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377 Well Completion Report & Water Analysis Report 2006 Section 2 Work Work Performed Performed Code Decommission DC Deepen OP Hydrofracture HE- New Wet NW Repair RP Replacement RE Section 5 Well Completion Report Codes Section 3 Well Type Well Type Code Cathodic Protection CTPR Domestic DMST Geoconstruction GCON Geothermal Closed Loop GTCL Geotherma Open Loop GTOL Industrial INDS Injection INJC Irrigation IRRG Monitoring MONT Pubao Water Supply Paws Recovery RCVR Test Wells TSTW Overburden Lithology Name Overburden Overburden (0B)Code Color Artificial Fill AF Boulders B Clay CL Coarse Sand CS Cobbles Fine J FS to Coarse to Coarse Send FCS Gravel Medium G nic Santl 0S Organics 0 Sand&Gravel SG Silt SI Silty Clay SILL Silty Sand SIS Silty Sand 8 Gravel 5156 Till T Section 7 Overburden Color Code Bedrock Name Black BL Bluish Gray BG Brown BP Dark Gray Du" Greenish Gray 63 Light Gray LG Reddish Brown RB Yellowish Brown YB Screen Screen Type Code Carbon Steel CST Continuous Wire PVC CWP Galvanized Wire Wrapped GWW Perforated Pipe PFP Pre-pack PVC PPP Prepack Stainless PPS Slatted PVC SLP Stainless Steel Vee Wire SS'/ Stainless Steel Well Point SSP Amphibolite Basait Conglomerate/Breccia Diorite Gab ro Gneiss Granite Limestone Matte Quartzite Rhyolite Sandstone Schist Shale Slate/Phylllte Pegmatite Bedrock (BR Code) AM PS CG/BR DI GB GN GR LS MA 02 RH SS SC SH SL/PH PM Section 8 Section 4 Drilling Method Drilling Method Code Air Hammer AH Air Rotary AR Auger AG Cable Toot CT Casing Advancement CA Core CR Direct Pusn DP Drive and Wash DW Dug DG Mud Rotary MR Reverse Rotary RR Sonic SN Section 6 Casing Type Thickness Casing Type Code Thickness NO CODE Cede-Lok CTL Schedule 5 Fiberglass FBG Schedule 10 Galvanized Pioe GLP Schedule 40 HOPE HOP Schedule 80 NSF Coated Steel NCS Schedule 160 PVC PVC SDR 13.5 Stainless Steel SST SDR 17 Steel STL SDR 21 SDR 26 SDR 32.5 SDR 40 175 195 Annular Seal/Filter Pack/Abandonment Bentonite Chips/Pellets Bentonite Grout Cement/Bentonite Grout Concrete Sand Native Matedal Section 12 Annular Seal/Filter Pack/Abandonment Purpose Material Code Purpose Code BC BG CB CT SD NM Pump Description Pump Description Code Horsepower 2 Wire Constant Speed Submersible 2WSS 3 Wire Constant Speed Submersible 3WSS Constant Sneed Submersible Turbine CSST Variable Speed Submersible Turbine VSST Jet JET Line Shaft Turbine LST Centrifiic; CENT 2 3'4 1 1c 2 3 7 14 19 15 26 53 fd 107 125 150 200 Fill FL Filter FT Seal AS Section 10 Method Method Code Air Now with Drill Stem AB Air tiff - - AL Bailing BL Constant Rate Pump CR Venable Rate Pump VR Slug 50 Section 13 Surface Seal Type Cemen+. Cement/Bentonite Concre:e None Well Seal Type Code C3 CT NT E OR PRINT ONLY.' Massachusetts Department of Conservation and Recreation Office of Water Resources Well Completion Report 148195 Eli.LOCATION I GPS (Required) North West — —° — — — —° — — ress at Well Location. �„ 5i\V '--`iOl \ .'� Propedy Owner/Client �s '.MG M�\..s :; Scd Mt1‘.\l division Name: Mailing Address: t\ \) e"L �� S Town: VCa'.C—p,.t..ski0c\ Cityrfowrc Ctc.c1A VP.Ak ;'\g A37\ assors Map Assessors Lot#: NOTE: Assessors Map and Lot If mandatory if no street address available rd of Health permit obtained: Yes ❑ Not Required L] Permit Number Date Issued 'ORK PERFORMED 3.WELL TYPE 4.DRILUNG 6ETHOD 6.CASING Overburden Bedrock From(ft) To(ft) Type Thickness Diameter Z "'v �l <y IN n c `ra‘.N n [5 y r#, v.» ❑ ■ ❑ ELL LOG OVERBURDEN Wate Bearing Zone Loss or Addition of Fluid Drop in Drill Stem Extra Fast or Drill H SI e • • ❑ LITHOLOGY 7.SCREEN (ft) To(ft) Code Color Comment From(ft) To(fl) Type Slot Size Diameter —1-Ec S(.