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HomeMy WebLinkAbout0032 BOW LANE - Health 0 Bow Lane Barnstable A = 299-049-001 V);_0 No. Fee BOARD OF HEALTH TOWN OF BARNSTABLE Zippficatiou ,f or Vern Cougtruction Permit Application is hereby made for a permit to Construct(V), Alter( ), or Repair( ) an individual well at: Location-Address Assessors Map and Parcel iayyl Sw;4- - �' - 80x Iav, f cnr�a��e ; oZ63U Owner Address �e sr�.�r�VJ�11 si���� 1�� 1'•a•eox L783, 0 c ike,h.;AQ2(,�3 Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons pp Type of Well "l"'S CVA40 f VC Capacity Purpose of Well \ 0i.�b 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. p Signed 1 Z 6-0 Date Application Approved By Date Application Disapproved for the following reasons: Date Permit No. Issued Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed QX), Altered( ), or Repaired( ) by Installer at YYV"V -L�� Oil rA 1 401 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.k)..P01d> 0 35 Dated /b—6 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector No. � Fee BOARD OF HEALTH TOWN OF BARNSTABLE t Zi pplicatton _for Veft Con0tructiou Permit 5" A licatiori is hereby made for ermlt to Construct Alter O or'Re aIr an individual well at: x . PP Y P �(), , p , . 3 + Z Location!-Address Assessors.Map and Parcel, l f : `�1 111�.1�1r� �kl�ll �' •{�• �(� 1�}�i, �raCnCEol� e- TM4 ZA o i Owner Address N "w,nnk 2_ 183 Ar14Ae)( _ n14 n2CS3 Installer-Driller ` , ° T Address w Type of Building Dwelling Other-Type of Building No. of Persons yp 1 � �b ��. „,- Capacity ' T e of Well - Vx Purpose of Well FOi"cL�U4. 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. a + Q A Signed �w. AA\n s 1 ZI 6-to f. � � _ • Date �. Application Approved By t,..," r �. .,— C).. y Date e, t Application Disapproved for the following reason. ' f \ Date Permit No. Issued Date r. .s.�,�.r:+.-r,�_..+:..,..s,�.�.rr.e"s.�.�c -- •.i.s.�-.�.�w.�w.���....�r.use..z..�.a�.....�,+,r_s.:...r.s.,a.c,®.o.a...as..s:.ns�...-ro:v o�aw.s...m..9-s�..-rw.re.�.,r.:e..rs:-s.s=s.w� a..i�. —� BOARD OF HEALTH . TOWN OF BARNSTABLE r Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed()q), Altered( ), or Repaired( ) by be nnL- .A; \rJ0kk Ic�\i.,nc� �lnl Installer at 'fZRiitJ U ,T3cac�,,ck+���_ rr" 2 C oL4gt0w has, 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.1J.704w b 3-5 ' Dated �d—(�`-- 2 ' 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 IveYY cou.5truction permit 6 � No. X :-U-- I J Fee r. ` Permission is hereby granted to ��n•,t, ;�1I��� tr,11t r� �Y1t . �, .Installer a. ' to Constructi. ), Alter.( ),> or Repair O an individual well at: No.; pistil � �rnAfcJota- kA" 2�g 1�41•1Oo � �x , street o -62 as shown on the application for a Well Construction Permit No. �.l� > 'Dated' a; Date �p -- �'� Approved By P' �" 7 1 ................ ....... ........... ...........................,....... .. .. ......................... ......................................... OWNER OF RECORD: WILLIAM F.$CATHERINE R SWIFT P.O.BO% 108 . BARNSTABLE, MA 02630 j REFERENCES: CERTIFICATE 0202151 LAND COURT PLAN R15234-C 2• .63' R-3s.ao' ASSESSORS MAP 299 PARCEL 49-1 tttE aF PY,vd[xr w - ZONING DISTRICT:RF-2 5 653!.. .,, 16.60 ,y,• - LOT AREA 43.560 S.F. . ..._. } / FRONTAGE: 150' ;8 a tp SETBACKS: FRONT: 30' q SIDE 15' SE—R E/SEUENT :•. ....