Loading...
19 THOMAS CIRCLE t �9 / 1rc �2 IIS) 10/18/2002 16:21 7815994380 MAVROS PAGE 02 LAW OFFICES MAVROS& FITZGEULD I19 WASHINGTONSFREV7 LYNN,MASS4C1(I7SH7TS 0190:•i797 ELI G. MAVROS Arca Code 781 RICHARD L. CAMANN 599.3649 399-5652 RICHARD B. PATTERSON,JR.' October 18, 2002 " Also admitted in Florida FAX Number (781)599.4380 Board of Health of the City of Salem EDWARD R.FITZGERALD 120 Washington St . , 9th Floor of counsel Salem, MA 01970 ATTN: Mr. Jeff Vaughn, Sr. Sanitarian RE: PROPERTY: 19 THOMAS CIRCLE: SALE34. MA OWNERS: PETER PASQUALE AND ALEXANDRIA ADAMO Dear Mr. Vaughn: Thank you for your letter under today' s date relative to the above entitled matter. Based upon our follow-up conversation, this will confirm that the hearing scheduled for Monday, October 21, 2002 has been temporarily suspended. Either my client, myself or a representative from Wilmington well and Pump Company will contact you as soon as we can arrange a date for them to come out and perform the necessary testing. Thank you for your cooperation. -.STeSY_ trulY Yours, OCT ZOO2 P.ICHMD L. CAMANN �. RLC:pc MAVROS & FITZGERALD BOARD OF HEALTH ?jie en io^^ t� P Wit 5to �� � (,� C g,�eaxol CITY OF SALEM, MASSACHUSETTS �y BOARD OF HEALTH 7 '� .h 120 WASHINGTON STREET, 4TH FLOOR ` SALEM, MA 01970 �.. �'fp6,Q TEL. 978-741-1800 '� FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT. MPH, RS, CHO MAYOR HEALTH AGENT October 18, 2002 Law Offices of Mavros &Fitzgerald Richard L. Camann 159 Washington Street Lynn, MA. 01902-4797 RE: 19 Thomas Circle, Salem (well) Dear Mr. Camann: The Salem Board of Health recommends the following regarding the private well water supply system owned by Peter& Alexandria Pasquale, located at 19 Thomas Circle, Salem: -Hire a DEP approved company to conduct a pump test -Conduct a water test through a certified lab for Coliform Bacteria and Volatile Organic Compounds (VOC's) -Have the approved company conduct an inspection of the well parts to be sure they are functioning properly and provide a written statement to this office with the results. This office has had conversation with the contractor you have lined up to do the work (Wilmington Pump) and we approve of that choice. If the pump test results are acceptable, the water testing is within limits (or can be with the use of a filtering system), and the systems structure and function are in order this office will issue a Private Well Water Supply Certificate. I thank you for your time and patience in this matter. If you have any questions please call me at (978)741-1800. For the Board of Health: Jeff Vaughan Sr. Sanitarian Cc: Mr. &Mrs. Pasquale Salem Public Services—J.Nerdon .1 �coxwr CITY OF SALEM, MASSACHUSETTS vg BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR `-� SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT Facsimile Transmittal To: Ile, Gl77�/cA/ �.9mA ✓✓ Fax �'��/� 5--99 - 9.780 RE: Date Page(s): including this cover # D Message: Board of Health News ----------------------------------------------------------------For Your Information Office Hours: Ettective September 3, 2002 through June 27, 2003 ; Monday, Tuesday, & Wednesday 8:00 AM to 4:00 PM Thursday 8:00 AM to 7:00 PM Friday 8:00 AM to 4:00 PM 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. i HP Fax Series 900 Fax History Report for Plain Paper Fax/Copier Joanne Scott Salem BOH 978 745 0343 Oct 18 2002 12:58pm Last Fax Date Time Tvoe Identification Duration Pages Result Oct 18 12:58pm Sent 917815994380 0:38 2 OK Result: OK - black and white fax 10/17/2002 12:37 7815994380 MAVROS PAGE 01 r LAW OFFICES OF OCT. 17 2002 MAVROS & FITZGERALD FAX TRANSMITTAL COVER SHEET Cl I y' GF SALEM BOARD OF HEALTH DATE: (� d FAX NO.: FROM: �s�c� � 1 MAVROS do FITZGERALD 159 WASHINGTON ST. TCL.# (781) 599-3649 LYNN, MA. 01902 FAX# (781) 599-4380 TOTAL, PAGES TNCT.ITDTN SIMS COVER SHEET: RE: sl��G�� 119 COMME=NTS: '1'IW INFORMATION CONTAINED IN THIS FACSIMILE TRANSMISSION IS INTENDE3 ONLY FOIlil1E PRIVATE AND CONFIDENTIAL USE OF ii{E DESIGNATED RECIPIENT NAMED ABOVE.j JIS MES.'AGE MAY DF A14 A1709NCY-CLIENT COMMUNICATION AND ASSUCI I IS PRIVI1.E.G1iD AND CONFIDENTIAL.IF THE Il11%)m OFTRIS M[SSAGL'I$N07"TIIE INTENDED I(ECIPIENT OR AN AGENT RESPONSIBLE VOR DELIVC)UNO M'TO THE INTENDED RECMICNT,YOU ARC WrIUAly NOTIFILD THAT YOU HAVE RECEIVED TI-115 DOCUMENT IN ERROR AND THAT A14 e RGVILW,DISSGMINAi"ION,DISIRIBUTION Olt COPYING Or THIS MESSAGE IS STRICTLY PROHIBITED.IF YOU HAVE RLCL•IVCD THIS MESSAGE IN EIUI.Olt,PLEASE NO'T'IFY US IMMEDIATELY BY TELEPHONE AND RETURN TILE ORIGINAL MESSAGETO US BY MAIL.TNANK YOU. .,* 10/17/2002 12:37 7B159943B0 MAVROS n PAGE 02 .. LAW OFFICES ® a0 \v} MAVROS& FITZGE6W 159 WASHINGTONSLREE7 OCT 17 2002 LYNN,MdSSACHUSE77S 01907--1797 ELI G.RICHARD X..RCAMANN QI I .� U11i- ui".i i Code 781 99- RICHARD B. FATTBRSON,3R.