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306 DEP Well Report 2021Massachusetts Department of Environmental Protection Bureau of Resource Protection GENERAL WELL REPORT Evate: UJJ,5 coordinates must be in WGS84 datum in de Tees. decimal de ree format, SELL 1L"ti4TI GPS (Required) North L , I ° West Address at Well Location , { ❑ property Owner Subdiviston/Property Descriptlon -� ra ❑ Engineering Firm n CityFrown f`°"l 4- Malling Address Assessors Map Assessors Lot # City/Town State Board of Health permit obtained Yes [:1Not Required Permit Number Issued '71�;) i D i 2.�C1Pt6C�6?�RF�J2�AEb `sl ;i3_,�W�h.L•51►,.fP>�. 11z.:,P, ��,.` .._.,�=neii��.tiift►vs"i°dii`�rue�;n;,„u „_ .i :,%�r.•.,.r.e. ..,�....�,.......n.......... _ ®ED --J®Mar= Overburden Bedrock I lar �& ® ® ❑ ❑ Developed p ®Y ffN Fracture Y L� N Enhancement 5:'Vt1EI:L 3L.G OVERBURDEN LITHOLOGY Drop in Extra Fast or toss or Disinfected Y N Surface Seal C, ❑ From TO... (K) (ft) Code Color Comment 8t2m Slow itio Addition Type Drill Rate Total Well i7epEl1} t Depth to Bedrock f i 'i. @w �] Y N E]F S ❑ i» ❑/ GL 222 ❑ Y ffN jI F ❑°5 ❑ L ZA I cASI:Nd: e ❑ Y nN ❑ F [218 ❑ L ❑'A From To Type Thickness Diameter ❑Y ❑N ❑F ❑S ❑L ❑A 0 RED i co tt El ©N ❑F ❑S ❑L ❑A ❑❑ ❑ Y ❑ N ❑ F ❑ S ❑ L ❑ A8SCfEEN ' ❑ Y ❑ N ❑ F ❑ 5 ❑ L ❑ A From To Type Slot Size Diameter ❑Y ®N ®F ❑S ©L 0 000 "a, .WELl L,OC` BEDROCK LITHOL OGY Drop Extra ❑❑� Extra Fast or . Loss or Visible From To (it) Code Comment In Drill Stem Large chips Slow Drill Addition of Fluid Rust Staining !$ WATER BEAFtINC, ZONES(ft) Rate From To Yield (gpm) L 19 6,❑Y N❑Y[6N®oF❑S❑L A0Y�°N 1C) 14 e4i S ❑Y N❑Y N ETF ❑S❑L A❑YDN ❑Y N❑Y N[Z•F❑S❑L A❑YDN ❑Y❑N❑Y❑N❑F❑5❑L❑A❑Y❑N ';RD PEtMANIENTPUMP(IFAVAILAStE) 0Y0N❑YElN[3F❑S❑L❑A0Y❑N pump 1:11:10EHorsepower ❑ Y❑ N El Y Q N❑ F❑ Sl [3 L© A© Y❑ N Description ❑Y❑N❑Y❑N❑F®S❑L©A❑Y❑hJ Pump Intake Nominal ®Y❑N❑Y❑N❑F❑t3❑L❑A❑Y❑N Depth ft Pump Capacity 4 ;Ai+ii lt9L'1�R :ISA (1 Fi1wi E1� f�ACCrt ,!,E, ±.. . •i4l:., m '12 (3 EOTliEfttlllAL,INFORMATION (t?pf:s Open Loop only) From Toj Material t Weight Material 2 Weight Water (gel) Batches Method of Placement Thermal Thermal Formation P r�–i r-•- I P--"— . Conductivity Diffusivity Water LJ LJ L i L_!LJ DEP U1C # Sample taken from this well [3Y ❑ N 13. WELL TEST DATA 14. WATER LEVEL Date Method Yield (GPM) Time Pumped Pumping Level Time to Recover Recovery Date Stattc Flowing Mrs (min) (ft SGS) (Mrs) (min) (ft BGG) Meaeured Depth BGS (it) Rate (gpm) ( ® Co s 't 96. WELL bRit_LE6Z3 $TATEMei41 This well was drilled or altered under my direct supervision, according to the applicable rules and regulations, and this r report Is compl®te and accurate to tits best of y knowledge. Driller �'� Supervi{sing Driller Stgnature _ l r�5,` ;�gn,s, Certification # Company "( l !)Date Job Complete A Rig Permit #