•.�. / REAR: 15' -- 1•'. y ��4 VERTICAL DATUM: NAw 1988 .T-.. ~} / f� E06£OF CIFMENC� E of aEwxc EocE or acNaNc �f,`\ — ROUSE 6MIQ OYPICAQ i PREPARED FOR: ?Z.x .tip t SCALE: 1" = 40'. SEPTEMBER 22, 2020 PROPOSED.Lu . '' �o�• - GRAPHIC SCALE IN FEET - .� 40 20' 0' 40' 80' 338 MAYFAIR ROAD SOUTH DENNIS. MA 02660 508-364-9049 Massachusetts Department of Environmental Protection s` ~T Bureau of Resource Protection Well Completion Reports .�r�c ",,,..,.+mr:-_......._______rrr- --..e..�..........._.. ...,...ten... ,...__, ...._.._..__..... 4 Well Driller = Please specify work performed: Address at well location: [New Well Street Number: Street Name: 0 BOW LANE Please specify well type: Building Lot#: Assessor's Map#: , Domestic 299 J. Assessor's Lot#: ZIP Code: ' Number Of Wells: 001 02630 City/Town: Well Location BARNSTABLE } d In public right-of-way: GPS d Yes r No North: West: 41.69783 70.29973 Subdivision/Property/Description: Mailing Address: jr click here if same as well location address ........................--..............................._._....__._..._.................._........................_............. Property Owner: Street Number: Street Name: WILLIAM SWIFT PO BOX 108 City/Town: State: Engineering Firm: l BARNSTABLE MASSACHUSETTS ZIP Code: 02630 " Board of health permit obtained: (*,Yes f`Not Required Permit Number: Date Issued: W2020035 10/06/2020 ................................_....._..._................................ ti � II Massachusetts Department of Environmental Protection , Bureau of Resource Protection-Well Driller Program y Well Completion Reports(General) Well Driller - General Well Form DRILLING METHOD Overburden Bedrock auger - Choose Bedrock WELLLOG OVERBURDEN LITHOLOGY _ I From(ft) To(ft) Code Color Comment Drop in drill Extra fast or slow Loss or addition j stem drill rate of fluid 0 15 Fine To Coarse S,i _.._.W rown B r Fast YES NO Slow Lo.s2 tion i 115 35 Silty Sand E`Brown +. (" t Fast('Slow l� �j I - -- - - YES NO Loss Addition 35 ^� 50 Silty Sand jI i 1 Brow na f Fast f Slow —i — YES NO Loss Addition Ii .............................. (50 (55 (Medium Sand !�?'Brown ( Fast C Slow .........__................................... ....................... YES NO ii Loss Addition ..................._..................... ;t 55 ; 60 [Fine To Coarse S €Brown ( Fast l'Slow -- -- i L I'_ YES NO Loss Addition ...... WELL LOG BEDROCK LITHOLOGY ....._........................_............................................_......_............................................._...................................................._..............................................................i............................................................. ..............................., Loss or Extra I Drop in 1 Extra fast or I Visible Rust i From(ft) To(ft) Code i Comment addition of Large i drill stem ,slow drill rate Staining i fluid Chips Choose Code { Yes' Yes l ! „ YES NO W Fast Slow =Addition i ADDITIONAL WELL INFORMATION , Developed G Yes (-No Disinfected 'r r No Total Well Depth 60 Depth to Bedrock Surface Seal Type None racture Enhancement .............................._.............._.._.._.......