HomeMy WebLinkAboutApplication - 45 LACY STREET 4/17/1984 Town of jorth Andover,Mass .
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APPLICATION FOR WELL & PUMP PERMIT
Application is heteby made for permit to drill a well Application is
made to install (-) a pump system.
Location: Address Igel ov-1 Lot #-
Owner MAddress 2
(�x Y T I
AM
W or , 12
ell Contract &jy,, Address 3
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, I- )
Pump Contractor c� a f( 1, Address I - - - "" Te I
WELL CONTRACTOR (To be completed at time of Pump test )
Type of Well --A--- Well used for
Diameter of W011 Size of Casing
6?
f y
Depth of Bed Rock Depth casing into Bed Rock
Was Seal Tested? Yes No Date of Testing_ ____
DepLh of Well Wel I Ended in What Mi3f-eria1..C.,
Depth to Water... Delivers Cals . Per Min . for 4 hziirs
Drawdown, Q,feet after pumping, A . -hours at _GPM
Date of CompI 1�
etion ;% V
A,
giiaLu 1 lie I I ConfractorY
PUMP INSTALLERATo be filled in before installation)
Site & Name Pump jHmp Type Used JQQ14Zf
Water Pump Deliversi- GPM Size of Tank
Pipes Material Used in Well : -Cast Iron Galvanized Plastic
Well Pit or Pitless Adapter
Was sleeve used to protect Pipe? Yes NO( Type or N': o Seal
Date.
Date Water analysis report submitted to Board of Hraluh
Date release givon tDowner of record & Bldg . Insp
lknl t Tr",parfor
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low
ly
Pumps
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INE1.1. St IT. M11 coll 'el
RT. 28 WINDHAM, N.H.03087 Cenlrifuga�
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Sewage[031898-4232 [617 W17-58 88
Tanks
Filters
o Sohener
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o Cha";a.C4;od
477 ANDOVER S7' ( r °Crc a NO ANDOVER M' 0184
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Pump Pura
LOT JaJt,r"J9h','ER OR SAMPLE L OC:A'F°,7C,'N rr r`.1iT 0.1 Motor Conlra:ais
/ate Softener Saah:
HATER TEST RESULTS 7 MAY 84 Ga.tMra C;ia.Qaac.aaar
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HARDNESS 68.4 (0-50 REC:: STANDARD) &at Tip Wn Remq.nver,
.l RON (ry,..,.. 3 Ra'::C:' ,,.,.J..AhJDARD) E"rAassiva°aa
MANGANESE'E' 0 (0—.05 le"Jr:C;; STANDARD) Permanganate
HYDROGEN SULFIDE 0 (0—.01 REC:' STANDARD) Fl asHc Pipe & FNtings
Ph (AC::,1`V.J..J.,a, ) 7.5
(6.5-7.5 ltt tl 'J1ARV.)
a.aa urtara
JU c1T y IT i 0 (0—20 15 J:':'C.". STANDARD)
Systrac°ra
CHLORIDES 10 (f1...,150 REC:` STANDARD)
Water Hextars fCtlJ tiH CAf7f1J A 0 (0 lE( tl1J7 7 °JZA/ ` )
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C;:/!s`IRl.%E FOR f:JIk::MIC::AL & BAC::.7.ER.'1.A '1°J.:';.T ** $2 5.0() a Heat Pump
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ABC7i/t': TESTS TS M1::J'::,.7 REQUIRED D ;`.1,.t"IJdDAf>tl.'S AND BASED ON THESE,,
HATER IS ;° ,fi!°'J: J't.'1 R JI,rAt.} :,J:':"J/f.>'l,D USE FIND J'It.1J'JAN C:(.'iJJ,::IIJ'J,''T'.2'C7Jda a=xi s
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