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Home My WebLink AboutFruit St. #175 - 5/6/2013Massachusetts Department of Environmental Protection LLO Bureau Resource Protection Well Comm pletion Reports Well Driller Please specify work performed: Address at well location: New Well Street Number: StreetName: - --- - 175 FRUITSTREET Please specify well type: Building Lot#: Assessor's Map :Monitoring Assessor's Lot#: ZIP Code: Number Of Wells: 2 �I City/Town: Well Location MANSFIELD In public right-of-way: GPS (GPS for the deepest well) ___' _Yes North: West: (" t: Nod-..-_-__— 42.00148 71.20437 SubdivisiordProperty/Description: Mailing Address: r click here d same as well location address,, --- Property Owner: Street Number: Street Name: 75 STATE STREET City/Town: State: Engineering Finn: BOSTON MASSACHUSETTS CDM SMITH ZIP Code: 02109 Board of health permit obtained: Cr Yes r Not Required] Permit Number: Date Issued: _ 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Well Driller Program Well Completion Reports(Monitoring) Well Driller - Monitoring Form DRILLING METHOD Overburden iAuger _.. _. Bedrock WELL LOG OVERBURDEN LITHOLOGY Choose Bedrock-- Drop in drill Extra fast or Loss or addit From(fit) To(ft) Code Color Comment stem slow drill rate fluid r0 10 11 Fine To CoarseSan'�� Brown — r YES r.Nol r Fast r. Slow .. l r Loss r: r10 _._ 30 ) Silty Sand Blh Grayuis r YES r NO r Fast r Slowl � (-Loss r_ I PERMIT INFORMATION DEP 21 E RTN # DEP Groundwater Discharge # ADDITIONAL WELL INFORMATION L,r Yes r Nol Are these wells nested? r Yes G No Developed _,_ I I i Surface Seal Type Ice ment - J Area of group (sq. ft) 178 Total Well Depth 30 Depth to Bedrock CASING r Is Casing above ground From To Type Thickness Diameter i0 i L0 _i I Polyvinyl Chloride m Schedule 40 � 2 SCREEN I r No Screed From"> To WATER -BEARING ZONES From To -- I [ _I ANNULAR SEAL / FILTER PACK Type Slotted PVC Yield (gpm) I Slot Size Diameter 10.010 IZ From To Material 1"5 Water Weight Material 2 Weight (gal) Batches Method Of Place Io I I1 I Cement/Bentonite Grout I --Choose Material II Gravity Native Material I ---Choose Material I Gravity Massachusetts Department of Environmental Protection Bureau of Resource Protection — Well Driller Program LLO Well Completion Reports(Monitoring) 16 I18 -_.- Benton0e Chips/Pellets �� - ---Choose Material Gravity 118 - 130 _ . i Sand _.._.� -- Choose Material -- -i -.. --� Gravity WATER LEVEL Date Measured Static Depth BGS (it) jowi/2015_ j COMMENTS Flowing Rate (gpm) 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 BONETTI,MARILOU, Driller GEORGE GUINTO Registration # 681 M SOIL EXPLORATION Date Job Complete 06126/2015 Firm CORPORATION Rig Permit# 271 i_._-___....-- NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion. Massachusetts Department of Environmental Protection Bureau of Resource Protection —Well Driller Program L01, — Well Completion Reports(Addendum) Well Driller - Addendum Form WELL COMPLETION ADDENDUM FORM MONITORING WELLS Well ID Well Depth Screen Interval FROM Screen Interval TO GPS Coordinates (WGS 1984) Degree Decimals 121.5 131.5 North: 142.00195 West: 7L20448 IL 31.5 iv !V t) f0 North: 00.00000._ West: 00.00000 NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion. Massachusetts Department of Environmental Protection !,- Bureau of Resource Protection WELL DRILLER Please specify work performed: Address at well location: New Well Street Number: Street Name: 75 FRUIT Please specify well type: Building Lot#: Assessor's Map #: Monitoring Assessor's Lot#: ZIP Code: Number Of Wells: 0 0 Cityrrown: Well Location MANSFIELD In public right-of-way: GPS (GPS for the deepest well) G Yes C No North: West: 42.00543 71.12396 Su bdivisionlProperty/Descri ption: Mailing Address: r click here if same as well location addres Property Owner: Street Number: Street Name: E= � 2� MERCHANT City/Town: State: Engineering Firm: ISHARON MASSACHUSETfS ENVIROTRAC ZIP Code: 02067 — Board of health permit obtained: C Yes f" Not Required Permit Number: Date Issued: Massachusetts Department of Environmental Protection Bureau of Resource Protection —Well Driller Program [LL Well Completion Reports(Monitoring) t Well Driller - Monitoring Form DRILLING METHOD Overburden Direct Push Bedrock --Choose Bedrock-- WELL LOG OVERBURDEN LITHOLOGY From To(ft) Code Color Comment Drop in Extra fast or slow Loss or addition of (ft) drill stem drill rate fluid F12-1 Fine Sand Brown 0 r Ye C` Fast r Slow C Loss P Addition PERMIT INFORMATION rDEP 21E RTN # DEP Groundwater Discharge # ADDITIONAL WELL INFORMATION Developed �' Yes G No Are these wells nested? G Yes O No Surface Seal Type Cement Area of group (sq. it) Total Well Depth 12 �� Depth to Bedrock CASING r Is Casing above ground. From To Type Thickness Diameter 2� Polyvinyl Chloride Schedule 40 F SCREEN No Screen From To Type Slot Size Diameter 2 12 Slotted PVC WATER -BEARING ZONES Yield From To (9Prn) ANNULAR SEAL / FILTER PACK From To Material 1 Weight Material 2 Weight Water(gal) Batche Method Of Placement �� I` 1 rSando --- Choose Material --- Gravity I` 1 ets O --- Choose Material --- Gravity 12 ---Choose Material --- = = = Gravity WATER LEVEL Date Measured �Static Depth BGS (ft) rFlowing Rate (gpm) LF� COMMENTS Massachusetts Department of Environmental Protection Bureau of Resource Protection —Well Driller Program Well Completion Reports(Monitoring) 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 a knowledge. Driller JAMESJAMES Registration # [606 Monitoring [M] Supervising Dri Firm _TECHNICAL DRILLING_Rig Permit # 70 Date Job Com NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion.