HomeMy WebLinkAboutMiscellaneous - 623 TURNPIKE STREET 2/26/2016 Massachusetts Department of Environmental Protection
Lill, Bureau of Resource Protection
Well Completion Reports
Well Driller
Please specify work performed: Address at well location:
lNew Well Street Number: Street Name: `;
623 TURNPIKE
Please specify well type: Building Lot#: Assessor's Map#:. COT" 0
Monitoring1
Assessor's Lot#: ZIP Code:
Number Of Wells:
1
City/Town:
Well Location NORTH ANDOVER
In public right-of-way: GPS (GPS for the deepest well)
Yes J No�
North: West:
42.39865 71.06837
Subdivision/Property/Description:
Mailing Address:
click here if same as well location address
Property Owner: Street Number: Street Name:
451 P O BOX
City/Town: State:
Engineering Firm: EXETER NEW HAMPSHIRE
EXETER ENVIRONMENTAL ZIP Code:
03833
Board of health permit obtained:
J,Yes , Not Required
Permit Number: Date Issued:
Massachusetts Department of Environmental Protection
Bureau of Resource Protection-Well Driller Program ❑
Well Completion Reports(Monitoring) ❑
Well Driller - Monitoring Form
DRILLING METHOD
Overburden Direct Push Bedrock , _'Choose Bedrock
WELL LOG OVERBURDEN LITHOLOGY
From(ft) To(ft) Code Color Comment Drop in drill Extra fast or Loss or addit
stem slow drill rate fluid
- --- - -
0 5 Urban Fill 6 Brown 6' � � YES
1 ___� �: �:t�� __�; Fast�: Slow
15 1 [13 Silty Sand And Gra 6 Brown 6 YES , I f Fast Slowl F-1, Loss j
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PERMIT INFORMATION
DEP 21 E RTN# DEP Groundwater Discharge#
ADDITIONAL WELL INFORMATION
7
Developed Yes ° No� Are these wells nested? _ ,Yes ], No
-- - -J
Surface Seal Type Cement_ Area of group(sq.ft)
Total Well Depth 13 Depth to Bedrock
CASING Is Casing above ground?�
From To Type Thickness Diameter
10 1 13_ - Polyvinyl Chloride 6 Schedule 40 6 12
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SCREEN No Screen
From"> To Type Slot Size Diameter
13 13 -- � Slotted PVC 6 r�-- 12--—�
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WATER-BEARING ZONES
From To Yield(gpm)(
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ANNULAR SEAL/FILTER PACK
From To Material V5 Weight Material 2 Weight Water(gal) Batches Method Of Place
Native Material 6 ---Choose Material--- 6
Gravity
(1 i 12 1 Bentonite Chips/Pellets 6 ---Choose Material--- 6 f
-
Massachusetts Department of Environmental Protection ❑
Bureau of Resource Protection—Well Driller Program
Well Completion Reports(Monitoring) ❑
� `ti ❑ -
�2 I13 Sand 6 Choose Material--- i
�. .----� 6'' Gravity
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WATER LEVEL
Date Measured Static Depth BGS(ft) Flowing Rate(gpm)
{{
102/-018/201-6_-1 (y_.._ --- 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.
Monitoring[M] Supervising Driller Signature NEWSHA
Driller MATT KELLY Registration# 606 PETER,W
TECHNICAL
DRILLING Date Job Complete
Firm SERVICES, INC. Rig Permit# 66 02/08/2016
NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion.