190 BRIDGE STREET i
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- RICHARD J."GO
Haley&Aldrich,Inc.
58 Charles Street
UNDERGROUND Cambridge,MA 02141-2147
ENGINEERING& Tel:617.494.4910,ext.443
ENVIRONMENTAL Fax:617.577.8142
SOLUTIONS Email:RJRQHaleyAldrich.com
2
UNDERGROUND _
ENGINEERING&
ENVIRONMENTAL
SOLUTIONS
L P 5
jj y-, 4r. yjgq� Haley&Aldrich, Inc.
58haz1es Street
Cambridge, MA 02141-2147
P� rill Z Z 1997 Pax: 617.577.8142
®
Letter of Transmittal ( ;I y Or 6ALEM Email:BOS@HaleyAldrich.com
HEALTH DEPT.
Date 18 July 1997
File Number 11246-046
From Richard Rago
To City of Salem Board of Health
Nine North Street
Salem, Massachusetts 01970-3928 (G�
Attention Ms. Joanne Scott and Mr. Mark Tolman �9
Copy to file K
S
Subject Application for Well and Pump Permit
Copies Date Description
Cy-
1 original 18 July 1997 Application for Well and Pump Permit
I
'
last entry
t
OFFICES Remarks
Cleveland In accordance with 313 CMR 3.0, we are providing you with the attached application. On behalf of our
Ohio client, Hasbro, Inc. of Pawtucket, Rhode Island, Haley&Aldrich is planning to oversee the installation of
Denver monitoring wells on the 190 Bridge Street property. These monitoring wells are being installed as part of
Colorado assessment activities required for compliance with the Massachusetts Contingency Plan, 310 CMR
Hartford 40.0000. The wells are intended for non-potable groundwater observation and evaluation.
Connecticut
We are planning on installing the monitoring wells in early August and are therefore providing you with
Los Angeles the attached Application for Well and pump Permit. If you have any questions, please do not hesitate to
California call me.
Manchester 1
New Hampshire
Portland
Maine
Rochester
New York
San Francisco f:\11246\044\b0hM11.%pf
California
Washington
District of Columbia
Ilk RECEIVED
h
Jul 0 8 1997
Haley & Aldrich, Inc.
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
Permit# Date 119 Sv 1-1A 191,1�
Application for Well and Pump Permit
A permit is requested to: drill a well install a pump_; other_
LOCATION: ; q O si ri4a S-4-reed— Lot#
Owner 4msiory , T;v1c Address 102f A1re Tel. 401 -7 Z7, -S%Ll0
Well Contractor Gr�yL!2bQ- , ai ic. Add. "Cl. £Lw. -5-}-� i-t, +w,Tel. Sad? -,43s=5-Sg3
Pump Contractor — Add. Tel. -
----------------------------------------------------------------------------------------------------------------------
Wells (T
Type of well fYLovt doyiN W e s Use o e ova two vl-(�,
Well Diameter Z' Size of casing 1/ 1,
Depth to bedrock - Depth of casing into bedrock
Was it seal tested ? yes ( ) no ( ) Date of testing
Depth of well n. AP -io 2 S-' Well ended in what material ?
Depth to water �0 ' Delivers - Gallons per minute.
Drawdown feet after pumping hours at - Gallons per minute.
(Please sketch map of well location with tie down lines on reverse side of this form.)
Completion date: Well contractor signature: Reg#
----------------------------------------------------------------------------------------------------------------------
Pumps (To be completed before installation.)
Name and size of pump: At A- Type
Water pump delivers: I GPM. Size of tank
Pipe material used in well: cast iron( ) galvinized( ) plastic ( )
Circle one : Well pit or Pitless adaptor.
Was sleeve used to protect pipe? yes( ) no ( ). Well seal type:
Date: — Pump installer signature: Reg.#
Plumbing Inspector Wiring Inspector Board of Health
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Jul, 0 8 1997
Haley & Aldrich, Ir
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO
HEALTH AGENT NINE NORTH STREET
Tel:{5081741-1800
Fax;(508)740-9705
I
App
lication f rr ei and Ump Permit
Date
A permit is requested to: drill a well ✓ ; install a pump other
LOCATION: 1 0 Lot#
Owner torn T.-r Address 102 " /i1z..,,p_ Ave _ Tel. µOl --72 -5g4c
Well Contractor ("r e„Lo,1� wic _Add. 'T6 5:lrn -54-,
Pump Contractor- Add. - 4`�Tel.
