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HomeMy WebLinkAbout1051 SERVICE ROAD - Health 1051 Service Road A= 153—035 W. Barnstable BOARD OF HEALTH TOWN OF BARNSTABLE t Certificate ®f (Compliance THIS IS TO CERTIFY, That Individual W 11 Constructed ( Altered ( ), or Repaired b-------- ( ) -` �- ---'-__-lnc�d ---- -------------------------------------------------------------------------------- - -- 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 SATISFACTORY. DATE- - - ---—---- — - - -- -- Inspector------------------------------------------—- - ------------ _ rd� C-X, �� . r 9- 1-7 /7 Fee------------ --- --..- BOARD OF HEALTH TOWN OF BARNSTABLE Application-*rVell Con0ruct ion Permit Ap lication is hereby made for a permit4t Construct/('� Alter ( ), or Repair ( )an ' dividual Well at: q 9 --------------- ---- 0 --� ----�/ Location — Address Assessors—Map Ma and Parcel Owner Address ---------- - ----- F � -� - Installer — Driller .Address Type of Building �. Dwelling f -�------- �' 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 P otection Regulation — The undersigned further agrees not to place the well in operation until a Certificate .o o ance s b n issued by the Board of Health. Signed ——- --------- ----------— ------------ -------------- — date Application Approved By ----- - ----------------- Sate Application Disapproved for the following reasons:--------------------------------------------------------------------------__________ --------------------------------------------------------------------------------------------------------------------------------------------------------- date Permit No. I ` ` r ------------------ Issued te tie is 1 II w r,.'K'.f;1� - .-, _ f : _.- rr?..-, ..•.. � � } �}' 1 � i...: n..�}.,.w.�rtt vr'c•i r :-.-. -. ���.-t vw�.•.r.n+w s .t•.I�}.k,�.y , r r *. - - s Fee--- -No- ------- -- '- BOARD OFt HEALTH TOWN OF BARNSTABLE Zipp[ication fforVe[[ CootructionV'rrmit -Ap lication is hereby made for a permit Construct( T, AItei'(.w ), or Repair.(�, )an.' di al Well at: e:i�-------e , Location;— Address ° Assessor M{ ap and Parcel ------------ f r ' Owner y Address �'"'' - Q - __ r1___------- - - Installer — Driller Address Type of Building - 'Dwelling--------------------------- r Other - Type of Building------------------------------- f No. of Persons--- ---------------------------------- --- -- - - ------------------ Type of Well Capacity, Purpose of Well - - - - --- -- - ------- Agreement: _ w The undersigned agrees to install the Yaforedescribed 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 .o o 'ance ,' s bCen issued by the Board of Health. Signed � ' ---- - -------- - /�da Application Approved By - ------ -- te 9--------- --- ate -- Application Disapproved for the following resons ,'=- =--------------------------------------------------------------—---- ----------- ' ;_ -- -- ------------- --——---------------------------------------------------------------------------------------- - - -- s date f Permit No. --- �� - - - - ---------------------- ---------- d-�---- - - Issued � -- -- ate BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance I I THIS IS TO CERTIFY; That,t Individual 711 Constructed ( Altered ( ), or Repaired ( ) bY--------� � -- - r-`"' --- -------------—------------------------------—----------------------- Installer — — — —— _------------------------------------ t I has been installed in accor mice itli the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in,t e''applicati4 for Well Construction Permit No. ------------------------Dated---- -------------------- THE ISSUANCE O r' / IISC'EZTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION,SATISFACTORY. DATE------------------—-— —-------------------- -- Inspector----------------------------------------------------------------------- _,..a.........a.�w,..�a�wY�.,..:�.,,ua�..waw,.i.ti�«.�d».!�,rw...b.M�•.�i.»,:...» - ... _. ..