApproved By-••-••••-•••-•••••--•••••-••-•-•-••••-----......-••--•••-••---------•-•....................••••-- ........................................ Date Application Disapproved for the following reasons:.............................................................................................................. -----•---------------------•-•-----••-----------•--...--------------------------•-------.._._._._..----=---•--•-•----•------••••----•-•••---••-•------•-----=-----••---••••-•-•-=---••••--•-•--...._.._. Date PermitNo.---•- .. ---- Issued....................................................... Date ly No...��...J.�.d Fxs..... c�'_........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF...r:.'�rrr� )}n _......... - - ---------------------....................................... Alip tratinn for Utipu, al Works Tonfitrnrtian .rrautt Application is hereby made for a Permit to Construct ( ) or Repair •(A- ) an Individual Sewage Disposal System at: ;� t 8 t0"dr? ►)rIIIC 1,Al # /r�) r ...................................................•-•--------------....=......--......-•------ ocahon-Address or Lot)NO, owner ! a Insta.ler Address J Type of Building Size Lot-Garbage Grinder q f eet Dwelling No. of Bedrooms................. Expansion Attic ( ) g ( ) P4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria. ( ) PL4 Other fixtures ----------------------•--------•-------•--------...•-- W Design Flow............................................gallons per person per day. Total daily flow--------------..............................gallons. WSeptic Tank—Liquid capacity............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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water---_------_-_-__.-_----. f3:4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •--••--••-••----•••••-••----•-•••--•-•---•--•-----......••-------••-•••---.......-••--------------•--•-...........------...--•-••••--•- ..... .-------------- 0 Description of Soil.................................................................................................................................................-.................... x W _ ------• •----------------------------••-•---....•••---------•--••--------••----••••••..........-•----•--••-•••---•••-•-••----•••---••--••--•-----••-•---••••-•--••---•--••--••----•--••-•............ U Nature of Repairs or Alterations—Answer when applicable. -�? =1 ...f�: _r= 2__- t�ra �? ?� li�� J. !T APT�e�f n!): Agreement: � The undersigned agrees to install the afor edescribed Individual Sewage Disposal System in accordance with the provisions of T__"TiE j of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed..........--=------•------..__........=•---••-•-----------......--------------------- t Date r•' ApplicationApproved By....................-............................................................................. Date Application Disapproved for the following reasons:.............................................................................................................. •-------------------•-----....-----------••--•-----------------------------•-------------------------•------•-•------•••--•••--••••-----•-•••---•-•-------•-•••-•----•--••-----••-•--••••--••••-•---•--- Date Permit No.............................. u---(.._.._..----•--. Issued Date THE COMMONWEALTH OF MASSACHUSETTS L rc��e BOARD OF HEALTH atom......................OF... �<..trn5.lr.. ............................................-....-.... Trrttftrate of Tompti am THIS QRTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (-/!) by.................................................................................................................................................................................................... > a l//o p.1 taller at.......... ---1....-•••-•••••--•-••----•••................•--- has been installed in accordance with the provisions of iii'T, j of The State Sanitary Code a� descr•bed in the r/ application for Disposal Works Construction Permit `o.......__..�._ _��..�............... dated....-_-.-_� --_z_�.-��'�.-._...... TIME ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT rHE SYSTEM WILL FUNCTION SATISFACTORY. J J DATE. == -{�-•-r .. Inspector -+ •-------------•----•----•---------•--••---------•------- 67-r�' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................OF.... /Q! T.... r.............................................................. r PTO....................... t'EE......t 1:............ Btopoiital nc�C lu trnduan rrruttt Permission is hereby granted ............................ to Construct ( ) or Repair ( ) �n Individual,Sewage�Dis osal System Street "3r] r l/ (, I as shown on the application for Disposal Works Construction Permit No.. ................. Dated..,...... .... ....................................................... Board,of,Health DAT E-------------------- '� ?. --/`� ............................ FORM 1255 '�HOBBS & WARREN. INC.. PUBLISHERS