• October 17, 2002 BOARD OF 19,4 F, $99.5653 •Also admittcd i.Florida t FAX Number (761)599.4380 Board of Health of the City of Salem EDWARD R.FCl2GER4,LD 120 Washington St. , 4th Floor Of Counsel Salem, MA 01970 ATTN: Ms . Joanne Scott, Health Agent RE: PROPERTY: 19 THOMAS CIRCLE. SALEM. MA OWNERS: PETER PASOUALE AND ALEXANDRIA ADAMO Dear Ms . Scott : As you know, this office represents Mr. Peter Pasquale and Ms. Alexandria Adamo Pasquale in regard to the above referenced property. At the last scheduled hearing on October 7th, the Board continued this matter to October 21, 2002 . One of the primary reasons for the continuance was to allow the Board to contact: the Massachusetts Dept. of Environmental Protection for assistance and guidance with respect to the private well on the subject property. It was also indicated that someone would contact me and let me knco7 the results of the Board' s inquiry to DEP. I called Mr. Vaughn yesterday to check on the status of this case and left a message for him, but have not hea3-d from him as of yet . In addition, I contacted Mr. Phil Dupree of Delta Well who, i am informed, has sent Mr. Vaughn a letter indicating that no alteration was performed to the well, but that a new pump was simply installed and the well began to :function properly. Based upon the contents of the original DEM Well Completion Report being filed in your office by Downeast Drilling (which is a DEP approved company) at the time the well was first dug, and the above referenced letter indicating that no alteration of the well has been performed, I believe the Board should be satisfied that the well was originally constructed in, and is now structurally at least, in conformity with all applicable regulations and the only remaining issues prior to the issuance of a Water Supply Certificate should be a PUMP test report and a water quality test. My client has arranged with Wilmington Well and rump of Wilmington, MA (which is also a DEP approved company) to conduct such a pump and water quality test in conformity with, and under the auspices of, your Board' s regulations, once we receive permission. Thank you for your cooperation. Very,truly yours, ICHA.RD L. CSMANN RLC:pc MAVR:S & FITZGERALD T ���� ����� ��� - 7�0� j I 4 10/15/2002 11:33 4347405 JB COPY INC PAGE 03 ELTA WELL SUPPLY HYDRO PRACKINO EQUIPMENT • WELL SLEEVES • SCREENS W ' I3S Fa c:�4 x _AA�-w► �P� S sPM -c i � XL r Pry Ji CCi 15 [uii2 CITY OF SALEM BOARD OF HEALTH P.O. 60x 965 • Derry, New Hampshire 03038 Telephone: 603-434-2028 10/15/2002 11:33 4347405 JB CDPY INC PAGE 01 ^�� r Na.pf PapBe ... To0aye 0a2 C G��� To, Frcm 66m 1nlo FBIB V1..1//f_ l.�lYl `- bonny I�t; 1 ; ': w\ (`��- 1 Telephonep . . _,Dept ChnT. I 'D2posllmm LjDesRatum El tmy � CEN or pip f ; .. �1a Nye .......� 7wL, 4 ., a .......,.. DELTA WELL CO. P.O.Box 965 0o Derry,New HarnPShlre 03038 f Yet: (003)434.2028 i 0I. E BOLD BT CIBM C.OU. fStAROt? Oft AOCT. amBE .efTV. PAID OIfr CITY. DESCRIPTION PRICE AMOUNT l I I S4L_ ......-.._.. ............. ............. ........... t n ��� I GGi 7 5 2002 CIT'Y' o ;_WEEN ....... BOARD OF HEALTH I 9E�EWEO in, TAX TOTAL l All ctelme and returned MUST be eccempmnlod by thin bill ds ff `TFtasr�k�'�t 10/15/2002 11:33 4347405 _ JB COPY INC PAGE 02 ~ ' = ti' n,3 P.O.Box 965 ��11 lorry,Naw Hampsbire =38 OCT 15 2002 ao3-a�+-2�s CITY CF 'ALEwl /(�� BOARD OF HEALTH Date: �-/" Well Location: J Q� Tax Map Lot #: Well Information: Casing:— Water Level: Dug: Depth��— F7 O© Casing: — Water Levels 1^ D lie Depth pump Information: 2- Type of System: Gtli` S<-a E �E Model and Year: yP �" r PM `906/9 Depth of pump: i O Wire Sizes �/ pump Test Information: Static Water Level: G.P.M. Start: G.P.M. Finish: Recovery (tate G.RMIS Ak Comments: �' ^1, F 0 �� `` !'ACT U r�.L leJ F 4,1 r, C.`kC� Dy5 ,� �'�, a��1ta11 Vim- � �r.�YVI-WY✓✓ � -^ 1"�/ 1. , 1 ld) S jo ro Q e4 Pe �4 n� 0-6��C¢�ri �� _ rS- �e L-,�,a uta- - 70)d, o(� - ��dl� (��7�,_ r��� - A)D r' k o s. — i � j—_ _ - n 17/3 i pas1u-a�� / L44- 9k_-AN.0 a 94- I' � ' d-_ � o UimC�A �_cJ�-�_._c1J_P�(�r�.c--W�=-•2e�.J-a�t�¢ . 6 LY✓LCwy� D /�'I� - EM [�,i7 U-Q- TD T�LG�I'uGLe C:-,yi-CX.e.. pi 1 .1 { to I CA"L� 0414t, I E� �5� II P.O. Box 965 Derry, New Hdmpshire 03038 603-434-2028 Date: Well Location: Tax Map Lot #: Well Information: Dug: Depth Casing: Water Level: Depth 494 Casing: (90 Water Level: 19(f-7 — Pump Information: pp Type of System: Model and Year: y� y� GpM J06© q Depth of Pump: D oar Wire Size— Pump Test Information: Static Water Level: G.P.M. Start: G.P.M. Finish: Recovery Rate GAM'S— Comments: �?j9AtiFh FuF GU4-TCk PuT �ZtssAE � kk as b' k1 �o Psi, 38 WATER QUANTITY (PUMPING TEST) This section consists of the following subsections: General Considerations Pumping Test Report General Recommendations for Performing Pumping Tests Testing Procedure Additional Considerations GENERAL CONSIDERATIONS A properly constructed private water supply well must have a sufficient capacity to provide for anticipated needs. In order to determine if the well can provide an adequate supply of water and to obtain information necessary for the design of the permanent production pump, the well driller or pump contractor should perform a pumping test. This test also provides information that may assist a contractor if the well malfunctions. Many local regulations specify a minimum well yield required for the issuance of a building permit. Fixed minimum yield requirements, however, do not take into consideration variations in the storage capacity of the well casing and variations in household size. These factors should be considered when evaluating the adequacy of a well to meet household water supply