HomeMy WebLinkAboutApplication - 2001 SALEM STREET 5/4/2012 mm�w A'OYVAY OF NORTH AINDO iR �,wrovr��tk
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11VAI,111 DEPARTMENT
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1600 0SCr00D S'I'.I2I{;I±T; BUILDING 20; SUITE E 2-36
�. : N C1t TI ANDOVER, MASSACHUSETTS 01845
V t t i� r v rr, I1"/x 9 78,68 ,954U--Phone FHEALTH� � NO
Dr-R 1F�W�>"TC t� L;jU ,'I)Ireetol, 978,688,8176—FAX
Ire�iltlul epl��)tc>�vnotii,C,rthanciovc,r,.ct>r�r
www.townof cii titan(1ovol-,com
,Well mid/or Prtml) Application
(Please print) DATE:
LOCATION W, 1111 kve)l off„install a pIt III r:. �'( �?( �'� <10;,
Licensed Well Contractor Nmuc and Comimny Name /6(_'i
C:ont7ut 1'110110 Numbors:
r�
Address: ,1(L.._... �r��r/Cr x'.S / 1 ��(_L�_ C) 7 >
- 1� - / /
Contact Phone Numbers:_
NVELLS(to be completed lit time of pump test)
Type of welt: __..� Us': f"
Size of Cnsingt
/ !
Depth f u of hcrlroA:, f� _ — Depth of rnsiug luto bcdrorlt:
Sell beeo tested? Yes( ) mi( ) Date of test: 6
3 S
Depth of well;. N1nter-brorim k roc :-JZ _
�.
Dr,pth of"wntcr: E7clivcrs:__--- ) _ GEM fol._.��
(how l(mg)
Drawrlorvn „� ", feet after pumphlg: hours at _GPM
Date of rlrt Coo
• I ion 'of
ig'nnlilrr Well Conti irtor
PUMPS(lb c filled In bciorc i ri:s_t,rllatio.n_.)
Name 6c size trf 1'u irtlr: s -.. Type:_
Size of I'll III(:
_...__._.... Purttp dclivorst
Pipe used ill well: Cast Trott Galvrutized - Plastic
Sleeve used to protect pipe," Yes. No X _ Typeorweli seal:,.��J��'�
1
Sit,mnture(it'Purup frl.stniler,
llatc.wntcr nnnl)'sis rr rnrl sub�nlltwl to ltrnith� „�
f
1f tuug lospertor health Div pmuvmPill TZeprescotntivc
C:\Documents and soft iiigs\pdel Ice) My Docut7rcnts\CC7itilN,11-RC1A1 Plil�ltl'I"S\Pcrnut\t'ermit AppluatiotlsvWell
Applicaiion,doc
DelleChiaie, Pamela
From: Brian Castora [bcastora @skillingsandsons.com]
Sent: Wednesday, May 02, 2012 3:39 PM
To: DelleChiaie, Pamela .
Cc: Sawyer, Susan
Subject: RE: Well Applications-2001 a d 2005 alem Street, North Andover
Attachments: 4120_001. df; 127878-2001 S ,. North Andover MA. df 127880-2005 Salem St North
Andover MA.pdf
Pam,
Please find attached well application and water test results for Salem St. I also mailed in a copy of each well application. If you need anything
further please let me know.
Thanks,
Brian Castora
Project Manager
Skillings &Sons Inc.
9 Columbia Dr.
Amherst NH 03031
local#(603)-4.,59-2000
toll free 1-800-441.5281
cell# (603)235-7646
e-mail Lcastorapskabgaardds ns.corn
website www,skillin g ndsons,com
Bringing water well technology to a.whole new level
From: DelleChiaie, Pamela rmilta a; N]ecl c:,vrr ofnorti a.ndoved &oL
Sent: Wednesday, May 02, 2012 1:15 PM
To: Brian Castora
Cc: Sawyer, Susan
Subject: FW: Well Applications - 2001 and 2005 Salem Street, North Andover
Importance: High
H. Brian,
Jttst f011OWing Up to SCC if}r0u have the wc1l testing results and the c::c nipleted al)pli.cations for 2001. and 200
Salem. Street., vic, owner Wants to acquire t.hc'builclin l.)ernnt, aincl ncxe cls to havc this information in order to
do so. Yotir sooi.icst rc:spor sc:i:s aplirCC�iatccl. If you could scma and send tli infortmati.on back to mac°via c nail,
that m7oulcl hr: great. Thank YOU for YOUr assistance.
Pamela DelleChiaie
Health Department
Town of North Andover
1600 Osgood Street I Bldg,20 l Suite 2-36
North Andover,MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email p(tellechiaie,@ tow rof noi,thando err.com
1
W0 www,:lownofNorthAndover corn
From: DelleChiaie, Pamela
Sent: Monday, April 09, 2012 2:02 PM
To: 'bcastora @skillingsandsons.com'
Cc: 'GEORGE.HASELTINE @GMAIL.COM'; Bill Dufresne (�r(d& i ��cortIca l.ri t)
Subject: Well Applications - 2001 and 2005 Salem Street, North Andover
Importance: High
Hello Brian,
Attached are the well applications signed off by Susan. Please fill in the remaining information required when
complete,and submit a copy back to us. Thank you.
Pamela DelleChiaie
Health Department
Town of North Andover
1600 Osgood Street I Bldg.20 1 Suite 2-36
North Andover,MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email pdellechiaie La�towraofsaorth ,ndov_er com
Web www.TownofNor,t[iAridovei-.com
ry
Please note the Massachusetts secretary of State's office has detonmined that most emails to and from municipal officers and officials are public records.For more
information please refer to:htt a://wwwq a=r,.state.tn�a.,as/ relpr eiLlx,htrn.
Please consider the environment before printing this ernail.
2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection
WELL DRILLER
Please specify work performed: Address at well location:
New Well Street Number: Street Name:
,2001 iSALEMST
Please specify well type: Building Lot#: Assessor's Map#:
ow
ttt fl&d tp:e td°t ANDOVER
Domestic
�p-AB tp M DEp AR~~tQ' p!i'NT
Assessor's Lot#: ZIP Code;
Number Of Wells: 01845
Cityffown:
Well Location NORTH ANDOVER
In public right-of-way: GPS
No North: West:
%42.B3680 71.05071
Subdivision/Property/Description:
Mailing Address:
F click here:if same as well location address!
Property Owner: Street Number: Street Name:
GEORGE HASELTINE 66 _ GILCREAST RD
City/Town: State:
Engineering Firm: aLONDONDERRY MASSACHUSETTS
ZIP Code:
03053
Board of health permit obtained:
Ce Yes C" Not Required
Permit Number: Date Issued:
NA 4/5/2012 ,
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
Air Hammer 'Air Hammer
WELL LOG OVERBURDEN LITHOLOGY
From To(ft) Code Color Comment Drop in Extra fast or slow Loss or addition of
(ft) drill stem drill rate fluid
Boulders Brown._ F Yo;� C �:, i r;s�, C nr' iii<<i,j
WELL LOG BEDROCK LITHOLOGY
Visible Extra
From Drop in Extra fast or slow Loss or addition of
To(ft) Code Comment Rust Large
(ft) drill stem drill rate fluid
Staining Chips
Granite F i
n
t
Granite _ > �,�;, (— v,�'
r r r << �����
I
Granite Yoy C V C �,r� C �,r,, ( �ii.�iar � ,�(e r 1
4 GPM
- Gneiss 1 G �' `(� F t• C ,,
2 GPM ;
i Granite
IF
C !as i C mv C
ADDITIONAL WELL INFORMATION
Developed r Yes C No Disinfected r Yes C No
Total Well Depth 440 Depth to Bedrock 06
Fracture
Surface Seal Type None Enhancement C Yes is No
CASING W Is Casing above ground? From: 1.5 To: E0
From To Type Thickness Diameter Driveshoe
Steel _ 17#
SCREEN W No Screen'
From To Type Slot Size Diameter
Choose Screen Type---
WATER-BEARING ZONES r DRY WELL
From To Yield (gpm)
PERMANENT PUMP(IF AVAILABLE)
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection—Well Driller Program
Well Completion Reports(General)
Pump Description submersible Horsepower 3/4
2 Wire Constant Speed i
Pump Intake Depth (ft) 400 Nominal Pump Capacity(gpm) y
ANNULAR SEAL/FILTER PACK
Water
From To Material 1 Weight Material 2 Weight(gal) Batches Method Of Placement
? Native Material Choose Material € (Gravity
WELL TEST DATA
Time Pumping Time To
Recovery (ft
Date Method Yield
(gpm) Pumped Level (ft Recover BGS)
(HH:MM) BGS) (HH:MM)
-Air Blow With Drill Stem i i}U 30 i 'loo i; I
WATER LEVEL
Date Measured Static Depth BGS (ft) Flowing Rate (gpm)
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 a
knowledge.
Driller JUSTIN SKILLINGS Registration# 546 Monitoring[M] Supervising Drill
Firm SKILLINGS&SONS,IN Rig Permit# 006 Date Job Compl
NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion.