HomeMy WebLinkAboutMiscellaneous - 623 TURNPIKE STREET 4/30/2018 (2)Massachusetts Department of Environmental Protection an
Bureau of Resource Protection
'" Well Completion Reports
Well Driller
JRFDE�VED
Please specify work performed:
Address at well location:
New Well
Street Number: Street Name:
rrp 2 6 2��6
623 TURNPIKE
f CD
Please specify well type:
Building Lot#: Assessor's Map
OF ND�roEpR
Monitoring
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Assessor's Lot#: ZIP Code:
Number Of Wells:
1
City/Town:
Well Location
NORTH ANDOVER
In public right-of-way:
GPS (GPS for the deepest well)
_. , Yes j No
North: West:
42.39865 71.06837
Subdivision/Property/Description:
Mailing Address:
click here if same as well location addres
Property Owner:
Street Number: Street Name:
451 P O BOX
City/Town: State:
Engineering Firm:
EXETER NEW HAMPSHIRE
EXETER ENVIRONMENTAL
ZIP Code:
03833
Board of health permit obtained:
,j Yes J Not Required
Permit Number: Date Issued:
I
i
�M
Massachusetts Department of Environmental Protection ❑
.j` Bureau of Resource Protection -Well Driller Program ❑
Well Completion Reports(Monitoring) ❑
Well Driller - Monitoring Form
DRILLING METHOD
Overburden Direct Push Bedrock Choose Bedrock --
WELL LOG OVERBURDEN LITHOLOGY
From(ft) To(ft) Code Color Comment Drop in drill Extra fast or Loss or addit
stem slow drill rate fluid
0� 5 Urban Fill 6 Brown 6F j, YES r, NO r�, Fast j Slow
+
5 13 Silty Sand And Ga 6' Brown 6 j
_ j YES _Jy NO J, Fast rj, Slow
❑ ❑ ❑
❑ ❑ ❑ ❑ ❑
PERMIT INFORMATION
DEP 21 E RTN # DEP Groundwater Discharge #
ADDITIONAL WELL INFORMATION
Developed I ❑j, Yes _It No Are these wells nested?
Surface Seal Type (Cement Area of group (sq. ft)
Total Well Depth 13 Depth to Bedrock
CASING (---Is Casing above ground'.
From To Type
0� 0 Polyvinyl Chloride 76
SCREEN I 4t�'No Screen
From"> To Type
F_= - 13 Slotted PVC !
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WATER -BEARING ZONES
From To Yield (gpm)
0 0 0
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ANNULAR SEAL / FILTER PACK
Thickness Diameter
Schedule 40 J 0
Slot Size Diameter
❑ ❑
From To Material V5 Weight Material 2 Weight Water(gal) Batches Method Of Place
Native Material '6 --- Choose Material --- 6 j Gravity
0 2 Bentonite Chips/Pellets --- Choose Material6�I Gravity
LlL7TMassachusetts Department of Environmental Protection ❑
Bureau of Resource Protection — Well Driller Program ❑
Well Completion Reports(Monitoring) ❑
]
L� 13 Sand _ --- Choose Material ---6! Gravity
WATER LEVEL
Date Measured Static Depth BGS (ft) Flowing Rate (gpm)
02/08/2016
17 —� —�
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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
and accurate to the best of my knowledge.
Monitoring [M] Supervising Driller Signature NEWSHA
Driller MATT KELLY Registration # 606 PETER, W
TECHNICAL
DRILLING
Firm SERVICES, INC. Rig Permit # 66
Date Job Complete
NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion.
02/08/2016
Commonwealth of Massachusetts
On- Massachusetts
System Pumping Record
System Owner
Date of Pumping: S - 3 • � O 6-0
Cesspool: No 4Yes L_)
System Location
�Oa3 �uAnp;�e �.
a
Quantity Pumped: --150 gallons
Septic Tank: No Yes L�f
System Pumped by: Faredart License #
Contents transferrred to : Greater Lawrence Sanitary District
llate:
Inspector-.
4