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BOARD OF IIII`ALTII
Town of North Andover ,Mass .
Date 19_
'ermiC V
APPLICATION FOR WELL & PUMP PERMIT/
lication is
� i
�ppia.cation .is hereby made for permit to drill a well (u APP
wade to install V a pump system.
,ocation : Address
)wner Address
A(ldress fi TeI
jell Contractor
i Address Tel
lump Contractor aoi{l - -- --=
JELL CONTRACTOR (To be completed at time of pump test )
,ype of Well Well used for
Size of C'asi.ng
)iamcter of Well ,
)epCh of Bed Rock Depth casing into Bed hock
Jas Seal Tested? Yes ( � No (_)
Date. of Testing
)epth of r'--••c1=— — Well Ended in Wh, -L:- Material
�eprh to Water-
feet tlin . for 4 hour
� hours' aC GI'M
)rawdownfeet after purnpin� -
Date of Completion
Sigraaturc L)eI1 GoiCracCor
•�:r k k�;r:4:. .. .. .. .. .. .:rr,, ..:4:r:' %;.'^•:r•>174:'r:, .. .. .... .. .. .. .. ., ., .. .. ,. .. ., .. .,;r:r it'r:. ..:r:. .. ,, ,. ,. .. ,.
PUMP INSTALLER (To be'' filled in- before insta7.F.ation )
' Pump 'type Used
Size & Name Pump
�Jater Pump Delivers-.GPM_GPM . , ., Size of "I'ranlc,—
Pipe Material Used in Well : Cast Iron (_) Galvanized (_) Plastic (_l
p •
Wcll Pit ( ) or Pitless Adapter
Was
sleeve used Co protect pipe? Yes (_) 140(_) l,ype or Namc t4cll Seal
Date
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of lleal
Date t•7at:er analysi's', repbrt submitted Co 13oarcl l h
Da _e release given try owner of record & I1lclg . Insp
Health Inspector
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Post-It"brand fax transmittal memo #of ll
One 0
6-:3 24'9- F/a4
[)epartwent of Ewironmental Mal)qcIrnent/Division 0!Water Resources
WATER WELL COMPLII ION REPOR I
WELL LOCATION GEOGRAPHIC DESCRIPTION
IN S E W uf
Well ovoner--r-Av-
N S E W of
Tm-,-in
Board Of Health permit: yes ri
WFUL USE WELL DATA
Doinesuc ep(&I'C 0 Industrial 'Total well depth-.-Ar—ft.
A/
Monitoring[J. OtI)er_.._ Depth to hedroL;k.__1dI_IA.
Water bearing rock/oncontsoIlidallea 111alotial
Method difled-441 �_X
Dato drilled-_.-
Wat(,r bearing zones:
CASING 1)
1 _4g& jr,
Length-1-0_1t, Diall.0 )__-JK_in- 2) From
3) From on) To
Lengili into berfiI-7.- ft. GiavIul pack well: dia,
hole'ellve well seal:
Other dWAXW Slot ----from----to---
PUMP TEST
Static water level below land surface__L r__ it, Date
(t, fn P i n 9 1)r. M i In' a 5pm
Drawdowt fr. a
How measured- after I"
LOG of FORMATIONS COMMENTS
MbleTials Front 'T"1�,
pop,
D r i I I er 9
Mass, Registration*___1d;a__)z
Firm_
Address�__�1:1?_
C i t y 17 0 w r I.
no- 0 0rvTSR0—,"1I d,
- -_---
MgWP7757 DRILLER COPY Z_' �
D E C — i me ra I
I
Matrix Anal.Alcall Inc, N A L R 0 R T
106 South Strout
Hqkintorl,MA 01"(
Matrix Analytical,Ync,
105 South Street
a ; Hopkinton,MA 01748 �" rd R E P 0 It T
8W 3-MATRIX
! C;"ldi;n�1»fanrtattart °° —
4cvsr�uat: Northeast Water Wells,Ina
Addeus: Tolley street project Name: CAC#Builders Corp.
Hudson,NH 03051 project Number:
project Manager-,
Sampler Name: Northeast Waiter
Utr 1b; 13190918-001
(r.l{fi15t Id; 23A forest Sircct Date Sampled: 11/YS/91
Matrix; Water Dace Received: 1111319116;06
;:,t Date Reported: 11/'27/91
ME MI In!'cr3: td, �+pvcr MA
Analyticc�Y'eyatnetc�
E MMMEM M IMM
�lYlS Il'aMNO
d 0,03 mg/! 0,05
Nitrite 1S3'.2 Ic 11/18/91
Odor none n mg/! 0,02 353.2 10 11/18/id
�
/
p1i ✓ 7.6 707 mm 71/15/91.
sulfates' 150.1 mm 2I/1�/9i
19 `m y mg/i 1 375.4 mm
i5
urbl,lity -- J rY 1Y 1'%91
1r.11 0,1 214A tt 11/1$/sl
Page
j P'0151-1t`brand tax transmittal memo 7671 a or pngae p
Matrix AnralAcat,Inc. TO � �' — — �—
106 South Strcet "
,,,j Hopkinton,MA 01748 � _
1800 3-MATRIX Wept, one
,1
Fax
'
Client 11110rniatrarl
\ / d
A-:rount; Northeast Water Wells,Inc,
Address; Tolles street Project Narne: CAG Builders Corp.
