HomeMy WebLinkAboutMiscellaneous - 350 WINTHROP AVENUE 4/30/2018 (17)Ll
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Massachusetts Department of Environmental Protection
Bureau of Resource Protection
WELL DRILLER
Please specify work performed:
Decommissioned
Please specify well type:
Monitoring I
Number Of Wells:
10 }
Well Location
In public right-of-way:
t Yes r No
Subdivision/Property/Description:
Property Owner:
GLOBALPARTNERS
Engineering Finn:
DEC 20 14011
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
Address at well location:
Street Number: S eet Name:
North:
NTHROPAVE
Building Lot#:
Assessor's Map #:
42.68435
essors Lot#:
ZIP Code:
Mailing Address:
City/rown:
r click here if no as well location addres
NORTH ANDOVER
Street Name:
GPS (GPS for the deepest well)
North:
West:
42.68435
Mailing Address:
r click here if no as well location addres
Street Number:
Street Name:
404
JWYMAN ST —�
City/Town:
State:
ALTHAM
MASSACHUSETTS
ZIP Code:
Board of health permit obtained:
r Yes G Not Required
Permit Number:
Issued:
yDate
r----. /e
Massachusetts Department of Environmental Protection
�- – Bureau of Resource Protection – Well Driller Program
i} Well Completion Reports(Decommission)
Well Driller - Decommission Form
WELL INFORMATION
Date Decommissioned 11/9/2011
Depth of Decommissioned Well 122
Area of group (sq. ft) 6000
ADDITIONAL INFORMATION (IF AVAILABLE)
Original WCR # for
�Well ended in formation type
Decommissioned Well I ,
Was a new well drilled? r Yes WCR # for New Well
DEP 21 E Site # DEP Groundwater Discharge #
CASING
Casing Type Polyvinyl Chloride Casing Diameter
Was Casing left in place?
From
Were obstructions left
in the well?
Surface Seal Type l]
DECOMMISSIONING MATERIAL
Was casing ripped or
r Yes t No perforated?
{0 To
C Yes G. No If yes, what type?
t' Overburden C. Bedrock
F—Choose Description
--
From To Material 1 Weight Material 2 Weight Water Satche Method Of Placement
(gal)
Concrete -- Choose Material -- I" JG.,dy
22 Cement/Bentonite Grout -- Choose Material - ramie
WATER LEVEL
Date Measured Static Depth BGS (ft) Flowing Rate (gpm)
F1 —1Y9T2-01 71 110 1
Massachusetts Department of Environmental Protection
Bureau of Resource Protection — Well Driller Program
Well Completion Reports(Decommission)
I�
COMMENTS
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 a
knowledge.
Driller DANIEL BRONSON Registration # r80 +I Monitoring [M] M� Supervising Dri
Firm IBRONSON DPJLLING7 Rig Permit # 182 1 Date Job Com
NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion.
Massachusetts Department of Environmental Protection
Bureau of Resource Protection — Well Driller Program
Well Completion Reports(Addendum)
WELL DRILLER • ADDENDUM FORM
WELL COMPLETION ADDENDUM FORM MONITORING WELLS
Well ID
Well Depth
GPS Coordinates (WGS 1984) Degree Decimals
MW3
20
North:
40.68450
West:
71.13891
MW7
15
North:
42.68420
West:
71.13861
MW5
20
North:
42.68437
West:
71.13846
MW6
20
North:
42.68437
West:
71.13853
MW4
20
North:
42.68450
West:
71.13864
MW8
18
North:
42.68451
West:
71.13877
MW2
19
North:
42.68440
West:
71.13905
NOTE: Well Completion Reports
must be filed by the registered well driller within 30 days of well completion.
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I
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important: North Andover
1n/hon ru;., . ^ F 1 Frnm-
242-1464
MassDEP File Number
Document Transaction Number
North Andover
City/Town
"' W "`
forms on the
" ' ' —" " Conservation Commission
computer, use
only the tab key
: a. check one 2. This issuance is for
( ) ®Order of Conditions b. El Amended Order of Conditions
to move your
cursor - do not
3. To: Applicant:
use the return
key.
Joe
Pasquale
a. First Name
b. Last Name
_k
R. M. D. Properties, Inc. & Delta Delta Realty
Trust
Ilkit
c. Organization
881 East Street
d. Mailing Address
Tewksbury
MA 01876
e. City/Town
f. State—.g. Zip Code
4. Property Owner (if different from applicant):
Same
a. First Name
b. Last Name
c. Organization
d: Mailing Address
e. City/town f. State g. Zip Code
5. Project Location:
350 Winthrop Avenue North Andover
a. Street Address b. City/Town
Map 26 & 27 Parcels 6,8,8,27, 30 and 31
c. Assessors Map/Plat Number d. Parcel/Lot Number
Latitude and Longitude, if known: 42-41'-06" 71-08'-08"
e. Latitude f. Longitude
6. Property recorded at the Registry of Deeds for (attach additional information if more than one parcel):
Essex North
a. County b. Certificate Number (if registered land)
5347,5362, 5412, 5754, 7483, 7826, 8800 and
8449 d. Page
10/09/09 11/4/09 11/5/09
7. Dates: a. Date Notice of Intent Filed b. Date Public Hearing Closed c. Date of Issuance
8. Final Approved Plans and Other Documents (attach additional plan or document references as
needed):
Proposed Site Development Plan, Sheets 1 and 2
a. Plan Title
Merrimack Engineering Services Inc. Vladimir L. Nemhenok, P. E.
b. Prepared By C. Signed and Stamped by
9130/09, revised 10123/09 1" = 60'
d. Final Revision Date e. Scale
f. Additional Plan or Document Title
g. Date
wpaform5.doc • rev. 11/08
Page 1 of 11