__...........1 CASING Ir Is Casing above ground? From: 1 To: 0 I................................................._... y ..................................................................................................................................................................................................... . From To T Thickness Diameter Driveshoe �0 56 Polyvinyl Chloride Schedule 40 r Yes ................................ SCREEN l No Screen ....................._....._..__.................._.__...._...._........_............................._..._..._._.._............................. .... _.._..........._......................................................_........L..............._..........................._.:........._...__ j From To E Type Slot Size 1 Diameter 56 60 � Stainless Steel Well Point 0 012 4 ._. ........ ..(...... ........... .. ........................ ..... ........ .. WATER-BEARING ZONES �DRY WELD .........................:..........._................................---_. ....._......__................. ............... From To Yield(gpm) PERMANENT PUMP(IF AVAILABLE) i Massachusetts Department of Environmental Protection ` Bureau of Resource Protection—Well Driller Program Well Completion Reports(General) I—Choose Pump ! -Choose Pump Description Horsepower ower Description--- Horsep --- E!! Pump Intake Depth(ft) Nominal Pump Capacity(gpm) ANNULAR SEAL/FILTER PACK From To Material 1 Weight Material 2 Weight Water ;Batches Method Of (gal) (count) Placement :::::::.:::::.__,.... _.:::::. _....... .._..__.._..-..__........___._._.....__.._._...._._.. ..__..........__.._...._...-...._....__.... - ._:_'-_-.............;- :::.-::.W.-.:.::::..:::.::................................_.__.-------------- Choose Material j Choose Material 11 Choose One ...-_____... ..�............. .. ....__., .._..._-._._._...,..,_.._,..._.. w.�_7w....-_.._..._. -.,__ WELL TEST DATA Time Pumped Pumping Level(ft 'Time To Recover Recovery(ft Date Method Yield(gpm) I (HH:MM) i BGS) I(HH:MM) BGS) 10/26/2020 FConstant Rate Pump—mFRN 12 01:30 28� 00:01 24 ......... ...._'". ....... .:`""""W""W ... .. ... 1 WATER LEVEL I < Date Static Depth BGS(ft) Flowing Rate(gpm) Measured ................ .........._._..........__._.....................-.............._.....................-...............-_._ _.....__._..._ .... __............ ...................._....:..._........ . .. 10/26/2020 24 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, Monitoring[M] DrillerURQUHART Registration# 299 Signature THOMAS,E DESMOND WELL Firm DRILLING,INC. Rig Permit# 0551 Date Job Complete 110/26/2020 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. ENVIROTECII LABORATORIES,INC. ' NIA.CERT.NO.:M MA 063 8 J"an Sebastian Drive Unit 12, S Sandwleb, ►A 02563 (.508)888-6460 1400-339-6460 FAX(S48)888-6446 Client Name: Desmond Yflell Drilling Location Address PO Box 2783 0 Bow Lane Orleans, MA Barnstable,MA 02653 Lab Number: DW 204114. Collected By: DWD Date Received: 16/26/20 Sample Type: Well Specs New Well 66124 L©Cwit)!?c"pYlrC t :x <A � � -• �10i26120 ,,,,n,; 14 30 :�._ ,� �� �..,�: �.a�• Analysis Recluestetl units Recommended Limits AnalysisResuill Method Date Analyzed Analyzed By pH pH units 6 5 8 5 6 20 SM 4500 H-B 10/26/2020 SD �._.._ - --.,_ ._._ � ..r_ Specific Conductanceo umhos/cm 500 167 EPA 120.1 10/26/2020 SD ............_ ... ... ....... _ ._..._.......... ...... ___.. .. - . Nitrite-N mg/L 1.00 <0.006 EPA 300.0 10/26/2020 LL ................................._.....__. ........... _.__..............._ __....._______ ...._ _.,,_, ...__ _ __ w,. Nitrate-N mg/L 10.0 0.99 EPA 300.0 10/26/2020 LL ........ .......... __.--... ...... ... _._ ...... ......_.. Sodium mg/L 20.0 16 EPA 200.7 11/01/2020 KB —. ...... - -_... .._.._...___.___ ._ . ... _... _ Total Iron mg/L w , 0.3 0.03 EPA 200.7 11/01/2020 KB ..... .... . Manganese mg/L 0.05 �0 005 EPA 200.7 11/01/2020' KB _..........._ ... . ..__ _.. __... _ .. ..._ Volatile Organic Compounds* ug/L See comment See attached EPA 524.2 10/29/2020 NEC* ... ._ . .. _. Total Coliform(Presence/Absence) Present/Absent Absent A SM92236 10/26/2020 CD @ 17:00 Comments: pH is below recommended limit and may have corrosive characteristics *Trace to low levels of chloroform are occasionally detected in ground water in coastline areas. 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. 7 °• Date 11/2/2020 �_ ....... ....... ......... _T_ �_ . .... .. 'Ronald l Sari Laboratory Direetor. YRL Beloit Repor•tnbir I:imits *See detached Page 1 of 1 rCee oficafiOR is r101 available for•th s anal-we Jor tTf)laNe 1-for salni%es... f - r v New England Chromachem 6 Nichols Street Salem, MA 01970 978-744-6600 Sample Information EPA Method 524.2 Rev4.1 Volatile Organic Compounds in Water Lab ID: 10569 Client: Envirotech Laboratory,Inc. Client ID: DW-204114 State: Liquid Date Sampled: 10/26/20 Date Received: 10/29/20 Date Analyzed: 10/29/20 MCL Regulated VOC's Results(uglL) (ug/L) Unregulated VOC's Results(ug/L) Benzene ND 5 Acetone* ND Carbon Tetrachloride ND 5 Bromobenzene ND 1,1-Dichloroethene ND 7 Bromochloromethane ND 1,2-Dichloroethane ND. 5 Bromodichloromethane. ND 1,2-Dichlorobenzene ND 600 Bromoform ND IA-Dichlorobenzene ND 5 Bromomethane ND Trichloroethene ND 5 2-Butanone ND 1,1,1-Trichloroethane ND 200 N=Butylbenzene ND Vinyl Chloride ND 2 Sec-Butylbenzene ND Chiorobenzene ND 100 Tert-Butyl benzene ND cis-1,2-dichloroethene ND 70 Chloroethane ND trans-1,2-dichloroethene ND 100 Chloroform 0.76 ......... 1,2-Dichloropropane ND 5 Chloromethane ND ..,.: Ethylbenzene_ . ND 700 2-Chlorototuene ND.... Styrene ND 100 4-Chlorotoluene ND Tetrachloroethene ND 5 1 Dibromochloro.methane ND Toluene ND 1000 1,2-Dibromo-3-Chloropropane ND Xylenes(Tota.l) ND 10000 1,2-Dibromoethane ND Methylene Chloride ND 5 Dibromomethane ND 1,2,4-Trichlorobenzene ND 70 1,3-Dichlorobenzene ND 1,1,2-Trichloroethane ND 5 Dichlorodifluoromethane ND 1,1-Dichloroethane ND Acetone Detection Limit.=10 ug/L 1,3-Dichloropropane ND ND=<Method Detection Limit 2,2-Dichloropropane ND NA Not Analyzed 1,1-Dichloropropene ND cis-1,3-Dichloropropene ND trans-1,3-Dichloropropene ND Hexachtorobutadiene ND Isopropylbenzene ND P-lsopropyltoluene ND Methyl-tert-butyl.ether ND Naphthalene ND N-Propylbenzene ND 1,1,1,2-Tetrachloroethane ND 1,1,2,2-Tetrachloroethane ND 1,2,3-Trichoorobenzene ND Trichlorofluoromethane ND 1,2,3-Trichloropropane ND 1,2,4-Trimethylbenzene ND 1,3,5-Trimethylbenzene ND Surrogate Standard Recoveries % Benzene=d6 _ 99 MCL TTHM's=80 ug/L 4-Bromofluorobenzene 99 Method Detection Limit=0.5 ug/L 1,2-Dichlorobenzene-d4 99 Analysis performed per 31OCMR42 r Electronically signed and approved by Mr.Bruce A.Bornstein,Lab Director Date: 10/30/2020