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s* , FAx 978745-0343
WWW.SALEM.COM .
Kimberley Driscoll JOANNE SCOTT, MPH, RS, CHO
Mayor HEALTH AGENT
WELL CONSTRUCTION PERMIT
Location: Pierce Avenue
Owner: National Grid
Address: 25 Research Drive, Westboro, MA
This permit is granted in conformity with the statutes and ordinances relating to well
permits.
Well Construction permits are non-transferable.
This permit shall be on site at all times that work is taking place. Permit shall expire one
(1) year from the date of issuance unless revoked from cause.
This permit does not constitute a Water Supply Certificate.
Permit#: 002-07
Date Issued: 5/3/07
(Monitoring Wells) (TED Inc. — Reg. #560)
HEALTH AGENT
05/01/07 12:01 FAX 7817214073 GEI CONSULTANTS INC. IN02
Apr, 30 07 03: 49p Joanne Scott Salem BOH 978 745 0343 p. z
CITY 4F SALEM,-MASSAC_HusmT'rS
BOARD OF HEALTH
120WASHINGTOWSTREET:-AT FLOOR,
SALEM, MA 01970
TV— 878.741.-1800
FAX 978-745-0343'
5TANLEY.. .L.UfiCLVIC7_ JR.. . JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
Well Construction Permit Applied,
Dale: S>/t r7 Fee: $100. Check payable to the City of Salem (no cash)
.rz"Bl-fly ly ?1 (?W L �
Location: 13eAea�lti w�c"A ad-(� eu b Salem, MA. 01970
Owner Al.s nua . Address at ,Ees&avk Ur- ' Tel. ' j .32-q Ll
Type of well: l_okhoa Well use:._
Well Contractor: �WJ43;EG• Pump Contractor: ( �
Address: -S(ea�a wd .l r.
�. . A 4v< 6(c.iu�},0Za4Address.
Phone:5-CF.384.Y434 Phone:
Reg, #: �gOM
Have abutters been notified?" (y)' ow? .
--- ---- -----------
In tha spars-provided below(or on.back).showthe.locadon.ofthe-proposed welfin relation(o. ..
existing or proposed above or below ground structures. A description of vitable prior and current
land use within(200)feet of the proposed well location, which represent a potential source of
contamination.
kAO- W6'Y &S
"s Ktt(44 —
There Is no fee for monitoring wells but a permit Is required for installation.
B.O.N. una only. Chock S: Chank date: Permit#:
Well wrist pertnil appl oe�rsebtrlZ.de2-`
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05/01/07 12:01 FAX 7817214073 GEI CONSULTANTS INC. r,�fZ 001
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TeL 781-7214000 Fax 781-721.4073
Wa .eeiconsultants.com
5/1/07 98461-5 1210 3
Date GEt Project I Proposal No. Task Code(if Required) umber of Pages
Including This Page
To: Salem Board of Health
Fax No: 978.745.0343 _ ^
From: Saskla Oosting, GrEI �
Message:
Dear Madatn/Sir:
Attached please find a Well Construction Permit Application for replacing two monitoring
wells at the National Grid/New England Power property on Pierce Avenue.
We plan to conduct the work on Thursday May 3,2007. Please call me ar781.721.4099 if you
have questions. Thank you,
Saskia
[G:E1Use: Check One File Discard_ Return to: -
I
Document2 0510920x?
HP Fax Series 900 Fax History Report for
Plain Paper Fax/Eopier_ Joanne Scott Salem BOH
978 745 0343
May-03 2007 11:-47atn__
st Fax
Date- Time Type- Identification , Duration Pago- sul
May 3 11:46am Sent 917817214073 0:35 2 OK
Result:
OK black and white fax
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
i� 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAx 978-745-0343
Kimberley Driscoll WWW.SALEM.COM
Mayor JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
Facsimile
Transmittal
To: .��
Fax # 9- J - psi- -),i,/- � -23
RE: .� Aw
Date : S` - 3 0-
Page(s): including this cover# �,j
Message:
Board of Health News ----------------------------------------------------------------For Your Information
OFFICE HOURS:
Monday, Tuesday, & Wednesday 8:00 AM to 4:00 PM
Thursday 8:00 AM to 7:00 PM
Friday 8:00 AM to 12:00 Noon
Do Salem Residents Know ? - Applications for a permit to remove exterior paint are required
by the Salem Board of Health. No fee for permit and electric sanding is not permitted.
Regulations for home owners and painting contractors are available.