General Well Report 2015 L
Massachusetts Department of Environmentai Protection
Bureau of Resource Protection
GENERAL WELL REPORT
384 datwn in degrees. decimal degree format
4
GP5(Required) North e' / 9 0 9-5- ° West 7. . yia 9.sG °
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S /✓c fete 4' D Property Owner j.4,,,,,,,,..-0 G A-s-.al"=a'/,... a°sc
Address at Well Location _
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0 Engineering Firm
Subdivision/Property Description
Mailing Address ' l u-/t. < cise-
City/Towr /y, -f/,u v,/aY-r- .,? G' _2' Y,
Lot# / City/Town La„/fires ,. State ,cs,.y
AssessorsMap OAK Assessors rY Yes"/
17 Yes ❑ Not Required Permit Number Date Issued 8 7`,2'lS
Board of Health permit obtained ,:7Q/S.'/
7..W ea.., �,
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Overburden
Bedrock
Fracture
Developed . Y N Enhancement • Y L'
1
N
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w�
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pm
Surface Seal
Disinfected [� Y S N
Type
-1
L�J
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OVERBURDEN
LITHOLOGY
Dro
D in
st m
Fast Lotl
From To Code
(ft)
Color
Comment
Slow
Dr➢I Rate
oor
of Fluid
Total Well Depth to
Depth /94) Bedrock Sy
C`J C
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E V Nil
DF Os
DL D A
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DYDN
DF Ds
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D Y D N
DF Ds
DL DA From
To
Type
Thickness
Diameter
DY ON
DFDS
EL EA /1,2.
it
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G
DYDN
DFDS
EL DA
IaIr0
_
DYDN
E Y ON
DFDS
OF Os
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O L D A ypgl�0,
Diameter
��
DL DA From
To Typett
Slot Size
DYDN
OF OS
CL 0A
— iu❑(�I
•r
5.'WELL"
BEDROCK LITHOLOGY
Drop
Extra
Large
Chips
Extra
Fast or
Slow
Rate
Loss o
Addition
of Field
V ble
�❑❑❑
Rust g~
Staining
From
(n)
To
To
code
Comment
inOnll
Stem
Fromm To
Yi Id(gpm)
51
leg
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GA
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DYrNDV®'NDFDSDLDADYDN
WYDNZYONDFDsDLDADY2N
DY$NDYieNEFES • LDAEY
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DYDNDYDNOFDSDLDADYON
EYO NDYD NO
P05D
LDADYON
Description cs,Hp
Pump Intake /
V
Nomina
Pump
DVDNOYENEFDSELDADYEN
Depth OJ ft
Capacity % pm
lit A� ` `�SE F,6 .'
.;z. = t "' . ^... •+
iF
-'`, 4£' .'�?. dad?..:r• ° '.a w'f
�E°v"
z , ' �'
From To
Material Weight
Material 2 Weight Wate (gal)
Batches
Method of Thermal Thermal
Placement Conductivity Diffusivity
slday)
Formation
Water
°F)
S ez-
O 2o0-
: :
3 S
r
ft
(BTU/hr- 'F)
(ft
Temperature(
O
❑
■ DEP DID X Sample ken from this wellfgY O
Date M t od 1Yleld(GPM
Time P peed 1Pumping Level Time to Recover 1 Re covery
(hrs) (mnr fd BGS) Ms ( In) (ft BGS)
Date F Static
Measured Depth BGS(fr
'i`/4°%5 i I3
Flowing
g
Rate(pm)
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c a,/ -- /Y
rjs
_re Ty
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16
18 Vf 6ti�C RSi T ENF ti,
This well was drilled or altered under my direct supervision,according to the applicable rules ano regulations,and this
is and accurate to the best of m�y1�pwledgg,
report complete /-v —T-
�l,j� f 1. �r
� ! / certification is ,c,-,5" '2,
Drller Yin* At e/�-� Supervising Driller Signature
/
// R.. n rou o Y If- 16
Date Job Complete' �// Si ti
l—
Company L.G. Q! HIN & RnN This_