- _ -- � - BOARD OF HEALTH TOWN OF BARNSTABLE )Veil Conoructioni3ermit No. --------------- Fee----------------- -- -------------------------------------------- Permission is bereby granted-------,��''- �---- -- - _ -- �� to Construct Alter ( ), or Repair ( ) an Individual V/ ell a� Street as shown on the application for a.Well.Construction Permit No. ----------------------------------------- Dated-(;�% ----ter- - - --_._ - Board of Health DATE—_y�'-�� _-���—---------------------- ' TOWN OF BARNSTABLE LOCATION 'oge Pj _.—SEWAGE # 93-,7g 1.53 - � VILLAGE W, j_�, ,A) 4u j_E ASSESSOR'S MAP Ora LOT c 56A) 77I—&JCS INSTALLER'S NAME 6z PHONE NO.J,� ,�6'JSlAL�(, , •_ SEPTIC TANK CAPACITY_ _0: !i Ad LEACHING FACILITY:(type) I'lbu�F�F`030 s a (size) t d NO. OF BEDROOMS___ __,� SATE WELDOR PUBLIC WATER BUILDER OR OWNER Y DATE PERMIT ISSUED: i Z " zv 93 DATE COMPLIANCE ISSUED:_ VARIANCE GRANTED: Yes - No l g �T7"- ® oLo- ® O No.4...�.".Y.1 _ FizB.. .:tom......._ t THE COMMONWEALTH OF MASSACHUSETTS 2 (. BOARD OF HEALTH ......OF...... PT Appliratiun for Ili-wiial Warkii Tunitrur#iun Permit Application is hereby made.for a Permit to Construct (x) or Repair ( ) an Individual Sewage Disposal System at: (� .� ._�T_...S. ............. L` J..�'...... .......................................- - d+'c v_e?- 8 Lam..._ `� •- Location-Addres or Lot No. ..... -• — •�./�.`..�.'.... ..........�T11-tom........--•- ......•.... ................ •.......... ..................._......-- owner Address a .....................:P. C ............-•-•-•---•-------•--...........----- ...................---•-••-----•-•._...------....----•---..........---•--......................... Installer Address Type of Building 3 Size Lot...1._`5a5�1� ''JLSq. feet ., Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) W'4 Other—T e of Building No. of persons............................ Showers YP g -------••................... P ( ) — Cafeteria ( ) QOther fixtures ............................................. ....=...................................................................... W Design Flow................55 ...........................gallons per person per day. Total daily flow.............--..33:�----.......gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width:............... Diameter................ Depth................ x Disposal Trench—No.(,... `.......... Total Length.....`........ Total leaching area.... .....sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area.................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) �� �. "' Percolation Test Results Performed by....._._PL0­!-k..... ... .��C...... Date......-_�.....1.3 Test Pit No. 1................minutes per inch Depth of Test Pit..........`F ..__ Depth to ground water.........? f� Test Pit No. 2...AS....minutes per inch Depth of Test Pit........ Depth to ground water.......... ,�h_... phi f ----°=Z='.T1:S..)..�:3....�'.`... '`!p'. : ► .�o.... f,�a— O t `T 5� t t �a�- l t- ... r-L Description of Soil..-.-----•-------- .. r i :......__..`.......fir}o......--•-------•-...... �+ �� Piiuk.. 17Mv�o •...- caESh�-4.S Cr 51yw. V .............:�.�c''..........Z....r.�.. a..._2=`?'..---. .. -..... ,l.... - �.�!i'.:f...__... 4�'''"`- t.... Lt1 8-`1..•---c-�----.......I.-!`.......-�.-N�+ w.�,.�.. ' �" VNature 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 TITLE, 5 of the State Sanitary e— The u ersi e further agrees not to place the system in operation until a Certificate of Compliance has bee ssued by t o liealt 9_Z Signed....... ........ . ...... ........................................ W .... .... Application Approved B ..................................... ' Dal-•--•--. �'- Date Application Disapproved for the following reasons:...............................................•--...................---....................................... ---•--•--•---•.............•--•--•------......-------•-----------•---•-----•----................----••-•---•--••--•-•--•--..........----•-----------..........--•------•--••••-•-----................... Permit No....:. .. ..�.. .