HomeMy WebLinkAboutMill Farm Dr. #23 - 4/29/1998Name
MANSFIELD BOARD OF HEALTH
APPLICATION FOR PERMIT TO DRILL WELL
FRANK CORLISS
Address 23 MILL FARM DRIVE
Location SAME
Registered
Well Driller
Address ._-" t'
TYPE OF WELL:
domestic Potable (for household use)
ZDomestic Auxiliary (for watering, pools, etc.)
_Industrial/Commercial Potable (for human consumption, including food processing)
Industrial/Commercial Auxiliary (for manufacturing, etc.)
_Agricultural (for irrigation of land in the business of agriculture)
Fee: XDomestic S 10.00 _industrial/Commercial 100.00 1�gqN/C Agricultural
Date: APRIL 17,1998 Applicant Signature:, ha"'A �- V�
PERMIT TO DRILL A WELL
The above application has been approved and permis ion is granted to drill a well for the
following use at Z,'L
omestic Potable (for household use)
-
_Domestic Auxiliary (for watering, pools, etc.)
_Industrial/Commercial Potable (for human consumption, including food processing)
—Industrial/Commercial Auxiliary (for manufacturing, etc.)
_Agricultural (for irrigation of land in the busiiness agriculture)
Date: L G C' Approved by:
For-tl a Board of Health
NOTE: Electrical permit required, underground cable trench must be inspected
Upon installation of well, call Department of Public Works office at
261-7331 to be added to well list.
3G .m+�.n.-0.iv, .Y. .n., .. v.. ...;.f. a �.,: n�P :. T, >C3. la.'fd �k K�"15. n�f.�i^ C. nt: f5�5Nao4 :1. �,._::..Tv L^.�l xk: l•i ,. .ei^�m'azmunx �w.c .-...-... ,s. .. .,
Y
CERTIFY THAT THE EXISTING DWELLING
CONFORMS' TO THE ,TOWN OF MANSFIELD
ZONING BY-LAWS.
z
H
a~�
N N 0
z y O 120.00'
i
LOT 24
24,000 SF
NO SEPTIC WHOLE LOT =
YSTEMS ACEPTABLE 110,E NO' SEPTIC
WITHIN 100' WELL AREA . , SYSTEMS WITHIN
100,65
o
p 5.0 N
0 t E r
N t,
EXLD
IST. HOUSE ro� "
26 i N N
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6.1
a 40.1 +
54'±
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r
120.00,
M.ILLFARM DRIVE
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z>_ 3: WELL 4/16/98
SQALE• DATE: J08-056 t
OWNER I _ h0 NOV. 19, 1997 89058
FRANK CORLISS
23 MILLFARM DRIVE Hutchins Trowbridge Associates Inc.
MANSFIELD, MA. CIVIL kWGAftWS suRVEYORs UiAV PL4NWRO
HUTCHINS-TROW49RIDGE ASSOCIATES INC.
200 CHAUNCY STREET MANSFIELD,MASS.
, r,Department of Environmental Management/Division of Water Resources
VIN; WELL COMPLETION REPORT
Address �i. /�/t // %c ,t/�� /�\� "c�xntrnon
0/N StE )W of
Cityliown %P� (le t) ale
Well owner _ Frtr n /{ ( 0p r It '5 5
(road)
'Address l pi N S E W of
(mi. In tenths) (clrole)
Board of Health permit obtained: yes no ❑ intersect. w/ t 11 St
--
Domestic ❑ Public ❑ Industrial ❑
VVMLL UATA -
Total well depth_ � , �) ft.
_
Monitoring El OtherZ:ri,'90bd Depth to bedrock
- /
Method drilled I
1U r'
_
Water -bearing rocklunconsolidated material:
Date drilled [fij.T —
Description _ l n
�
CASING c
Type VP o
Water -bearing zones:
1)From RUC To1ao
Length-6-9—ft. Dia(I.D,) _ 0 in.
2) From To
3) From To .�
Length Into bedrock / n ft.
Gravel pack well: dia.
Protective well seal:
Grout El Other f V y]�p
Screen: dia.
STATIC WATER LEVEL (all wells)
Slot# length _ from _ to._,
Static water level below land surface --/ iQ ft. Date--,:Z /— R
WELL TEST (production wells)
Drawdown ft. after pumping
.]
_ hr. 0 min. at _�Q. 1
9pm
How measured Recovery
I
�`� fL after_ hr..—/—a min.
LOG of FORMATIONS COMMENTS I
Materials From To
a I
'ler
-
H
ELUNO WELL A PUMP INC.
as
— 244A Haven Street i
own neaamg,
MSupervising Driller Reg.#
Signature o/ superv�srng regisfered well dollar
i Lasepantrm/y
BOARD OF HEALTH COPY