needs. PUMPING TEST REPORT All pumping test data should be recorded and included in a report that the contractor should submit to the well owner, if the well driller performs the pumping test, a copy of the pumping test report should be appended to the Water Well Completion Report that is submitted to the local Board of Health and the Office of Water Resources. The Pumping Test Report should include, but not be limited to, the following information: (1) name and address of the well owner (2) well location, referenced to at least two permanent structures or landmarks (3) date the pumping test was performed (4) depth at which the pump was set for the test (5) location of the discharge line (6) the static water level immediately before pumping commenced (7) the discharge rate and, if applicable, the time the discharge rate changed (8) pumping water levels and respective times after pumping commenced (9) the maximum drawdown during the test (10) the duration of the test, including both: a) the pumping time, and b) the recovery time during which measurements were taken (11) recovery water levels and respective times after cessation of pumping (12) reference point used for all measurements 39 GENERAL RECOMMENDATIONS FOR PERFORMING PUMPING TESTS The following general recommendations apply to all pumping tests: (1) upon completion of drilling and developing the well, and prior to beginning the pumping test, the aquifer should be allowed to recover from stresses induced by drilling and development procedures (2) a temporary pump should be used for the test (3) the discharge line should be located where it will not cause recirculation of pumped water (4) before starting the pumping test, the discharge line should be filled with water to prevent unnecessary fluctuations in the discharge rate at the beginning of the test (5) the discharge water should be checked periodically for sediment: excessive sediment in the discharge, which could damage the pump, indicates that the well needs additional development (6) water level measurements should be measured in feet and hundredths of a foot (7) water levels should be monitored in any test wells or supply wells that could potentially be influenced by the well being tested TESTING PROCEDURE This subsection consists of the following parts: • Calculation of the Required Volume • Pumping Test • Examples Calculation of the Required Volume The pumping test should demonstrate that the well can yield the Required Volume of water within a 24-hour period. The Required Volume is calculated as follows: (1) determine the volume of water necessary to support the household's daily needs using the following equation: (number of bedrooms plus one bedroom) x (110 gallons per bedroom) x (A safety factor of 2) = number of gallons needed daily (2) determine the storage capacity of the well using the measured static water level and the depth and radius of the drillhole or casing (3) calculate the Required Volume by adding the volumes of water in (1) and (2) above. It is this volume of water that must be pumped from the well within a 24- hour period. Table 3 provides values that are useful in determining the storage capacity of a well; Table 4 provides flow volumes in gallons per minute and corresponding flow volumes in gallons per day. 40 Pumping Test The pumping test may be conducted at whatever rate is desired. Following the pumping test, the water level in the well must be shown to recover to within 85 percent of the prepumped static water level within a 24-hour period. If the well fails to yield the Required Volume within a 24-hour period, or if the water level in the well fails to recover to within 85 percent of the prepumped static water level within a 24-hour period, the well should be redeveloped, hydrofractured, and/or deepened. After completing the chosen procedure(s), another pumping test should be conducted. Examples Example 1: For a 1 bedroom house with a well that is eight (8) inches in diameter and contains 200 ft. of standing water: (1) (1 bedroom + 1 bedroom) = (2 bedrooms) x (110 gallons per bedroom) x (2) = 440 gallons needed daily. (2) the volume of an 8-inch well is 2.60 gallons for every foot of length. Therefore, (200 ft. of standing water) x (2.60 gal/ft.) = 522 gallons. (3) 440 gallons + 522 gallons = 962alg Ions that must be pumped from the well in 24 hours or less to demonstrate suitable capacity. Example 2: For a 4 bedroom house with a well that is six (6) inches in diameter and contains 100 ft. of standing water: (1) (4 bedroom house + 1 bedroom) = (5 bedrooms) x (110 gallons per bedroom) x (2) = 1100 gallons needed daily. (2) the volume of a 6-inch well is 1.48 gallons for every foot of length. Therefore, (100 ft. of standing water) x (1.48 gal/ft.) = 148 gallons. (3) 1100 gallons + 148 gallons = 1248 gallons that must be pumped from the well in 24 hours or less to demonstrate suitable capacity. ADDITIONAL CONSIDERATIONS Experience has shown that a well producing less than 0.5 gpm (720 gpd) is a marginally dependable source of water for domestic use. It is recommended that a minimum cutoff of 0.5 gpm be established. Due to seasonal variations in recharge of the groundwater, pumping tests performed during times of seasonally high ground water