�t.................. Issued...................... Date................. ......... Date THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) IM ^� , JC DATA No..l. .._ , _. s THE COMMONWEALTH OF MASSACHUSETTS BOARD OFF HEALTH 153.4 Appliirtttion,for Bisvoiittl Works Tonstrurtion rantit t Application is hereby made for a Permit to Construct ( X) or Repair' ( ) an Individual Sewage Disposal System it: . i , 16 0..... :..- oT .......................... tt .. - = - "�'t er 6 L {f9 L�-lti Location-Address or Lot No. - ... - ___....._.._.:•' ........... ....`...: ...................... -•---•-•------------•--------•..........•-•••.........................__._....................... Owner Address a ................................ .......?..... .............................................. .....•----------•---------...........-----•--...........•-•--.......................•............. Installer Address Type of Building Size Lot...).':9 ql.'....Sq. feet �-. Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g -----•---------••-•--------- P ( _) — Cafeteria ( ) Otherfixtures -----•-••------•••---••••.............................•------•---•••---••••••---•---•--•-••••---.........---.............------..................--- W Design Flow.................5.__-5...................gallons per person per day. Total daily flow... .........................................gallons. 04 Septic Tank—Liquid capacity............gallons Length................ Width,.A__;...._..... Diameter................ Depth................ Disposal Trench—No. . !�._!.!FWidth.......�C......... Total Length...:= ........... Total leaching area.__..-?'�..1 ....sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.......:-........... Total leaching area..................sq. ft. Z Other Distribution box ( ). Dosing tank ( ) Ili a Percolation Test Results Performed by....... 7 .._...._."'`'� .G....... Date......��.: �. Gl.��............ Test Pit No. I................minutes per inch Depth of Test Pit.........'.`....... Depth to ground water........�.�:5..... 44 Test Pit No. ....minutes per inch Depth of Test Pit........ ... Depth to ground water.........ti` ._.. 2 i 4 ........................................................r 5 ' t t �A . Gam.-t�4 "f. 1 0 'r•L. ............................................ ......................... O Description of Soil....... 1' --I l �) � t lr- i I ram.4 4 ' k 1= �,4 ....................................................w-4, o w��a. .��•^� ........----•.............• . -----...--•••....... --•--- ------ -• ►�+ -ru 6) ,-. 2 '1 4 . 4• Via...`� ,h A+a �;/d.:.v.� .��� e i'., F•• Ea r+y � V ..---•- -- --------------.... ---------- ------------------ ..........................................-I•�......-�NY � .....ems .. `..... ...'/,...._.......:-----------.............................. VNature of Repairs or Alterations—Answer when applicable........ ...................................................................................... .................................................... ...•-•---....-----•----•-••-•----.............----•-------------------------------------------•--------•--.........-.,...............--.......-•-- Agreement: _ The undersigned agrees to ]ns`tall the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:ITL-: 5 of the State Sanitary e— Thgersi further agrees not to place the system in operation until'a Certificate of Compliance has bee ued byhealt Signed... .:'_ �.... Da e Application Approved BY ....R...... Date w Application Disapproved for the following reasons:............................................................................................................ e .._... ..............•.•--•-•--•-•-••---•-••----••••.................................... ............ Date . Permit No....... ... .... Issued-........................................................ Date .^.a.........s. ......................... --­--------- THE -. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' ...........