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538 Well Completion Report 2001 YPE-OR PRINT ONLY Massachusetts Department of Environmental Management Office of Water Resources Well Completion Report 103748 Wdress at Well Location: Lot 1 Sylvestor Rd Property Owner Stan lawalick subdivision Name: Mailing Address: PO Box 114 11ity/Town• Northampton City/Town: Leeds MA 01053 \ssessors Map Assessors Lot#: NOTE: Assessors Map and Lot# mandatory if no street address available 3oard of Health permit obtained: Yes D Not Required Cgi Permit Number sate Issued New Well Deepen ❑ Abandon ❑ Recondition ® Domestic D Monitoring D Irrigation ❑ Municipal D Cable ..,;,.. 'i D»uger CC Air Hart T'7 Direct Push D Mud.Rotarv.,_0 Other _ nepaue u €ist.ta` ! Lit ¢ 3 mI emmsbuln I .. . Unconsolidated Consolidated I,. M e_s . so ,c+r • C s-r ;eh /r1 )c{i 's .0?C- ) / lid From (ft) To (ft) o _ t° o m m N o Y g E m a $ Other Rock Type YP High Low 0 15 45 60 Soft Tan -"-�"� tx 60 125 Graywh to 125 126 X Tan S I t' 126 440 GrayWh] te c. 4----^ vse' w«-, o y 72--- Total Dep h Drilled 441 From (ft) To (ft) Casing Type and M terial Size O.D. (in) Well Seal Type Date Drilling Complete 6-12-01 0 70 17 pound Steel - ii" . Driveshoe r CO SCREE u.,.,�x;.._ .�....,...- ._._,... . ...& aaeu^uxs^.t�sr...a. :..a.:vyvsi: _... z-,.. .� From (ft) To (ft) Slot Size Screen Type and Material Screen Diameter 10.'FILSER_#AC c. c +r 5'Ptl '=lt , '- ``1e,/ka4- r. C ' " Y. '' e ,.1L1)1M Th EP I s From (ft) To (ft) Material Description Purpose Developed? E Yes O No Fracture Enhancement? D Yes ❑ No Method Disinfected? IX Yes ❑ No 12.-WELL TES. 'OA .-.L -je rr or a .. £ "^ ' ` :t? ,y�° ya.�kAr.: 1 - r Depth Below Date Measured Ground Surface (FT) Yield - Time Pumped Drawdown to Time Recovery to Date Method (GPM) (hrs-& min) (Ft. BGS) (hrs & min) (Ft. BGS) 6/fa,i.A 4. , (Jr G -1 3c,4 voa /A, -, /so G;r3/oi G,ee.,. / It yet _kw1 14..PERMANEN1? UM�'i � ` � :'.. � yam" " _" ,�: t7l� irt x '" l .,,7 fi x'.. _...mod�:nl�i .,.- Kirke R Renshaw Inc Aergmotor Submersible Horsepower 3/4hp Pump Description Pump Intake Depth 340... (ft) Nominal Pump Capacity p (gpm) 130 Cutnmington Rd 01 084 t( jr its 2 s i - This well was drilled and/or abandoned under my supervision, according to applicable rules Driller ,iokU !Bisbee Supervising Driller Signature: y Arm. T4 ``:zG ,4-n ttn . 1n < Date 6727/c/ Rig Permit#: I )°2I / I/ I NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion. BOARD OF HEALTH COPY Registration rid I 1 13 16 1