may not accurately predict performance during times of reduced water availability. A well that passes a pumping test in the spring, during high water-table conditions, may not be able to provide an adequate supply in summer or during drought periods when the water table is lower. Tests performed between June and October are more reliable for determining if a well will satisfy household water demands than tests performed at other times of the year. 41 TABLE 3: GALLONS OF WATER PER FOOT OF DEPTH FOR VARIOUS CASING OR HOLE DIAMETERS GALLONS OF WATER DIAMETER OF PER FOOT PER 100 WELL DIAMETER GALLONS OF WATER WELL CASING OF WATER FEET OF IN FEET PER FOOT IN INCHES DEPTH WATER OF WATER DEPTH DEPTH 1 % 0.092 9.2 2 23.5 2 0.163 16.3 3 52.9 3 0.367 36.7 4 94.0 4 0.653 65.3 5 146.9 5 1.020 102.0 6 211.5 6 1.469 146.9 7 287.9 8 2.611 261.1 8 376.0 10 4.080 408.0 9 475.9 12 5.876 587.6 10 587.6 TABLE 4: FLOW VOLUMES IN GALLONS PER MINUTE AND CORRESPONDING FLOW VOLUMES IN GALLONS PER DAY Flow Volume Flow Volume (9pm) (9pd) 0.3 432 0.4 576 0.5 720 0.6 864 0.7 1008 0.8 1152 0.9 1296 1.0 1440 1.5 2160 2.0 2880 2.5 3600 3.0 4320 3.5 5040 4.0 5760 4.5 6480 5.0 7200 Permits • Reports PERMITS This subsection consists of the following parts: • Required Registration of Well Diggers and Drillers Required Building Permit { Recommended Permits i Required Registration of Well Diggers and Drillers Chapter 21 , Section 16 of the Massachusetts General Laws requires any person engaged in the business of digging or drilling wells within the Commonwealth to register annually with the Office of Water Resources of the Department of Environmental Management. In addition, MGL Chapter 21 , Section II, authorizes the Office of Water Resources to establish regulations i;. necessary for the proper administration of the law cited above. The regulations developed by the Office of Water Resources are contained in 313 CMR 3.00, "Registration of Well Drillers and Filing of Well Completion Reports. These regulations (1) provide the criteria necessary for the registration of well diggers and drillers in the Commonwealth of Massachusetts, (2) establish the information that must be furnished as a prerequisite for registration, "(3) establish the information that must be submitted to the Office of Water Resources upon the completion of.any well, and (4) set forth penalties, including revocation of registration, if a driller is found to be in noncompliance with state or town regulations. i Accor_d:ing- tyianyizper_son-zin�Lthe=business::-of diggi_ng::�or drilling=whomconstr_ucts,- er pairs or aiters�a pr_ivate�weli�must=be-registered with the;O.ffice-of=UVater-Resources at-theAimeithe=work-is per-formed.rned. In addition, any person who decommissions (plugs) an abandoned well must have,a valid Office of Water Resources registration. Required Building Permit Pursuant to MGL Chapter 40, Section 54, which governs the powers and duties of cities and towns, "no building permit shall be issued for the construction of a building which would necessitate the use of water therein, unless a supply of water is available" from either a public or a private water system. Recommended Permits t / J.9� '� �A.I��Q i;..Fa `7• �/os �i-Jy:7 1�2,'//,' A �T � �.d.v-,.9cP C.'u� X0,0 6t,.,.^o.�• .�P/f<'9-� 1.✓e/�/2iQ/�GA�a,✓ _ , --- __-- - T�_� -- ___ - + a+ C or.unicition Report #k:%: r r,,s SALEM HEALTH APR 15 '98 12; 14 FM fNk-kA:Y.NkN::Y.YYNNN:Ak:kA:tWk.fYY:K:A:k.AW.k1:N'YWrAh:k:kkA:h:A 644 4. ck k,I.A:%:k.kk.N.AYR'.Y::Aa::1:4Y Kc:f:kW:ki lkt Y.:y:4. 4. AN,.N X1Y:e: A MODE P.E4M17-TE''ERM I MAL I0. START TIME TIME PAGES STATUS a: a. N. k TX 978 768 3850 04/15 12: 11 PM 03: 32 6 G3 S N: M N M: RESULT TRANSMISSION Or y k'A'Xii.l'kA'.ka.W.A1 KWY:11::K:NN k.YN A:'d::Y.MaiAAk:A:AkIt KYN'Y:i::V%::IfAAAdk.'h:'A:d Y81:Aa'a::%ki 4N'd:N-A::1:kMMSN:N�'.'B�YYt#:W'd::Aa �AN'.1.-A A:N'4:.Y. IMPORTANT MESSAGE FOR -4�G�(y DATE .` �Y'-/6 TIM E/AAL/� M OF PHONE AREA CODE NUMBER EXTENSION ❑ MOBILE AREA CODENUMBER TIME TO CALL TELEPHONEDPL SE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE uv SIGNED Vr0F, FORM 4009 �i MARE IN U.S.A. V NOTES i D r: its Groundwater Specialists 1-888-H20 EASY LOU RIM _ Account Executive 03:24 PH SALEM HEALTH -5087409705 To- .............. Fax: From: .............. ................. Date: page(s) including this page. ........................ ................. .......... fax From the delis!... Joanne Stott,MPH,RS,CHO Health Agerit Salam Board of Rulth 9 Korth Street Salem,Ka,01910 (508)141-IB00 Fax:(508)140-9705 APR 15 '99 12+ 12 PH SAI-Ek HEA�IH +508 J409v BS pp�A Ot I � r CITY OF SALEM BOARD OF HEALTH Salen,, MaS"chusetts 011970-3928 JOANNt. SC011,ntvrt,RS.CHH NINE NORTH 1 1 630 HF,AITH AnNT o0 jri8t 7c, ,eou Fa,�t,tifY;l 75V9 rot "!' it tl Ua (?L Application for Well Drilling antl FumP Testing A Pcrwit is rcquoL d to. 3ri11 aot LOCATION: _ i leatle_r �cr__A&0)n_ Q W'olll;oCfrui'.ul — -- J JTci dad Pump C'unn:ictor �Z� — — — _• — .. prlsiltt ppR 2 � 1998 F.AO N pEPM N 0 OL 7� IT7 T�f7�T►j'�'I�_�L� O� J� MASSACHUSETTS d N N l _ co titl5rillmo Cgrr - CDMLor � � � � :rte h x� t accurcance with Ii�c pr.:vistoras of -x' a= Mas LIchuserts General I-aw Chapter i :ectiu�, l6 ma a� off• ..+� a; ro? RC1NALD S. DYER m --. HARRIKG70N, =EN HANpSH?R& _ ro; � issuthoriredtodieordrtl] ttielts m : iu the Ccxucrwnwealth of�Iduri(tk the pc r.-)d ?o �j KI Y I , L) a4' 199; to JUNE- 30, x998 N Nf} 595 E - C .. ✓ F —o /�PESO- a No. 0 S g Q V OEF AATIAfNT OF EN4 f3ONMENTAi M"AGENET N- 7 '1 N - 0), N� xr 0. a APR 13 199 12•. 12 PH _ALEM MEALTH +SBB%d 097Vfp 41' � MAY2 7 1998 CITY OF SALEM HEALTH DEPT. CITY OF SALEM BOARD OF HEALTH Salem, Massachuseft 01970-39228 JOANNE SC011,A7Nh,P5,CHO NINE rJORTH S1 REt m..ALTH AOr.NT lel: (508)7at 1800 htx (firYS)TAZ,17UU permit d ... bate �L Applicatio l) for Well Drilling an[I Pump 'Ccsting A Permit is requcvlcd to: drill a well _!� jr„tall a pUtnn/�� ut'IrI _ _ --.- -- u>cnTloN: c Add 1 z{. V llu�li:r - Well Contt'acloij .. 45— 11id c vor y �.2✓�/� lel. . l20�G�� Pun1p C'pnir3 tot'_ cz/fJ _ Add. — _. _ — _ Tel — S—l,6—luti8 "7' 1�G(A FI:,Q' ::Udvf:E4'_I LLL 11%,G 'I Nk I1 21 12:12 !N !A.!• YlA:•• .f!!V[97sE Y' MAY 2 7'998 CITY OF SALEM i HEALTH DEPT. t � Rl ww CITY OF SALEM 9OAM OF HEALTH Salern,n+assa:n4sett:,of sr0 9D2o JOANNE%4011 MPn.PS.G'O 11IN: "VAT.f&4fr.I WON AOf N1 It (-1101?41.1 ko 1!• 04x;ldp(AM11 P5-,IA PUMI)$ Neme:tIltlrimofpunlp: j$l'I::SG�2 _ J N6' ._._ Ivl,r Suf�HRRSIBcc`._ Pipe rowans 160, '"ue1L ('fill, u<r I i S ctl.' 1 p dSrti�X) Cirl�efnre ' Wolllill r ii!leuaJA}s(dr —�� Date �'Puutp htctall:l ; :: XW, Pli^NPglbsp"clnr ... H`pnw• lu,. ;<I,f: lufarQo' KA5t11 �_ ° Department of Environmental Management/Division of Water Resources WELL COMPLETION REPORT WELL LOC TON GEOGRAPHIC DESCRIPTION Address_/ a�+.co�( �v"� �--i AIBdd .t/pd N S E (l� of City/Town Well owner 1 ( Aiw Fi /ss or r1OBd) Address /G Q , W NO E W of f Board of Health permit obtained: yes/ no El /Ole sect. w/ wd) WELL USE I WELL DATA _ Domestic.q Public❑ Industrial ❑ Total well depth S Yo ft. Monitoring❑ Other _ Depth to bedrock G h. Water bearing lock/unconsolidated material: Method drilled A/A/T . ' Description Date drilled '✓ � t-- 4 Water-hearing zones: CASING 1) From To Type 2) From 22To.-2-- 7//, Lenglh,'2_,�_ft. Dia(I.D.) e—' in. 3) From To Length into bedrock ZY ft. Gravel pack well: dia. Protective well seal:?�^f v-ar A oe - Screen: dia. Grout.[] Other Slot Plength _from_to_ STATIC WATER LEVEL(all wells) 'n Static wa tar level below land sur face ft. Date WELL"TEST(production wells) OO Drawdown_r Oft. after pumping_. a lir. .-- min. at-gpm How measured/_ CRecovery�.�ft. after' hr. "Min. 0 LOG of FORMATIONS COMMENTS $' Materiels Fre.. T. c CC G � _ 3 Driller /C a w T)u s/r� Firm Address'e2-fin, --�- Ciry/Town Supervising Driller Reg.A /�ar r�» ;rm,re rsNmd/rvel/driller Flus Fnnr lrrmly - BOARD OF HEALTH COPY COWNEAST DRILLING CO., INC 23 Rieroe Road Barrington NH 03825-615 1 8 ? P.8{��} � y" 8 p,2-38910 2 , -3 a 1 c 8 9 1 0 d;3� U N '-9 - 1 9 J '.? BARR TO $`E�� �� 77yy x.$416 .a/93�� Illnunlii,l,ii,nlil a,l,�nlil ul,l„I�',���il n� �el�ull .TUN-03-95 05 :261 AM. LOU RICCI369.63278374J464 978 -768 3650 F. A. 6_L�_lyg�} a•2�At1 FF'UM QQWpEAST,GRILLLNG 16C^36E4'2113 10 Ixpvlment el Enruone+enlnl WELL COMPUTION REPORT Mr+tq^�nentJ0l+ition of Water 9105-101 ij�d � 6EOGRAPXIC DESChIPTION 0 ; WELL Lac T N I�(pA N S F 00 b. I Add n �, ®/ 0. n,� rrrrrrrr � iia•e OitY/ruwn1 ..... l Well ewnrtr r /.L N�L W Of Address /�C o yl ,Q/�•1 n , I�tPdKrl r�t^����Ci rj1�� � ,�' /�4LC• '.6 �j1� NINrIICi, w/��� f otr�ined; .yeeN DATA(jpgrtl dlleallh pOrrNt yyELL LATA �^y� WELL USE Total wall depth-JZ'.r:-=-fl. 1998 �p1esl a�Pub110[� Indgprtel❑ ` k JUN 2 77 } � Deplh to(xdlrxl• d gtoni lrxlnp❑ Other-�, 1, 4 Walar G�arng rockluncontoedalod matn�lel: CITY OF SALEM Method dMiM �fe - Uescriptlon — HEALTH DEPT. Dale drilled— We,crbearinq xo^=e: i + CASING (1 Il rrern,�j-� .� To (�f ]-w�_ arijLaOgth�-11.Ole1•LD 1-- -•'rr' II From to } 't/ -- Lingth 1nw bedroek.- GmvePpack,welL dle. I � Proteeli�e well sed;�Y+<'A Ire Stceer. d1A. { SI c l 0, 1 Grout.❑ 001v STATIC WATER LEVEL(all walla) Ih Static water level below lend surlooe WEI I.TEbT0udurdlon Wel191 pO I�.hr. •-- ndn.eh44' p J l v 14 aIle Pumpine�.. Orewduwu � / natovory-1 ft• (111(_1,1._... Mln. How n,eawla o LOG of FORMATION$ COMMON I S a MueNls NOT Ta ('T� � � 6C Q ` Dlidar r c K ,11 n s Firm !/ i Addret? 1 �" "-- soorvicinq Draw R"A fy 1 DRILLER Copy BI0ML7RINE 19782833374 P.01 ' JUN-05-1998 11 53 4CSI 6®f'1"1ai" ine JUN S 1998 18 EAST MAIN STREET, P.O.BOX 1153. GLOUCESTER, MA 01931-1153 TELEPHONE: (978)281.11222 FAX: (978)2833374 . CITY OF SALEM H--A!-71 H DFPT. CERTIFICRTE OF RNRLYSIS Mr.George Belleau Report No.: 80,919 Town&Country Homes Inc. June 1, 1998 16 Bourbon Street Peabody, MA 01960 He: DRINKING WflTER RNRLYSIS WELL INFORMAT70PE New weft, 540 feet in depth, looated at 19 Thomas Circle, Salem, MA. SA PLltao: Sample taken by Customer on June 2, 1998. FINDINGS: flnaigsis Parameter Result Guldellne Date Total Coliform 8aclerial Count/100 mL 0 0 06wee METH=: Analysis performed in accordance with Standard Methods for the Examination of Water & Wastewater, 18th Edition (1995). REMAR The bacteriological level of this sample meets the requirements of Mass. Department of Environmental Protection's 310 CMR 22.00, 'Drinking Water Regulations' for human consumption. Johef MadetteAab Director JWds Mass Certified Laboratory OMA-026 ,L � r � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741.1800 Fax:(978)740-9705 June 16, 1998 George Belleau Town& Country Homes 16 Bourbon Street Peabody, MA. 01960 Dear Mr. Belleau Before the dwelling can be occupied at 19 Thomas Circle in Salem, Massachusetts the Biomarine Laboratory Tox and Group II portion of group I water quality test results must meet State and City Minimum Water Quality Standards. Once the water quality standards are acheived by Tox and Group 11 Standards you must have the Health Department sign the routing slip for your Occupancy Permit which you will receive from the Building Department. The dwelling may then be occupied but the domestic water from the well may not be consumed until the final portion of Group I testing has been completed. If you have any questions feel free to contact this department at 741-1800. Fo he Board of Health : Reply to: anne Scott Mark Tolman ealth Agent Sanitarian cc: Building Inspector& City Engineer Delivered in Hand by Constable Mark Tolman on Tuesday, June 16, 1998. JS/sjk iN door c-mttc 01' Ncw Eno and I \; I3o:.,rboit Strc:,.t, t cahody, I'vIA 01` GO June 18, 1993 Joanne Scott Health Agent City of Salem Board of Health 9 North Street Salem, MA 01970 Dear Joanne: In response to 1'ola lettc� .,:aed .ilale Iii. 1;.H3 1, am pfovidln you with 1111 group �i 1 Test results as rep:,rted i.r Ei. n,;;rire. a;;:o had 'hese result:; s_nt to kquaT&h Water System, Inc. and ',ave ^ro.-ided you Vith a copyoPthere response. The SystM will be 1:;Stalled -,n Wednesday, Julie 24, 1998 ',t'ot:Jd you be able to sign the routing slip before thec so i csr complete getting the Ccttil;cate of Occupancy. No one will be drinkin the 1\':iter u!1t1t the n 'stem is iustalicd. I do appreciate your attentic:n in re;-=13 to this mattcr if Lave La:e any qustions, pie-.se call me at Your earliest convvnicnco. n cerely, / V George D elleau President GDB/jhh •ret: ";s 5 - I "Z"9 Fix:" S-5" ;i79!j +W1 -ll 1JJV a/ J� Ul1.n . ..i.� 1JIlKl1JJJ1Y , Va iomarine 15 EAST MAIN STREET, P.O. SM 1183, GLOUCESTER. MA 01931-1153 TELEPHONE: (978)281-0422 FAX (978)283.3374 CERTIFICATE OF ANALYSIS Mr.George Belleau Report No.: 80919 Town&Country Homes Inc. June 17,1998 16 Bourbon Street Peabody, MA 01960 Be: DRINKING WATER ANALYSIS WELL DESCNIP4ItM: New well, 540 feet in depth, located at 19 Thomas Circle, Salem, MA. SAMPLING: Samples taken by Louis Rkxi of Downeast Drilling on June 2, 1998. FIN13INGSi !elle! Detected in Mill Analgtis Parameter MO Water. Guidelines Date Totes Condom:t3acteriai GnwnV100 mi 0 0 06/0?/98 Chloride Contend(mgA) 313 250 06103/98 Iron Comend(mgll) 0.68 0.3 06117198 Manganese Convent(m9n) 0.08 0.05 08/17!99 Nitrate Nitrogen Concord(nW) 5.55 10 06/03/98 PH Yahre 7.37(rrotly alkaline) 7.0(neutral) 06103/98 Sodium Cordent(aryl] 15e 28 06/17/98 Hardness(CaCO3.mg/I) 112(moderate) - MMM. Analyses performed in a=dartce wilh 518ndwd Methods.for the Examinatlon of Water& Wastewater, 19th Edition, 1995. 'Guldefines are based on the maximum contaminant levels recommended by the Massachusetts Department of Environmental Protection for drinking water. sr�axs: Iron and manganese are naturally-occurring metals that are primarily of esthetic concern in terms of discolored water,off-flavors in beverages: and nuisance staining of laundry, plumbing fixtures, and dinnerware. Excessive levels can also cause off-odors. These metals can be picked up from the soil or leached from the pipes from corrosive water. Elevated levels can cause decreased well efficiency due to incrustation of the well screen. Sodium and chloride are present in most natural waters varying from less than 1 mgtL to more than 500 mg1L. Intrusion of sea water and road salt runoff are common sources of contamination. High levels may be responsible for a sally flavor or accelerated corrosion in a water system. High salt concentration in agricultural waters may be unsatisfactory. (Continued) iUh!-1C'-:99R !9 `= 6.•?i::.tiR.i:'<E ♦ _^' GJJ��^ P.(J' Oki rn � 1S EAST MAIL: FTSE ET PCL [3 ix •ei"3, GL OVCr.ST.ER, .VA 0i937 1153 TFiEPK-NF.• (9?2)<S1.?222 r.;x (976)2113- 374 CriRTfFICA i EE OF ANALYSIS Mr. George Belleau Ra_part No.: 90949 Town g Country Homes !nc. ,Lane 17,1998 16 Bourbon Streot Peabody, MA 01860 Re: DRINKING WATER ANALYSIS aliP�SCRIPTION: Now wail. 540 feet in dopth, !o,;•ated at Thomas Circle, Salem, MA. SAMPLING: Samples taken by Lc:.,m Rh i c. Dew;-asst Drilling on June 2, 1958. ELNDJ SaS: Leuel: Det.rected frt �•, aEll analysis Parameter _ ,Your 11111 T fiiit�ellne" Date Total Col form Baotoriai Cotun11100 mi U 0 MU M �� Akalitidy,Contend(C40,2,rngll) Gi 100 06/03/98 Calcium Content(ino) 36.5 06103 8 Chloride content(m94) 313 250 06/03/98 Conductivity (µmhowcm) 1,190 OS/03158 Copper Content(mg)t) 4.02 1.3 06117!98 Fluoride Content(mgr!) <0.75 2.0 08103;98 Iron Content(mg/1) 0.69 0.3 06/1:1''1? Load Content(mgrl) 0.014 0.015 0611tv0s Magnesium Content(rrol) 5 06/0358 Manganese Content(m99) 0,08 0,05 D61t7198 Nitrate Nitrogen Content(mV) _ 5.55 10 06103158 Nruite Nitrogen Content(mg(i) <0.25 1.0 06 03198 pH Value 7.37(rlligntty alkalin) 7.0(neutral) 00/03198 Sodium Content(mg9) 158 28 06117188 Total Dissolved Solids(mgt) 632 500 OWM98 SuHate Content(MV) 23.2 250 06/Osw Hardness(CaCO3,m9A) 112(moderate) . FIMar Stability Index(2CC) 8.7(aiightry:onosivet 8.0(epflmum) merH=3: Analyses pst-formed in ;accordance twth Standard Methods for the Exam;nailon of Vlater a Wastewater, 19th Efton, 1995. 'Guidelines aro based on the max'Mum Contaminant levels recommended by the Mnssaftone-tts Department of Environmental Protecticn fot drinking water. (ccntirued) �1�iT9118r 9fi969 Aim Report No.: 809 i 9 June 171TA REMA=: Conduct'Ji1j !s a gitast�r,+ Cl ihC' '.T..UU^.:Uf O155'C!'':Sd ltiihL'r;! G.2•::5 .R avater. An {r1GrcSGC in conductivity promotes inctma� ;nrros c 5n, The higr:conductivity and totai&.Eblved solids tou!d rause water spotting in domestic sr uommefriaf usage and could hara an adversa effKt on certain sensitive plants. Iron and manganese a.ra nate ally-lxcumrg metais ;hal are primarily of esthay!c concern in terms of discolored water, off-flavors n beverages;and nuisa=e staining of Laundry, plumbing 'r,tures, and dinnerware, Excossive fevels can also cause off-odors. These metals can be picked up frdm rte leached from the pipes from arra<irz water. Mevated levels can cause decreased well efficiency due to incrustation of the well screen. Nitrate/Nitrite may entor watoi systems via runoff from hnaviiy fertilized areas, septic contamination, or from degraded vegetahre material. Eeasslve ievels of nitrate in drinking vrater have mused serious illness and sometimes death in infants under$ months of age. Nitrate is ccnvertad to nitrite in the bury which interferes with the s;yg-n carrying capacity of a child's blood. Nitrite, of itself, can react with organic material in water to prviuce ozicer•causing compounds. Although 4-he Nitrate Nitrogen level detected does not exceed tho EPA r=ccrnmerdod maximum, it.is alevated in comparison to most area wells tested. Care show d he t-aVen tc avoid iho use of lartilizer compounds in the runoff arr,,a of the weii. Sodium and chloride ata present in mrn natur i wafero varying from less titan 1 mVI to more than,, 500 my'L. Intrusion of sea water and road salt runoff are.••ommon sources of contamination. High !evels may be responsible for a sstfy Ivor or accel_rated corrosion in a water system. High salt concentrator, in agr'culturzf waters may be unsatisfactory. Total dissolJad solids refers lie ai! tic disscived mate ia!s present in a water from natural sources or otherwise. A high level may Nz caused by hard or saity water or vtasiswatar contaminstion. Mren in excess (500-1000 mglL), flavor is affected, undesirabta physiological ructions in transient c071surrars may occur, and unsightly water sporting or corrosive/scaling problems may develop. 7hess levels may abate so-errhal with continued usage and flushing of the well; however, filtration such as reverse osmosis shou;d be c nsidered. Approved 9y: dms John Marl allab Director Mass.Certlf•F d Labs MA026&MA123 GEORGE D.BELLEAU F -00 liilww.n & Country Homes, Inc. Of New England Land -Financing- Construction Bus. 978.535.1724 16 Bourbon Si. Pager 978-545.2112 Peabody,MA 01960 Fax 978.535.3099 `� ' --- - Uro /*70f- , �N� �. ° / - (Ja-e4O CUS OMER INFOR ATION Report It: O NEL ID LEAD & COPPER ($30): Corrosive water Name: —I— ;8 fS Tests Requested: �- �. Q,L_— can leach undesirable levels of lead and copper Cost: Paid: from your plumbing and/or well pump. Sample A/ddre (32 oz)should be taken from the kitchen faucet L 1 Bottle ID: Coliform Result: after non-use of at least six—collect before r/}xxkkJ� 5= < of G d flushing. This will give the highest reading. PLEASE MAKE CHECK PAYABLE TO RADON 5301: A natural) occurring Phone: 9 7fJ 1 y�� 2//� BIOMARINE INC. TESTS WILL NOT BE ( y STARTED UNTIL PAYMENT IS MADE.. radioactive gas that is produced in the ground. Fax: It can dissolve in well water and contribute to radon in homes when released through running Address f NI (if different : _ Please read the following instructions carefully since water. Run the water for 5-15 minutes. Fill a / R S failure to do so can very likely result in a contaminated bowl with the faucet under water. Submerge _6- sample. Whenever possible,collect the sample from a the vial until it fills. Lift out, cap, and turn over. kitchen faucet. KEEP SAMPLES COOL AND WE MUST If any air bubbles appear, repeat the process.. Date Sample Taken: 2. RECEIVE THE SAMPLES WITHIN 24 HOURS. TURNAROUND TIME: BACTERIA: 1-2 days;REMAINING TOX ($90): Total Organic Halides Sample Taken By: screening ( g TESTS: 2-3 weeks THM's, Organic Solvents, Chlorinated COLIFORM BACTERIA ($22): Indicator of the & Brominated Pesticides & Herbicides, PCB's, cc: bacterial safety of your water. Remove the and Aromatics. Fill the brown bottle or two screen/aerator from the faucet before collecting the vials the top. Keep out of sunlight. IF SAMPLE!NFORMATION sample. Dry the mouth of the faucet and wipe with Available: 24-48 HOUR TURNAROUND = $150. alcohol. (If sample must be collected from an outside _ Cistern _Public Water ell Swimming VOC ($150): Volatile Organic Compounds: _ faucet, first clean with bleach). Quickly flame the Detects compounds originating from such Well Information: Agee Depth � �(� residual alcohol. Run the cold water for at least two SCJ minutes. Collect a sample in a sterile 8 oz container, sources gr septic systems, gasoline, starting leaving