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HomeMy WebLinkAbout0011 HOWLAND LANE - Health (2) 11 LELAND LANE, W. BARNSTABLE A=112-001 i f= Fee--- BOARD OF HEALTH TOWN OF BARNSTABLE �ppCication,�for�eCC �ongtruftion�ertnit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair (✓San individual Well at: -------- ------------— -------------------------—----- ---------------------- - Location — Address / I. /Assessors Map and Parcel n, �c 1 r /f f /G a G_ try �, - r ------------------------------------------------------------------------------------------ -------------------------------- --------------------- Owner Address Installer — Driller Address 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 aforedescribed 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 � s 0 ---------—-——------—-—---------- -XA0/0o------------ date Application Approved By —-- -- r --fed Lnt ---------- -- — ——— date Application Disapproved for the following reasons:-------------------------------------------------------------------------------------------- -------------------------------------- ---------------------- ---- - - - ------------------------------------- date PermitNo. ---------------------------------- Issued_--------------------------------------------------------------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certif irate ®f CompCianfe THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired (&-T by--------- ----------------------------------------------------------------------- ----------- --------_------------------------- / Installer 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 SATISFACTORY. DATE--------- —---- - -- — - -- Inspector-------------------------------------------------------------------------- 4. Fee---��------------ BOARD OF HEALTH TOWN OF BARNSTABLE Zipplicat ion i orVell Cootruct ion Permit Application is hereby made for na permit to Construct ( ), Alter ( ), or Repair (man individual Well at: ---� /(z ©a /w hJ FJ u r•.� Location — Address Assessors Map and Parcel �i t� IG� � t� 1A_ ' 4.1 eJ -------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------ Owner Address /Jv. x 9G rk o o� A - ------------------------------------------ �---------------------------------------- Installer — Driller Address Type of Building Dwelling fi Other - Type of Building -------- No. of Persons--------------------------------------------------- �}' ---------------- Capacity - --- - Type of We11-�-r----�J G---------------------------- P Y------------------------- ---------------------------------- Purpose of Well-- o _c7 _w` C-- Agreement: The undersigned agrees to install the aforedescribed 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. ------------------------------------ - o Signed ��--- -------- -- ------------ M date Application Approved ------ ---------------- - i date i Application Disapproved for the following reasons:------------------------------------------------------------------------------------ - ---------------------- --------------------------------- date PermitNo. -------- ------ -------------------- Issued------------------------------------------------------------------------------ date a.mw a.uao +wM.,.`..A+nM+! .w ewa wHwim.n+.!{Ih.Wales«..Mr ciY>«.+rc a9wWaw�Niw+Mw.wc.yr.+1a. BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of (Compliance a THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ' bY------------- A__�c a-"' -r -- --- - ---------------------------------------------------------------------------------- -------------------------------- Installer 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-_--_-______- f_tl__ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------—----- —--------- — - --- Inspector---------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE lVell (Congtruct ion Permit No. ---------- Fee----- -- Permission is hereby granted e1---------------------------------------------- to Construct ( ' ), Alter ( ), or Repair ( 4) an Individual Well at: No. ---------------------------------------------------------------------------------------------------------------------- Street as shown on the application for a Well Construction Permit No. --------------�------�---- ---------- --------------------------- Dated-----�,//"TO Zo'bzi-------------------------------------------------- ------- =---- ----------- a ' T -' DATE Board of Hea th ----�----1--�-�'-------------------- ENVIROTECHLABORATORIES,INC. MA CERT.NO..M-MA 063 449 Rte. 130 a Sandwich, MA 02563 908(888-6460) 1-800-339-6460 FAX(508)888-6446 CLIENT. DA Scannell LOCATION: 11 Howland Ln ADDRESS: (Mr Belfit) W Barnstable MA COLLECTED BY. DA Scannell SAMPLE DATE. 6/1/2000 SAMPLE TIME: 1:00 WATER SAMPLE TYPE: New Well Repair DATE RECEIVED: 6/1/2000 LAB I.D. #. 0006026 WELL SPECS.: 37' RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Analyzed Limits Coliform bacteria /100ml 0 0 9222 B 6/1/2000 PH pH units 6.5-8.5 6.15 4500 H+ 6/1/2000 Conductance um'hos/cm 500 69 120.1 6/1/2000 Nitrate-N mg/L 10.0 < 0.005 300.0 6/1/2000 Nitrite-N mg/L 1.00 <0.003 300.0 6/1/2000 Sodium mg/L 28.0 7.8 200.7 6/5/2000 Iron mg/L 0.3 0.079 200.7 6/5/2000 Manganese mg/L 0.05 0.011 200.7 6/5/2000 COMMENTS: pH is below recommended limit and may have corrosive characteristics. WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. <=less than DateL' L! 0- >=greater than ftnald J ri TNTC=too numerous to count Laboratory Director