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0230 GOSNOLD STREET BLDG 1 UNIT 1A - Health
a3 p 6�osnol d - 4ja.onIs 30&.- r f E- of A 'I 0 Massachusetts Department of Environmental Protection Bureau of Resource Protection Well Completion Reports Well Driller Please specify work performed: Address at well location: :New Well Street Number: Street Name: 230 GOSNOLD ST Please specify well type: Building Lot#: Assessor's Map#: Irrigation 306 Assessor's Lot#: ZIP Code: Number Of Wells: 115 0 1 Q 02601 city/Town:- Well Location BARNSTABLE In public right-of-way: GPS f Yes C,No North: West: .............---._.......................- 41.63961 70.28813 Subdivision/Property/Description: Mailing Address: click here if same as well location address Property Owner: Street Number: Street Name: CAPT GOSNOLD VILLAGE 230 GOSNOLD ST City/Town: State: Engineering Firm: BARNSTABLE MASSACHUSETTS ZIP Code: 02601 Board of health permit obtained: t�-Yes (i Not Required Permit Number: Date Issued: W2022003 02/10/2022 ..................................................................................... Massachusetts Department of Environmental Protection ` Bureau of Resource Protection-Well Driller Program Well Completion Reports(General) Well Driller - General Well Form DRILLING METHOD Overburden Bedrock Auger Choose Bedrock WELL LOG OVERBURDEN LITHOLOGY ( Drop in drill Extra fast or slow Loss or addition From(ft) To(ft) I Code [Color Comment _- 1 stem drill rate of fluid ...... ., __ 0 20 ne To Coarse S! ?Brown { Fast Slow I 1I€ i _ YES NO __...... l Loss Addition I .m....._...___._.._..._....-.. f . 20 �25 [ Fine To Coarse S ;Brown ! r Fast(-,Slow -"' YES NO Loss Addition -_ Medium Sand � ;Light Gray �l (`Fast�Slow __ YES NO i Loss Addition [30 40 Clay ± ; Bluish Gray ) (`Fast C Slow ............... _-... ._.....��... _... 1 YES ;l Loss Addition [YES (` 40 45 Fine Sand Brown �Fast(',slow L- �,.......... i. 1 NO Loss Addition ........ ... ....... _ ..... 14 5....._._.._.._.. 55 ;Medium Sand - Brown Fast f"Slow 1 L_ _ I YES NO ; a ..........................° Loss Addition ___----- ... 55 60 I'€.FineFine T� I I Brown ..................._ � ! Fa w st f`Slow J� YES NO _ - l Loss Additon WELL LOG BEDROCK LITHOLOGY E Drop in Extra fast or Loss or Visible Rust Extra 3 From(ft) TOM I Code Comment addition of Large ( i drill stem slow drill rate ;Staining fluid Chips - ..�.-_._._- - i � [YES C` Fes YeChoose CodeO Fast Slow Loss Addition i .. ADDITIONAL WELL INFORMATION Developed 1 'Yes C"No Disinfected Total Well Depth 60 Depth to Bedrock Surface Seal Type None -- racture Enhancement 'Yes is No ; __` . . CASING r Is Casing above ground? From To Type ;Thickness Diameter Driveshoe _ __ _.__ __ ._. _ _ m m 0 56 Polyvinyl Chloride Schedule 40 .i 4 r Yes �I i.. SCREEN':No Scree From To Type ?Slot Size (Diameter ............... 6 60 Stainless Steel WeII Point ' E,0.012 1 WATER-BEARING ZONES Fr DRY WEL4 Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program Well Completion Reports(General) From To Yield(gpm) E17 j €[60= 12 PERMANENT PUMP(IF AVAILABLE) ......................................................................................... Pump Description 2 Wire Constant Speed i p p j Horsepower !Submersible 1 Pump Intake Depth(ft) 55 Nominal Pump Capacity(gpm) 20 ANNULAR SEAL!FILTER PACK ...............--_......._.......................................,........................................................................................................................................................................ From To Material Weight Material Weight Water Batches Method Of — (gal) (count) Placement 13 �(' Choose Material � ;Choose Material i { Choose One L � ..................................�_°:::::::::: ; . C� ...... ._ _.._ .... 1 ..............................................._..._......................................................................_..................................................................._......_..........................................................................._............._.�......... WELL TEST DATA ......................................................................,.............................................................................................................................................. .. Time Pumped Pumping Level(ft Time To Recover Recovery(ft Date Method Yield(gpm) (HH:MM) BGS) (HH:MM) BGS) 0 211 7120 2 2 Constant Rate�Pump L1( 2 6130 ZO 00:01 17 � WATER LEVEL Date s Static Depth BGS(ft) Flowing Rate(gpm) ;Measured i t 02l17l2022.... 17.......................... ............_ `1.2.........................._........................................... ..1 _.._........................_........__............_.._..__.._.._............1..............._.........._............................................................ 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 Monitoring[M] Supervising Driller DESMOND, DrillerURQUHART Registration# 877 Signature PATRICK, DESMOND WELL Firm DRILLING INC. Rig Permit# 0551 Date Job Complete � 03/11l2022 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. ENVIR0TECH LABORATORIES,INC. MA CERT. NO.:M MA 063 81an Sebastian Drive Unit 12 Sandwich,MA 02563 (508)888-6460 1-800-339-6460 FAX(508)888-6446 Client Name: Desmond Well Drilling Location Address: PO Box 2783 230 Gosnold St Orleans, MA Hyannis,MA 02653 Lab Number: DW-220471 Collected By: Desmond Well Drilling Date Received: 02/18/22 Sample Type: Well Specs zC deQF �' RC1►17utteTlfSr " _. >;©�a�tan' trurce IDate trbllected TYe, ales t1 n m..s.w-.-„-„ ..n ..-,r >. ..,"P . ........ '....e...... •- _.ram.,cr�mxxx wm xs.�.,. ....,... ",xi,_x Ae -. f Analysis Requested Units Recommended Limits "Analysis Result Method jDate Analyzed?Analyzed By':, Total Coliform CFU/100mL 0 0 SM9222B 02/18/2022 JM:@ 13:15 pH pH units 6:5 8.5 6.70 SM 4500 H B 02/18/2022 SD Specific Conductances umhos/cm 500 209 EPA 120.1 02/18/2022 SD Nitrite-N mg/L 1.00 0.023 EPA 300.0 02/18/2022 SD Nitrate-N mg/L_ _ 10.0 0.456 EPA 300.0 02/18/2022 SD Sodium mg/L 20.0 22 EPA 200.7 02/221 022 KB Total Iron mg/L 0.3 016 EPA 200.7 02/22/2022 KB Manganese mg/L _ 0.05 0.923 EPA 200.7 02/22/2022 KB Comments: Sodium level is not a health hazard. Over a lifetime,the EPA recommends that people drink water with manganese levels less than 0.3 mg/L and over the short term,EPA recommends that people limit their consumption of water with levels over 1.0 mg/L All samples were analyzed within the established guidelines of US EPA approved methods with all requirements met, unless otherwise noted at the end of a given sample's analytical results. We certify that the following results are true and accurate to the best of our knowledge. Water meets EPA standards and is suitable for drinking for parameters tested. Date 2/24/2022 Ronald J.Saari Laboratory.Director BRL-Below Reportable Limits 'See Attached Page 1 of 1 oCert fication is not available for this analyze far potable water samples.. No. Vv�2 03 Fee 1�s BOARD OF HEALTH TOWN OF BARNSTABLE Zi ppltcatiou _for Yell Cou5tructiou Permit Application is hereby made for a permit to Construct(�, Alter( ), or Repair( ) an individual well at: 230 &gSn0ld 5±, Hyo-fjhIS II1 Location-Address Assessors Map and Parcel ca GoSr oIa U;1\*�: 23o c-v,Srso1J 5+3140.NYniS TA o2601 Owner Address Y Qnd- U)at6n1I , 1AC Qa 60)( 2,7931 Or MA b2G 3 Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well u Ir�2' f9 V 6- Capacity Purpose of Well i r r, mh 6n 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. J Signed Date Application Approved By Date Application Disapproved for the following reasons: Date Permit No. V�' Issued Date -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE certificate of (Compliance THIS IS TO CERTIFY,that the individual well Constructed 00, Altered( ), or Repaired( ) by _ esr�onl WIA► �r I III n n 4 , � C 11 Installer has been installed in accordance with the 6rovisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No.Ih&.G ,003 Dated fJ '112_ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector No. Vv ZV y� LZ3 Fee BOARD OF HEALTHq TOWN OF BARNSTABLE , 0[ppricaction -for 30ell Construction Permit `¢ Application'is hereby made for a permit to Construct(X), Alter( ), or Repair( ) an individual well at: .4 VQ f115i��a ! 11 t Location-Address Assessors Map and Parcel {Oz.w . Owner Address iDrn . 6rllliI , Joc ox 275 , kil - Installer-Driller J 4 Address Type of Building i1 Dwelling ` Other-Type of Building No. of Persons .. Type of Well - �C{•�U(T �!ti h .,.�. -- Capacity..... Purpose.of Well i r j i nn i bn 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 a well in operation until a Certificate of Compliance has,been issued by the Board of Health. Signed �1/`�+.:A),U Date Application Approved By Date Application Disapproved for the following reasons: t Date Permit No. Issued � . t Date BOARD OF HEALTH TOWN ' OF BARNSTABLE Certificate of Compliance THIS'IS TO CERTIFY,that the individual well Constructed V), Altered( ), or Repaired( ) byc:.r����1 �/UP I( �r II► het ; rG: Installer at L J��. t�` �Y1 } Hy Cl h n(C 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.IA/y�003 Dated 7 /Uf 2Z 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 Construction Permit �. ,,�v jj yr k. No.Y 7fi Z�Z � Fee . Permission is hereby granted to 7_q-,��1i eA C Installer J t to ' Construct( ,;Alter( ); or Repair O an individual well at: a. _30 . C=c��ti�,c�lA c } . H�tnti���t 1 Street as shown on the application for''a Well Construction Permit No. kvl��� -Dated Date /�d /Z—'" Approved By /� 1 # ! Ay,f i r Legend • e • .a Road Names w Ak e m, Q! Y .a . a a , IN' L ! il a a ,f4 > # a m . e r Jt, " { '' r ,gam m. •'! PAN ` " +e'�y". o ffy " 9- s x• • rr z'q S 4 � Map printed on: 2/6/2022 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 _ i Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA o26oi 0 42 83 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= 42 feet 0 cartographic errors or omissions. gis@town.barnstable.ma.us