------------------------------------------------------------------------------------------------------------------
Wells (Ti, Of PURI-
4F
Type of well 1tVLo tWe;lj7aUse o�g�.Vva }wv; �vt
Well Diameter 2" t Size of casing
Depth to bedrock Depth of casing into bedrock
Was it seal tested ? yes ( ) no ( ) Date of testing
Depth of well n.. "t' 4,� 'z s' Well ended in what material ?
Depth to water ,�- &o ' Delivers - Gallons per minute.
Drawdown I feet after pumping - hours at - Gallons per minute.
(Please sketch map of well location with tie down lines on reverse side ofrhis form.)
Completion date: Well contractor signature: Reg #
-V E - -- --- - ---------------------------------------------
I4� �
Pumps (- -
To be completed before installation.)
Ila �
,''II 1997
rne and size of pump: N 4 Type -�
Cly o-06 rs: -- GPM. Size of tank
-
ripe used in well: cast iron ( ) galvinized ( ) plastic ( )
Circle one : - Well pit or Pitles5 adaptor.
Was sleeve used to protect pipe? yes ( ) no ( ). Well seal type:
Date: Pump installer signature: Reg#
Plumbing Inspector / Wiring Inspector Board of Health
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To IWI TOLM Ahs From nr� SOWIIOtiS
CSHt_eF,M co.
Pnone a'50P V41 /000 Phone Haley&Aldrich,luc. ..._-
- ,--.----._.- 58 Charles Street —.,:..
FaxgFop 7y0 97G,S
Pax#6/7 .57-7 L/�/Z Cambridge,MA 02141-214,
Tel: 617.494.1606
Fax: 617.577.8142
® Letter of Transmittal Hmait:B0S0Htley Ud kb.com
Date 18 July 1997
File Number 11246-046
From Richard Rago Pn
To City of Salem Board of Health
Nine North Street
i
Salem, Massachusetts 01970-3928
Attention Ms. Joanne Scott and Mr. Mark Tolman
Copy to file
Subject Application for Well and Pump Permit
Copies Date Description
1 original 18 July 1997 Application for Well and Pump permit
last entry
OFFICES Remarks
Ohio
Cleveland In accordance with 313 CMR 3.0, we are providing Ohio p g you with the attached application. On behalf of our
client, Hasbro, Inc. of Pawtucket; Rhode Island, Haley&Aldrich is planning to oversee the installation of
Denva monitoring wells on the 190 Bridge
Colorado Street property. These monitoring wells are being installed as part of
assessment activities required for compliance with the Massachusetts Contingency Plan, 310 CMR
Hartford 40.0000- The wells are intended for non potable$roundwater observaAon and evaluation.
.. -- - - -
Connecticut
Los Aagcles We are planning on installing the monitoring wells in early August and are therefore providing you with
California the attached Application for Well and pump Permit. If you bave any questions, please do not hesitate to
call me.
Manchester
New Bompshire
Portland
Marne
Rochester
New York
San Francisco Ht 124"44ftap %pr
Lal(,brnia
.Washington
District of Cotumbia
NUMEXER FEE
THE COMMONWEALTH OF MASSACHUSETTS
cil/----- Of -- s. ........ .................................. .......
This is to Certify that ------6&010-%iC.... ............. .......... .
NAME
AI� I
......................... ..............................................y.............. ......................................................... ------------------------ -
ADDRESS
IS HERErBY GRANTED A LICENSE
M'Otil'
For .... ------jQ.-t-....... . . . ...
.............. ...... ...... ZI
e - -1...... ....
.............. . - DX......... f It---/CZ7............... .. . --------------------
..................................... -----------------------------............................................................................--------------- ---------
This license is granted in conformity with the Statutes and ordinances relating thereto, and
expires..... zk--------------------------------..__..__...._unless sooner suspended or revoked.
.. .............
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/... ......- .. 19
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............ ......... .............. .........................
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FORM 433 HOBBS & WARREN. INC.