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Home My WebLink AboutMiscellaneous - 540 BOXFORD STREET 3/31/2015 COMMONWEALTH OF MASSACHUSETTS NUMBER BHP-2015-0081 North Andover FEE BOARD OF HEALTH $135.00 Charles M. Rollins Co., Inc. ------------------------------------- - ----------------------------------------------------- NAME BOXFORD STREET ------------------------------------------------------------------------------ ADDRESS IS HEREBY GRANTED A PERMIT Well Construction Well-Lot 1 This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires _ June 30,-2015---------------unless sooner suspended or revoked. March 31, 2015 -------------------------------- BOARD OF ------------ HEALTH --------------------------- ---------- BOARD OF HEALTH CHAIRMAN TOWN OF NORTE ANDOVER 1600 00 SG D TI ;I T; (.lI'FE 2035 S(:)RTfI ANI: OV "R, MA SA(IT11 JSETTS U 1845 Susan Y. Sawyer,I'tERS/IIS 97&68&9540....-Phone Public Health Director 978.688, 476-_.FAX }caltltt:dept(ailtcimnoChorttyandove .c on m(Nvw.towttof itotilactttdovet°.coiii Well and/ter Pump Application � � / � /-5(Please print) DATE: .. LOCATION to Drill Well or install a pump: Licensed Well Contractor Name and Company Name: " N LL INS Qz', t� ° 116, INTI T RA Contact Phone Numbers 6_ Homeowner:_ 9Y 1'4.S,S 1A A DO—,v 2 "7 '7 �� t cr"' /P Address: 's° ( k/e i,. p�. Contact Phone Numbers:_9.-) 2 9 3 7 ® `A 5 2 - tiYI:LLS(to be completed at time of pump test)�W_.-..�...�_.......�..w�W- p.,��.�v�..,,.,.-.�..�,.w.�.� -a..W..-...M.�.y.-.,,.�.,......�w,_.....��..-w..��,,��..a. Type of well: -�� Use: Vo k`e✓^r \ C Diameter of well: Y Size of Casing: (S/ Depth of bedrock: Depth of casing into bedrock: Seal been tested? Yes( ) No( ) Date of test: Depth of well: Water-bearing rock: Depth of water: Delivers: GPM for: (how long) Drawdown: feet after pumping: horns at: G Date of Completion: d. Signatur Well Contractor PUMPS(To be filled in before installation) Name&size of Pump: Type: Size of Tank: Pump delivers: GPM Pipe used in well: Cast Iron Galvanized Plastic Sleeve used to protect pipe? Yes No Type of well seal: Date: Signature of Pump Installer Date water analysis reportµsubmitted to Health Department Plumbing Wiring Inspector Health Department Representative SM-lealth\Permit ApplicationMell Application.doc TOWN OFNORTH ANDOVER Office ttl'(-'C. Nli\ItJNI'rN' I)EVf:I..,O]'lIENI' i\NlD SERVICES 11EAI 'I"I# DEPARTMENT 1600 OSGOOD STREET; SUITE 2035 NORI I ANDOVER MASSAC'I--IU` F.a`hS 0I845 Susan Y. Sawyer, RUTH s/lIs 978,688.9540-._Phone Politic Ilealtb Director 97V)88,8476 FAX IIc.iIl 11 fnorillandover.com w�4�t.tfrwnuf"n�rrthsrndvver.cf>rrr Well aiLd/or• 1'upi . A. Aication r .... � (Please print) DATE: LOCATION to Drill Well or install a pomp:--Lot# 1 Boxford Road Licensed Well Contractor Name and Company Name:George W. Rollins Charles M. Rollins Co., Inc. Contact Phone Numbers: � Homeowner:Messina Development Co., Inc. Address:277 Washington Street, Groveland, MA Contact Phone Numbers:978-837-9583 W Et.t.s(to be completed tit tittle or punatr test) Type of well:Bedrock Domestic Diameter of well:C_1__ Size of(,,list fig: r � Depth of bedrock:..___._...____..__,.......__..,ww._..... .._ Depth of casing into bedrock:31__._ 'feat been tested? Yes(K) No( ) C7attc of test: ��°_ t , Depth al'well _500, . .........,._ .........._ \Valet-beatrml rtrric aka'...r tCC ='Depth of water: l.)elivcrst_._ w_...___ C',PM for: --- r J (trove long) Drawdowm � feet after parnphap:_ „4 _ hours fit: GIIIti1 Date or Completion: Siknatturt o`Vell Contractor � PUMPS(`o be filled in before installation) "game&size of 11untp:Goulds 1 HP "ype:SubmersiblE Sire ot'"I'ank:TBD Pump delivers:5 _61"M Pipe used in Drell: Cast Irarn— Galvarnized______ Plastic +�� ,.fJC-r�'5 � !Sleeve used to protect pipe" Yes No `type 0;�tsell seal Date: Signature of P a f�Installer° Date water a I I a I),sis retTort submitted to Health Deparrhnent: _...........,....... Plambfnl Wiring Inspector Health Department Representative X:A0l flay 2012\IIEAL,TI-I\WebUp elates\Wor(IFoi-n7s\\Vell Application.doc �J O Analytical,l� o�uv" [[C Tel:978-391-4428 Fu:n8-sv/-4ms LauNumbec 164348 3|*Willow Road,Arnwxo/4az xeusite:lit tp:x"w".muno»axu/rocu|zwo Use mi`noubu with all correspondence Client: RECEIVED Well Water Connection John Larsen �&A � 7 7D�R Rmpo�Du�: 3d8�018 P0 Box 158 ' '"'` � � —' Tewksbury, MA0187G 04[0VER Certificate o G40Boxfonj St, North Andover MA Parouuotcr N{m{bod Result MCL AfRL Da1unY&oaly*is &uulyot ' Well Tank Samp��311412n/oVxno0AMbyP8onazzo0 Total Co|iform Bacteria,/1oom| ENZ.SUB.SMeoon Absent Absent Absent 3/14/2016 10:25:00 AM M-MA1118 � Arsenic,Total, MG/L SMx11aB 0.003 0.01 0z01 3/15/2016 M-MA1118 � calcium. MG/L EPA 200.7 51.2 NotSpoc nu 3/15/20 16 NFMA1118 CoppocMG& EPA 200.7 ND 13 0.803 3/16/2016 M-MA1118 |mn. MG/L EPA 200.7 0o62 ua 0.003 3n5/2016 M-MA1118 � Lnad.M6/L SNu1138 NO 0u15 0,001 3/15/2016 mFMA1118 Magnooum.MG/L EPA 200.7 6.9 Not Spec 01 3/1e/2016 M-MA111e ManOanem.MG/L EPA 200.7 0.032 0.05 0.002 3/15/2015 M-MA1 11e � Pmaxsium. McvL EPA 200.7 ns Not Spec 0.1 3/15/2016 M-MA1118 Sodium. M8/L EPA 200.7 11.7 See Note 0.2 3/15/2016 M'MA1118 A|ka|inity.MG/L SM 2320B ea Not Spec 1 3/14/2016 M-MA111e Ammonia auN. MG/l SM4soo'NH3'o No Not Spec 0.1 3/14/2016 M'MA111e — Ch|ohdo.Mo8' EPA 300.0 61.8 zmo 1 3/14/2016 M'MA1118 Chlorine, Free Residual,MG8 SM45un'oLo wo wmSpeo 0.02 3/14/201e M-MA1110 Color Apparent, CU SM 2120B n 15 O 3/14/201e M'MA1118 Cnnduohvity. UMHoSXCM SMus1o8 412 NotSpac 1 3/14/2016 M'MA1 11e � F|uo/ide. MG/L EPA 300.0 ND 4 01 3/14/2018 M'MA1118 Hardness,Total,M@l SMza*oo 156 Not Spec 1 3A5/2016 M-MA1118 � Nitrate umN.MG/L EPA 300.0 ND 10 0.05 3n4/2016 M-MA1118 Nitrite amN. MG/L EPA 300.0 ND 1 0.02 3/14/2016 M-MA1118 | Odor,TON 0N21snB 1 3 U 3n4m01e MFL � pH, PHATzsC 8M4sooH'e 7,5 6.5-8.5 NA 3/14/2018 M'MA111e Godimem.poo/nog -------- NEG --- NEG 3/14/2016 MFL sv|fa/e.MG/l EPA 300.0 17.2 zoo 1 2V14/2016 M'MA1118 Total Dissolved Solids,MG/l SMzs4oC zuo 500 1 3/17/2010 M'MAI118 ' Turbidity. NTU EPA 180.1 na Not Spec 0.1 3/14/2016 M-MA111e MCL=Wmimum Contaminant Level(EPA Limit). MRL Minimum Reporting Level Sodium Guidelines-Mass zo. EPA zmn. w=Result Exceeds Limit orGuideline No=None Detected(<MRL). Background Bacteria Noted � Massachusetts Certified David L.Knowlton � Laboratory#M-NN1118 Laboratory Director Page of � � � N sh.oba 1alyf cal, L LC el 978-391-4428 Fax,978-391-4643 LabNumber 164747 31A Willow Itoad,Ayer MA 01432 WebsirC hltp corn USC rhk nurnber with all correspondence Client: Charles M, Rollins Co., Inc. ReportDate: 4/28/2015 126 Depot Road Boxford, MA 01921 Certificate of Anal sls Lot#1 Boxford Rd, North Andover MA I'arameter Method Re>srrlt NICI,, 11111 L Date oi'Analysis Analyst -Wellhead Sampled::412312015 4:00:00 PM by Client E.coli,/100ML NA-MUG-SM9222G Absent 0/Absent Absent 4/24/2015 11:10:00 AM M-MA1118 Total Coliform Bacteria,/100ML MF-SM9222B # 3 0/Absent 0 4/24/2015 11:10:00 AM M-MA1118 Arsenic,Total,MG/L SM 3113B 0.008 0.01 0.001 4/27/2015 M-MA1118 Calcium,MG/l. EPA 2007 35.4 Nat Spec 0.2 4/28/2015 M-MA1118 Copper,MG/L EPA 2001 ND 1,3 0.003 4/28/20,15 M-MA1118 Iron,MG/L EPA 200.7 0.078 0.3 0.003 4/28/2015 M-MA1118 Lead,MC/L SM 3113B ND 0.015 0.001 4127/2015 M-MA1118 Magnesium,MG/L EPA 200.7 4.5 Not Spec 0.11 4/28/2015 M-MA1118 Manganese,MG/L EPA 200.7 0,039 0.05 0.002 4/28/2015 M-MA1118 Potassium,MG/L EPA 2007 03 Not Spec 0.1 4/28/2015 M-MAII 118 Sodium,MG/L EPA 200.7 12.3 See Note 0.2 4/28/2015 M-MA1118 Alkalinity,MG/L SM 23208 72 Not Spec 1 4/24/2015 M-MA1118 Ammonia as N,MG/L SM 4500-NH3-D ND Not Spec 0.1 4/24/2015 M-MA1118 - Chloride,MG/L EPA 300.0 41.6 250 1 4124/2015 M-MA1118 Chlorine,Free Residual,MG/t.. SM 4500-CL-G ND Not Spec 0.02 4/24/2015 M-MA1118 Color Apparent,CU SM 21208 5 15 0 4/24/2015 M-MA1118 Conductivity,UMI-1OS/CM SM 2510B 333 Not Spec 1 4/24/2015 M-MA1118 Fluoride,MG/L EPA 300.0 01 4 0.1 4/24/2015 M-MA1118 Hardness,Total,MG/L SM 23408 107 Not Spec 1 4/28/2015 M-MA1118 Nitrate as N,MG/L EPA 300.0 ND 10 0.05 4/24/2015 M-MA1118 Nitrite as N,MG/L EPA 300.0 ND 1 0.02 4/24/2015 M-MA1118 Odor,TON SM 2150B 0 3 0 4/24/2015 RPM pH,PH AT 25C SM 4500-ti-B 6.9 6.5-8.5 NA 4124/2015 M-MA1118 Sediment,pos/neg --------------- NEG NEG 4/24/2015 RPM Sulfate,MG/L EPA 300.0 163 250 1 4124/2015 M-MA1118 Turbidity,NTU EPA 180.1 1.5 Not Spec 0.1 4/24/2015 M-MA1118 MCL=Maximum Contaminant Level(EPA Limit),MRL=Minimum Reporting Level Sodium Guidelines-Mass 20,EPA 250, #=Result Exceeds Limit or Guideline ND=None Detected(<MRI.), "=Background Bacteria Noted Massachusetts Certified David L.Knowlton Laboratory#M-MA1118 Laboratory Director Page 1 of 1 LlMassachusetts Department of Environmental Protection I Bureau of Resource Protection Well Completion Reports Well Driller Please specify work performed: Address at well location: New Well Street Number: Street Name: LOT#1 BOXFORD ROAD Please specify well type: Building Lot#: Assessor's Map#: Domestic 1 Assessor's Lott: ZIP Code: Number Of Wells: 01845 City/Town: Well Location NORTH ANDOVER In public right-of-way: GPS C ),es r No North: West: 42.66778 71.04858 Subdivision/Property/Description: Mailing Address: F (,lick here it same as well lo,.,o on address Property Owner: Street Number: Street Name: MESSINA DEVELOPMENT CO.,INC. 277 WASHINGTON STREET City/Town: State: Engineering Firm: GROVELAND MASSACHUSETTS ZIP Code: 01834 Board of health permit obtained: f: Yes Not Requued Permit Number: Date Issued: BHP 2015 0081 03/31/2015 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program Well Gomple Noo/Peports(Getwial) Well Driller - General Well Form DRILLING METHOD Overburden Bedrock Mud Rotary Air idan7mer WELL LOG OVERBURDEN LITHOLOGY Drop in drill Extra fast or Loss or addition From(ft) To(ft) Code Color Comment stem slow drill rate fluid 0 19 Silly Bard And CrBrown.. �m ..,......a ._,..w �.. ^(1':E, �" t,r) t., H,0 (, ;slow Loss, (" Addi WELL LOG BEDROCK LITHOLOGY Drop in drill Extra fast or Loss or addition of Visible Extra From(ft) To(ft) Code Comment Rust Large stern slaw drill rate fluid Staining Chips 19 100 Chµ ...._.... ....._.... I r °raraite �' < r1�,3 )� P�N:� �� 1 rst ( `sk)vr �' l r€„> �, �«:ie{it[��r'� �� Y�±�.r *` Yee 100 200 4'�iranite C' Yi:; (0- [,v7 ( I'<a,;l �” ",dery Loss �� Addition rm...Y', Ye 200 300 Pt (�.�... if.�k ('e' Slow ( C° r rr� '' "' Y 300 400 �(aranite C ,r s 60 fJJ (i f C. ss,Y `;��Irrw f Lu�s t„ Ae7R)ificau I Yu,,n Y 400 500 Granite � � v(�°i r'� rb:) f`4 r.. Slaw � Loss � Addition (c's, �,�, r �� E''�r�l fin., w� Ye ADDITIONAL WELL INFORMATION Developed C Yes t No Disinfected Yos h° No Total Well Depth 600 Depth to Bedrock 19 Fracture Surface Seal Type None Enhancement t.., Y "r r tab CASING (" Is Casing above clrauntl'? From: 1 To: 0 From To Type Thickness Diameter Driveshoe 0 31 "teal . 17# 6 (k y % SCREEN fJt�)',icroen From To Type Slot Size Diameter Massachusetts Department of Envirtrntnental Protection BUIVAI of RCSOul-Ce 11'0tes.1i0r1 Well Griller PWgI1,1111 CramPletforl Itr.polvs(l melwl) ................ ---Choose Screen Type--_ WATER-BEARING ZONES i..... t)HY M 11_ From To Yield(gpm) 218 219 2.8 PERMANENT PUMP(IF AVAILABLE) :3 Wire Constant Speed Pump Description Horsepower SUbmersible 1 Pump Intake Depth(ft) 480 Nominal Pump Capacity(gpm) 5 ANNULAR SEAL I FILTER PACK From To Material 1 Weight Material 2 Weight Water Batches Method Of (gal) (count) Placement 0 19 Native Material e CvlaCerial I la'reavit 19 31 Bentonite Grou 24 1 �Trerinie WELL TEST DATA Date Method Yield m Time Pumped Pumping Level(ft Time To Recover Recovery(ft (gp ) (HH:MM) BGS) (HH:MM) BGS) 04120/2015 [X'ir `" _ _ n_.__ "` it Biow Wit th_C)rill Ster -. 2.8 02:00 480 04:10 13 WATER LEVEL Date Measured Static Depth BGS(ft) Flowing Rate(gpm) 04121/2015 13 COMMENTS Massachusetts Department of Environmental Protection Bureau Of Resource Protection -- Well Driller Program bi'ell Complelion Reports(Gerreral) i 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. Supervising Driller ROLLINS, JEFF Monitoring[Ml GEORGE. Driller ROLLINS 307 Registration# 305 Signature W CHARLES M. Firm ROLLINS CO., INC. Rig Permit# 0208 Date Job Complete I04/20/2015 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. Ncas110bca Anal tical, LLC I 97x-391.4428 Fax:978-391-4043 LabNumber: 154853 31 A Willow Road,Aver MA 01432 Website:hur,Owww NashobaAnalytical Cone Usc this ndrober with all correspondence Client: Charles M. Rollins Co., Inc. ReportDate: 4/30/2015 126 Depot Road Boxford, MA 01921 Certificate of Analysis Lot#1 Boxford Rd, North Andover MA Parameter Method Result MCL MRL. Date of Analysis Analyst -Wellhead Sampled:412812015 4:00:00 PM by Client Total Coliform Bacteria,/100ml ENZ.SUB.SM9223 Absent Absent Absent 4/29/2015 10:45:00 AM M-MA1118 MCL=Maximum Contaminant Level(EPA Limit),MRL=Minimum Reporting Level Sodium Guidelines-Mass 20,EPA 250, #=Result Exceeds Limit or Guideline ND=None Detected(<MRL), `=Background Bacteria Noted Massachusetts Certified David L.Knowlton page 1 of 1 Laboratory#M-MA1118 Laboratory Director