• l i% Y / N Y / N F / S U❑❑ - - - Y / N Y / N F / S . • ❑ . - - _ Y / N Y I N F / S &ANNULAR SEAL/FILTER • ❑❑ MTL Y / N Y / N F / 5 PACK/ABANDONMENT Y / N Y / N F / S From(ft) To(ft) Material Description Purpose Y / N Y / N F / S ❑❑ ❑❑ • • Y / N Y / N F / S ❑ • Y / N Y / N F / S El ON Y / N Y / N F I S • • • • ELL LOG BEDROCK Water Bearing Zone Drop in Drill Stem ExtraEi Large Chips ra Fs4ur sbN Dri Visible Rust Staining Loss or Addition of Fluid #d Fractures per foot 9 SITE SKETCH ! 2ry .L (f- •• I 4 l�,o-� r ✓' LITHOLOGY 1 (ft) To (ft) Code Comment �C) r S iZ\\G\,y Y / NY / NF / SY / NY / N / = 4 IrIi',.:it, b� S� ".°�V.,AY C.AS� Y / NY / NF / SY / NY / N �{ t�i SL � t�"\ Y / NY / NF / SY / NY / N 1 A.',] Sc. A-,.1/4��t' \ Y / NY / NF / SY / NY / N I Ve {;,�® ,� ` ‘.o' 1 C r\ %S SA S C CD \�,v\.,,1 Q— '\\/ N Y / N F / S Y / N Y / N 31 7)2' SC- \v\..i i LVt a,"l �e-S /�Y / NY / NF / SY / NY / N FYI/ N Y / N f S Y / N Y / N a-Q Sit\D S Q'\y'V Y / NY / N F / S Y / N Y / N ''AC a S� AraA-, ,t- Y / NY / N F / S Y / N Y / N 1 lb ■ 1 MtAb 5t•- �\■ iCO Y / NY / NF / SY / NY / N ,fj 1-VAos , C,iq.\ QA.„ A<- Y / NY / NF / SY / NY / N II WELL TEST DATA(ALL SECTIONS MANDATORY FOR PRODUCTION WELLS) 11.STATIC WATER LEVEL(ALL WELLS) Yield Time Purged Pumping Level Tee to Recover Recovery ate Method (GPM) (Ius&min) (FL BGS) (his&min) (Ft.BM), Date Measured Depth Below Ground Surface (ft) sk,kc cSztdkJ, `iLk ∎ - vL t . X13 ' 1— I- - PERMANENT PUMP(W AVAILABLE) 13.ADDTIIONAL WF1L INFORMATION Description Horsepower Developed Q/ N Fracture Enhancement Q Disinfected`F)./ N Surface Seal Type / - N ) b b Intake Depth (ft) Nominal Pump Capacity (gpm) Total Well Depth I-)() to Bedrock a COMMENTS I WELL DRNyHi^S STATEMENT 'This well was drilled,altered, and/or abandoned under my supervision, according to applicable rules and regulations,and ass report is pletg and correct to the best of my knowledge. h1\C• q-C\ CZoC\-.0 Supervising Driller Signature: " ll/C ""/ /1 Ir'7f 1'/ Registration pit 1 1 11 ( `ri er. \iC. \ IC¢.. bc\-i\tn._\-O.■ �K'--?i K . Date Canplete: 1, \-t ' )`0 Rig Permit#: 1 I 'a1 i '{ t. NOTE: Weil Completion Reports must be fried by the registered well driller within 30 days of well completion. BOARD OF HEALTH COPY JV-22-2006 09 :27 AM P. 01 Howard Laboratories 62 Main Street - Hatfield, MA 01038 Tel. (413) 247-5533 Fax (413) 247-9599 Henshaw Well Drilling Client: Melissa Seymore WATER ANALYSIS REPORT Invoice Number: 12761C Sample Location: 377 Sylvester Road, Well Head. Sampled By HWD Date Sampled: 10-11-06 Date Received: 10-13-06 Parameter Results Limits Comments Total Collform Bacteria 0 colonies/ 100m1 0 colonies/ 100m1 OK Color 25 PtCo Color Units 15 PtCo Color Units • Iron 0.28 mg/I 0.3 mg/I OK Manganese 0.019 mg/I 0.05 mg/I OK Nitrate 0.34 mg/I 10 mg/I OK Nitrite 0.006 mg/I 1 mg/i OK pH 7.90 pH Units 6.5 - 8.5 Ph Units OK Sodium 3 mg/I 28 mg/I OK Conductivity 0.24 mS/cm No Standard No Standard Turbidity 9.16 NTU No Standard No Standard Chloride 60 mg/I 250 mg/I OK Hardness 101 mg/I No Standard <50 soR >100 hard ND = None Detected Recommendations: This sample meets acceptable standards of potability. The parameters with an asterisk which are over the limit should go down alter a few weeks as the water and materials Boating In the well settle. Analyst: SL Date: 10/19/06 MA Certification: M-00851