�..r ..........OF........... ...................... Trrtif irate of Toutpliattre THIS T��RTIFY, >hAt the Individual Sewage Disposal System constructed (V) or Repaired ( ) by -- ............................•-...•............•..-•---•--•---............----•-...---•---•-- -....... .......----•-- L^ 11 at..........-`~ ...............................................................7..Ins„..... ..� ....................••-•--------------------...................................... has been installed in accordance-with the provisions of TIT 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.......... = _.-_?.-_ry_9' dated................ .................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................ - _ / .. Inspector----------- ..................................................................... - - - - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH SQ .................T ..OF.......-- .......•••--•.............. NO.. ..._..._..�.. (. FEE..... • ......-- Disposal Works Tonotrurtiott f rrntft Permission is hereby granted........ `::�...I...._��.Z./`..5 CCJ.0- to Construct (_ �X) or Repair ( ) an Individual Sewage Disposal System - at No. Ltd.. `� �. /�`�', x I'�GZ%�a�--�ZI& - •----------•--.•-••••......-- -•---•--------•---•--------------•-----•--------•-•••-•--•••......-----••.•..... treet �r �-���� as shown on thWpplic:ion for isposal Works Construction P o._ 3� / d.o .... ............... -• . •. . ......................... Boar of I ea DATE-----------� --•---.. ._.__. r Logged In As: Parcel Deta I I Monday, March 3 2008 Parcel Lookup Parcel Info Parcel ID 2153-035 Developer;.LOT 5 Lot i Location 1051 SERVICE ROAD Pri Frontage ........................... Sec Sec Road ;RANTA CIRCLE Frontage ge'658 _ ; Village;WEST BARNSTABLE Fire District jW BARNSTABLE ___ ......... Sewer Acct 3 Road Index 2101 Interactive g1 Map 1 Owner Info owner!STILL, DONNA RANTA& Co-owner STILL DAVID B 11 Streetl ;P O BOX 618 Street2 City W BARNSTABLE State(MA Zip 02668� Country USA Land Info Acres i4.68 use°Single Fam MDL-01 Zoning RF Nghbd 0105 Road � ._. Topography.Level Paved utilities'Gas,Well Septic Location Construction Info Buildingof I Year Roof�� `��� � Ex l 11993 struct Gable/Hi Wall lWood Shingle Built�_._ _.-- _........ _.. p Effect' _.` Roof AC Area 12268 Cover Asph/F GIs/Cmp Type e None . style;Cape Cod Int iD wall ] Bed Bedrooms _._. .._ ._.__...... Wall .... .. ...._._..._ __1 Rooms! � Model ?Residential Int ] Bath 2 Full + 1 H Floor . .-. ] Rooms, _._... Heat _ _..._ ._ . Total Grade;Average Plus Hot Water ;6 Room Type! Rooms ,,. .. .... .. .:. Heat'— __. _ Found. Stories:1 112 Stories ;Oil }Poured Conc Fuel �_. _ _-_ _ ation E. __.._ ...� Permit History Issue mate Purpose Permit# Amount Insp Date Comments 11/1/1993 B36317 $135,000 1/15/1994 12:00:00 AM WB 11/2 S f Visit History_ _..__...__ __ _ ". v..", Date Who Purpose 1/17/2008 12:00:00 AM Paul Talbot Cyclical Inspection 3/27/2000 12:00:00 AM Paul Talbot Meas/Listed 2/15/1994 12:00:00 AM ML Sales History Line Sale Bate Owner Book/Page Sale Price 1 7/15/1993 STILL, DONNA RANTA& 8675/202 $1 2 10/15/1990 RANTA, ROBERT E & 7340/260 $100 - Assessment History"" Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2008 $203,300 $0 $0 $208,600 $411,900 3 2007 $241,200 $0 $0 $208,600 $449,800 4 2006 $215,100 $0 $0 $226,800 $441,900 5 2005 $197,600 $0 $0 $154,700 $352,300 6 2004 $157,800 $0 $0 $123,800 $281,600 7 2003 $140,600 $0 $0 $132,200 $272,800 8 2002 $140,600 $0 $0 $132,200 $272,800 9 2001 $140,600 $0 $0 $132,200 $272,800 10 2000 $114,900 $0 $0 $80,200 $195,100 11 1999 $114,900 $0 $0 $80,200 $195,100 12 1998 $114,900 $0 $0 $79,900 $194,800 13 1997 $115,100 $0 $0 $58,500 $173,600 14 1996 $115,100 $0 $0 $58,500 $173,600 15 1995 $69,000 $0 $0 $58,500 $127,500 16 1994 $0 $0 $0 $0 $52,700 Photos OLE f �• 9 3 fin' BOARD OF HEALTH TOWN OF BARNSTABLE S�'U'G Ips� Uj .6 Zippiicat ion ArVerr Con5truct ion Permit Application is hereby made for a permit to Construct (&J, Alter ( ), or Repair ( )an individual W 11 at: -IFCJ T Location — Address Assessors Map and Parc I ly1,C:�,' S_i_��/J u_ �N. P,�j N�4!