Hudson NBC 03051 Project Number
Project Manager,
Sampler Name: Northeast Water
Sample Y,^r farlrtrxtlarl
1 ab 11); 13190918-W1
Olent ld: 23A Forest Street Date Sampled: 11115/91 ;
Nlairix: Water Date Received: 11/15/9116;06
1nfo3; N.Andover MA Date Reported: 11/27/91
�nri 7tcal l'+,+ Aoletlon M'ethc?d
Result
i Xlfllt 1`�Tb
'I imlt
,. wd
L,ri'1 IC Ft013IfJi l')2( Y
t.oliform l�s.'tr;r(;l [1011
909A mm 11/15/91
Coliform results arc reported as(<)'Less "an"
basal upon the dilution used.Dilution was nwes8 ly
due to interfering background bacteria and the sample
should be retested after corrective measures havc be;:,,
taken,
7'RhCB M1r1'AL„S
(rtllriUm r./
32,9 mg/I 0,1 0,7 t1
Iron 20
0,50 11/18/91
'
mg/1 0.01 200.7 tl 11/18/91
The maximum limit for iron and manganese is based upon
taste and staining considerations,
t+t�gr,cc:um• S.$
Manganese n'g/I 0.1 200.7 tl 11/18'91
Sodium 0'24 mg/1 0.01 200,7 tl 1116(91
7 mg/I 1 700.7 t! 11/18/91
MISCBLLAN OUS'IESTING
Alkalinity //�'�
nlmonyia / D05 mg/i 2 310.2 Ic 11/13/91
ChlOrldo 0.2 mg/I 0,05 350.1 Ic
Color a 14 mg1l 1 325.2 IC 11/18/91
1lardncss 10b 0 204A tnm 11/15/91
n,g/I I 3140 tI 11/18/`71
Page 1
Pif lA'ri rtP�1 �'�il ((/�� f vbi7�ifA I!!Ifi11
�TOR'r NO. 49217-1337
lAMERICAN ENVIRONMENTAL LABORATORIE, �1'JNC. (sob)534-1444
60 Elm Hill Ave. Leominster, MA 01453 I.A13 II)#MA076 800-11A13-0094
SAIVIPLL INFOI2mxriON
Requested By Northeast Water Wells Inc.
Address : 2 Tolles St . Date Received : 04/17/92
City : Hudson, NH 03051 Date Analyzed : 0411.719 ' f
Sample ID : Well Head Collected By : David Hayngs
Matrix : Water
Sample Location (if different): C.A.G. 23-A Forrest St . N. Andover, MA
PARAMETER RESULT MCL LIMIT BRIEF DESCRIPTION
Coliform Bacteria [P] Neg Pos/Neg Animal/vegetational bact .
Fecal Bacteria NT Pos/Neg Animal bacteria
Standard Plate Count NT No Limit General water bacteria
Sodium 7.30 20.0 mg/1 Mass D.E.P. Gui.del.i.ne
Potassium [S] 1.60 No Limit A component of salt
Copper [S] NO 0-1.3 mg/1. Indicates plumbing corrosion
Iron [S] * 0.68 0-0.30 mg/1 Brown stains, bitter taste
Manganese [S] * 0.55 0-0.05 mg/1 May cause laundry staining
Magnesium 5.90 No Limit A component of hardness
Calcium 45,30 No Limit A component of hardness
Alkalinity [S] 85.00 No Limit Ability to neutralize acid
Chlorine NO 0-0.05 mg/1 A disinfectant ( bleach }
Chloride [S] 14.00 0-250 mg/1 A component of salt
Hardness 136.50 No Limit 0-75 soft
Nitrate [P] NO 10.O mg/1 Indicator of biological waste
Nitrite NO 1.0 mg/1 Indicator of organic waste
Ammonia NO No Limit Gas from organic breakdown
Sulfate IS] 12.00 No Limit A mineral, may cause odor
i
PH [S] 7.20 6.5-8.5 The acidic/basic condition
Conductivity 239.00 No Limit E1-Pc. resistance, umhos/cm
Sediment Neg Pos or Neg Presence of sediments s
Total Dissolved Solids [S] 14 .40 0-500 mg/1 Total minerals present
Color [S] 4.00 0-15 cu Clarity/Discoloration, (0-15) !
Odor [S] NO 0-3 ton Odors due to contamination
Turbidity [P] 4.60 0-5 to Presence of particles
Comments=
For those items tested this sample meets the following EPA criteria
for drinking water (x] Primary 1_ ] Secondary [ ] Neither.
Complete ` Analyst : Scott Richmond
= Exceeds EPA Proposed MCL Limits } 'PLEASE NOTE`
MDL= Minimum Detection Limit The relll,t here, can not be reproduced in whole or in part without our
prior co lint. The results apply only to the actual sample tested.
MCL LIMIT= Proposed EPA Maximum contaminant level American shall be held harmless from any liability arising out of the use 1I
ND = Level present is below detection limit of such tesults. The integrity of the sample and results is dependent on
NT Not Tested
the quality of sampling.
WATER ANALYSIS PARAMETERS
As a minimum, the following parameters should be tested for
private Wells:
- Coliform Bacteria*
- Ph*
- Alkalinity
- Color
- Conductivity
- Hardness
- Iron
- Manganese
- Calcium
- Magnesium
- Sodium*
- Turbidity
- Nitrates*
- Nitrites*
sulfates
* Considered primary contaminants and shall meet EPA -Standards.
A well with a quantity of water less than the- following
shall be considered inadequate for a single family dwelling:
Well Depth Gallons Per Minute For
Four Hours
0 - 150 feet 5 - 6
150 - 200 feet 4
200 - 250 feet 2 - 3
250 - 300 feet 1 - 2
350 and over 1/2
MJR/cj p