some airspace in the container. fluids, degreasers, pain( removers, solvents, Water Treatment Device? p cleaning fluids, and plastics. Fill each of the two FECAL CONFIRMATION ($15): Additional test vials with a slow stream of water to just Purpose: when a coliform count is found, to determine if the overflowing. Make sure no air bubbles are left in Is This Sample Treated? contamination is the result of human or animal waste. vial before capping. COLIFORM RETEST ($15): TITLE V ($200): Coliform, Ammonia, Nitrate, Curre I nown Water Problems: VOC. Follow the instructions for(1) VOC,(2) /// GROUP II ($75): coliform bacteria, pH, coliform, and then fill the remaining container. hardness, specific conductance, nitrate nitrogen, iron, TAKE BEFORE ANY TYPE OF WATER manganese,chloride,sodium. OR TREATMENT. Well Location: Is the well located in close N GROUP 1 ($125): coliform bacteria, pH, INDIVIDUAL TESTS AND OTHER TESTS NOT proximity to the septic system, road, landfill, hardness, specific conductance, nitrate nitrogen, LISTED ARE AVAILABLE UPON REQUEST. heavily fertilized area,ocean,swampland,or nitrite nitrogen, iron, manganese,copper, lead,fluoride, PLEASE CALL(978)281.0222 WITH ANY other area which could possibly influence your chloride,sodium, calcium,magnesium,alkalinity,sulfate, QUESTIONS. water quality? total dissolved solids, and Ryznar Stability Index (corrosivity). Follow the instructions for Coliform and then fill the remaining container(s)[at least 32 oz]. _�� v CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 June 16, 1998 George Belleau Town &Country Homes 16 Bourbon Street Peabody, MA. 01960 Dear Mr. Belleau Before the dwelling can be occupied at 19 Thomas Circle in Salem, Massachusetts the Biomarine Laboratory Tox and Group II portion of group I water quality test results must meet State and City Minimum Water Quality Standards. Once the water quality standards are acheived by Tox and Group II Standards you must have the Health Department sign the routing slip for your Occupancy Permit which you will receive from the Building Department. The dwelling may then be occupied but the domestic water from the well may not be consumed until the final portion of Group I testing has been completed. If you have any questions feel free to contact this department at 741-1800. Fo he Board of Health : Reply to: anne Scott Mark Tolman ealth Agent Sanitarian cc: Building Inspector& City Engineer Delivered in Hand by Constable Mark Tol n on Tuesday, June 16, 1998. JS/sjk Le,--k iN doom c-mttc Jun 05 98 11 : 57a George D. Belleau 1 (9781 535-3358 P. 1 JUN-05-1998 ]]�53 BiOMRRINE 19782833374 P.01 B101'1'1c'i. P ine JUN 5 1998 18 EAST MAIN STREET, P.O.BOX 1153. GLOUCESTER, MA 01931-1153 TELEPHONE: (078)281.OM FAX: (ale)2a3.3374 . CITY OF SALEM 40 HEALTH DEPT. CERTIFICRTE OF RNRLYSIS Mr,George BeDeau Report No.: 80919 Town&Country Homes Inc. June 1, 1998 16 Bourbon Street Peabody, MA 01960 ite: DRINKING WRTER RNRLYSIS WELL INFORMATION: New well, 540 feet in depth, (Coated at 19 Thomas Circle, Salem, MA. 5ANZLtp_G: Sample taken by customer an June 2, 1998. FINDINGS: Rnalysis Parameter Result Guldellne D to Total Coliform Bacterial COW11100 mL 0 0 06/02!98 METHOOB: Analysis performed in accordance with Standard Methods for the Examination of Water & Wastewater, 19th Edition (1995). REMARIS$ The bacteriological level of this sample meets the requirements of Mass. Department of Environmental Protection's 310 CMR 22.00, "Drinking Water Regulations' for human consumption. Jobd Merletta/Lab Director JM/ds Mass CoMed Laboratory kMA-02e TOTAL P.01 Jur? 18 98 04: 11p George D. Be11.ZaU 1 ( 9781 535-3358 P. 5 From HDVANCEDb)RTER 5eP-922-8:29 lure. 18. 1995 02:E1 Pm P01 ATItia Water %Ystenls, Inc. t)CPT�C PSCIICRU Town "'cotli'y Hsw. nee , Inc 16 RouftHln St Peabody,M A 0060 060 ��1d, fcllo'k'!<74 fir.}"5': 2'. K I %r.tt�r9t Is(C<.;i:+'.trt�idc':7t1 fGf tl1C s:}.CUCF1}' ii?(:11tQi1 al 19 Thor i(55 . Oicie, Saiern, rNi A' lid ty C(ht�CS fii;:r..' gprY $1$S%Sj- l for drinki(t;; wut'J. :7C(C,(;C+Y.1?iri.Li.tt C-gtl;)-Y s w %:;i l t6juxd &; Pl kzged rr'm C piv`t§+` tnc' §w.; fullowg- i�etl7i"6de..' Bt:lttx ��P Sta((dar?> `'�-- !ton Wow VET :Sty-girds Sodium $ TUS 33 'Wiv, h'kWIvCJ SDI- 1h{KMG talc Plila7l-d ng W,WteT Har&eS`., Rcl. -rvr DSA f4> ndaTdt AquaToch }N:t; pwi <ejt :i wA trui r iRsisiv&I whi iik; It slice; t1wge chl.`go This is ript a tkr,'sf ea# twss`. pleasreel free I1 ('": 17,ti' r 7C 2ft a SY{1.?7w Ny-if4 4!1v ('Itikt-J:,7f;S Vile' Im have, /f Sin�er>;fy, �r j Tick Theisen Sales Manager i�;:fty "dtr•,t,u,<vti ,art(l "'t,r,tr;'altr=�; St'�t(•,71s f8t}k S"10,Ma1n,+e1 ,' , A^.;drf' Inn ...•* 1444 . Pt. :468, x7 ',rri(r • N160 :T+-t7OV S"oo � i 7Sr mti��i�-f U�c� IMPORTANT MESSAGE FOR p DATE ? TIME q•�c5 A.M. M OF ,S G03-- C- -Z(l\ PHONE ¢"(Ax 4 � AREA CO E NUMBER EXTENSION ?P,-7G -36So ❑ MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED'. PLEASE ALL, CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE -Aw ClE� �e it_ zz SIGNED �IFORMU.S. Yr�7 MAGE w u.s.A. NOTES (-IMPORTANT MESSAGE FOR /' C DATE y"2/-9p (///✓���� � aTIME 70 2,�) M PHONE AREA CODE NUMBER EMENSION U FAX O MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE O-C.0 td v SIGNED �( FORM 4009 MACE IN U.S.A. NOTES