/,°J C� Ti d� --- -- �— •--`--!--_C_�_-G_ __ n.�i 1i2,. -LE'----n!tt G--______ — Own r Address ------------------------- -----1------- Installer — Driller j Address Type of Building Dwelling-------J°u.t-c ----------------------- Other - Type of Building --- No. of Persons------------------------------- Typeof 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 aVCert*ficate Compliance has been issued by the Board of Health. Signed— J. - ► �Q- ----------------------- date Application Approved By - date Application Disapproved for the following reasons:----------------------------------------------_______—____ — - — ----------------------------------------- ------- - ----- `� date PermitNo. ---------------------------- Issued----------------------------- ---- date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of (Compliance THIS IS TO.CERTIFY, That the Individu I Well Constructed (�, Altered ( ), or Repaired ( ) - /a p Installer at has been installed in accordance with the provisions of the Town of Barnstable Board pof�Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -/�y_ Dated----_—__— THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------------------------- --------------------- Inspector---------------------------------------_ W No.--- *- -�---- _ Fee---— __�_ -------- BOARD OF HEALTH TOWN OF BARNSTABLE } AppricationArlftl Con5tructionpermit Application is hereby made for a permit to Construct (V), Alter ( ), or Repair ( )an individual Well at: t�! ---- f C^_ c� , p / Location — Address Assessors Map and Parcel y ------------------------ ------------------ - ----- IOwner Address — —-- _ � • Installer — Driller � Address / Type of Building Dwelling �"u r ---------------------------------------------------------------- - Other - Type of Building------------------------------------ No. of'Persons---------------------------------------------------\ Typeof Well- 11 L�------------------------------------------------ Capacity------------------------------- Purpose of Well--lagt.-AS- •----------------------- 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--F.' E_ `'`"",'-- ---------- --------------- date Application Approved By----------- -- `�;---= - _ "_ 3_ ---- --- -------------------- date Application Disapproved for the following reasons:----------------__-------------------------------_-----------------------------__---_---------—-------_ ----------------------------------------------------------------------------------------------------------------------------------------------------------- -------------- date PermitNo. --y�`—-1—��- - - - ---------- Issued------------------------------------------------------------------------ -- date BOARD OF HEALTH r TOWN OF BARNSTABLE 'r Certificate ®f (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (,,I), Altered ( ), or Repaired ( ) -----------=----------- Installer t 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 SATISFACTORY. DATE------------------------------------------------------------------------------------- Inspector-- --- --------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Ivell Congtruct ion 3permtt --- Fee--------�--- c Permission is hereby granted--------'------=-=- - - -�"--- -----.----�-------------------------------------------------------------------- to Construct (41), Alter ( ), or Repair ( ) an Individual Well at: J No. --------`----4g7----------�---------A-A'a�'e�d — -----�'---- ---------------------------------------------- Street as shown on the application for a Well Construction Permit No.-------------------------------------------------------------------------------------- Dated----------- --- - - ram . - ------- ---------- ------------------------------------ M — '- DATE � -------------------------------- ----- .3 - Board of Health -------- �-- ----------------- J*. _ eve ENVIROTECH LABORATORIES Mass. Cert.#:MA063 449 Route 130 Sandwich,MA 02563 • (508) 888-6460 CLIENT. Bayside .Buildinp, Co. LOCATION: Lot 5 Access Rd. ADDRESS: 1645 Rte 28 W_ Rarnstah1 e, MA Centerville, MA COLLECTED BY: D.A. Scannell SAMPLE DATE: 12-8-93 TIME: 12;OON DATE RECEIVED: 12-8-93 SAMPLE ID: DAS 5 JOB#: New well WELLDEPTH: 100, RESULTS OF ANALYSIS: Parameter Units Recommended limit Result Coliform bacteria/100 ml (MF Method) 0 0 pH pH units 6.0-8.5 6.03 Conductance umhos/cm 500 95 Sodium mg/L 28.0 10.2 Nitrate-N mg/L 10.0 0.03 Iron mg/L 0.3 <0.05 Manganese mg/L 0.05 Hardness mg/L as CaCO, 500 Sulfate mg/L 250 Potassium mg/L 20.0 Alkalinity mg/L 200 Chloride mg/L 250 Turbidity NTU 5.0 Color APC units 15.0 Background bacteria/100 ml (MF method) 200 EPA 601 602 # ug/L N.D. COMMENT: # See Report attached. YES NO uX ❑ WATER IS SUITABLE FOR DRINKING PURPOS OR P ETERS TESTED. '. DATE + f ` GROUNDWATER ANALYTICAL EPA METHODS 601 and 602 Volatile Organics (GC/PID/ELCD) Field ID: DAS 5 Lab ID: 6597-01 Project: Bayside Lot 5 Access Batch ID: VG3-0164-W Client: Envirotech Sampled: 12-08-93 Co,nt/Prsv: 40mL VOA Vial/NaHSO4 Cool Received: 12-09-93 Matrix: Aqueous Analyzed: 12-14-93 PARAMETER CONCENTRATION REPORTING LIMIT (ug/L) (ug/L) Dichlorodifluoromethane BRL 5 Chloromethane BRL 5 Vinyl Chloride BRL 5 Bromomethane BRL 5 Chloroethane BRL 5 Trichlorofluoromethane BRL 1 1,1-Dichloroethene BRL 1 Methylene Chloride BRL 1 trans-1,2-Dichloroethene BRL 1 1,1-Dichloroethane BRL 1 cis-1,2-Dichloroethene * BRL 1 Chloroform BRL 1 1, 1,1-Trichloroethane BRL 1 Carbon Tetrachloride BRL 1 Benzene BRL- 1 1,2-Dichloroethane BRL 1 Trichloroethene BRL 1 1,2-Dichloropropane BRL 1 Bromodichloromethane BRL 1 2-Chloroethyl Vinyl Ether BRL 5 cis-1,3-Dichloropropene BRL 1 Toluene BRL 1 trans-1,3-Dichloropropene BRL 1 1,1,2-Trichloroethane BRL 1 Tetrachloroethene BRL 1 Dibromochloromethane BRL 1 Chlorobenzene BRL 1 Ethylbenzene BRL 1 meta-and para-Xylene * BRL 1 ortho-Xylene * BRL 1 Bromoform BRL 1 1,1,2,2-Tetrachloroethene BRL 1 1,3-Dichlorobenzene BRL 1 1,4-Dichlorobenzene BRL 1 1,2-Dichlorobenzene BRL 1 QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS a,a,a-Trifluorotoluene 30 27 89 % 87 - 113 1,2-Dichloroethane-d4 30 28 94 % 83 - 117 BRL = Below Reporting Limit. * Non-target compound. Method References: Method 601 - Purgeable Halocarbons and Method 602 - Purgeable Aromatics, 40 C.F.R. 136, Appendix A (1986). Department of Environmental Management/Divisigptt f:Water Resourcepi WELL COMPLETION REPORTS �—%P WELL LOCATION GEOGRAPHIC DESCRIPTION Address r 6 ~� o r'IC-SS �/• oov' N �ci W of (leer) (circle) City/Town r~!­24-1 /r AAd Q Q( Cr'C S Yr�1 Well owner. )u rVr_I C[�_ ' (road) Address/! N S 1E W of e O-Jle/ tenths! (circle) Board of Health permit obtained: - yes 19"' no 0 ultersect. w!_C4, 11C(rOe T WELL USE WELL DATA Domestic QiPublic❑ Industrial ❑ Total well depth /00 ft. Monitoring❑ Other Depth to bedrock - ft. IWater-bearing rock/unconsolidated material: I Method drilled CJ (J `s F°����'T / Date drilled/ta I� I�-/ 3 ' Description A-4 e d( CoG/S e SO., N Water-bearing zones: CASING 1) From To Type Sc 4 ri -2) From To + Lengthft. Dia(.I.D.) =in. 3) From To Length into bedrock ft. Gravel pack-well: dia. Protective well seal: Screen: dia. Grout_[ Other Slot 0_Z S—length_9_�_from�R . to.&r2 STATIC WATER LEVEL(all wells). Static water level below land surface a / ft. Date WELL TEST(production wells) r v Drawdown�ft. after pumping �(_Itr. . min. at ZT _gpm How measured n ko Recov'ery�ft. after_hr.I S min. 0 LOG of FORMATIONS COMMENTS MaterialsFiom a n Driller 1, ^t erl Firm /Caa / Address/�.b. AGk 2A0 �► d + Gr m r P City/Town ryas /J E1z �61 g U/t 4 J rr/per Supervising Driller RegA S"-) Sr nature or superv+sln re tstered well driller P1easp""""m" BOARD OF HEALTH COPY 72NO FoWIZ,477o1✓ --- F-y / H 4;Ae'09105 /MW SGO � o— — - - - -- --- --- - 4LU9M--- �CCOVEK LDA�>y B LGs��:v 12"N1/N/N5`iVE.Q/R/ENs/D� -—_ /Z" M/N•ZO 346. ?_.s Y/�, SNYI� Si1NU sc�•--lee P✓c 5�H/�Oil 78. 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