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16 WYMAN DRIVE (2) �//// SJ�aEcvneo�o iatettlQ, , UPC 10333 N0, 1531-3 �gPosr.coms°� HASTINGS, MN ,�--- 1 � v --.-�! 4 1 /�� .�{ � � ` f-+-� ' 1 � 1 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection f` RFc�►p� � WELL DRILLER c _ Please specify work performed: Address at well location: BOiNiiU OF H New Well Street Number: Street Name: 16 JWYMANST Please specify well type: Building Lot#: Asse�ssor's Map#:: Domestic � 0 lI u Assessor's Lot#: ZIP Code: Number Of Wells: 01970 Cdy/rown: Well Location SALEM In public right-of-way: GPS C'Yes f No - -4-+ North: - West: 42.49196 70.93340 Subdivision/Property/Description: 0 Mailing Address: FFI-,Iiok here if same as well location addres Property Owner. Street Number: Street Name: BILLELLIOT i6 WYMANST City/town: State: Engineering Firm: ® MASSACHUSETTS 0 - ZIP Code: 01970 Board of health permit obtained: F Yes C Not Required Permit Number: Dale Issued: 00 6/27/2013 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection–Well Driller Program l Well Completion Reports(General) I, Well Driller - General Well Form DRILLING METHOD Overburden Bedrock Air Hammer Air Hammer WELL LOG OVERBURDEN LRHOLOGY From To(ft) Code Color Comment Drop in Extra fast or slow Loss or addition of (ft) drill stem drill rate fluid '. 0� � Organics Brown � r Ye f Fast C; Slow r Loss r,Addition WELL LOG BEDROCK L ITHOLOGY From Drop in Extra fast or slow Loss or addition of Visible Extra To(ft) Code Comment Rust Large (ft) drill stem drill rate fluid Staining Chips 103 Granite r.Ye C;Fast G Slow r Loss C:Addition r:Ye r Ye 103 F20-3-1 Granite r Ye f;Fasl �' Slow F Loss �.Addition E9 E9 203 303 Granite r Ye r Fast G Slow r Loss C; Addition Fr--y e r-y e 303 345 Grani[e -Y e (;Fast I''Slow r• Loss r Addition r Ye Fr–.-ye ADDITIONAL WELL INFORMATION Developed t' Yes �' No Disinfected Total Well Depth 345 Depth to Bedrock Fracture Surface Seat Type lNone Enhancement CASING r Is Casing above ground. From To Type Thickness Diameter Driveshoe 20 Steel – 7 17# r Ye SCREEN r No Scree From To Type Slot Size Diameter ---Choose Screen Type-_ WATER-BEARING ZONES rDRY VvEI From To Yield(gpm) 340 341 30 PERMANENT PUMP OF AVAILABLE) ---Choose Pump ---Choose Horsepower-- Pump Description Horsepower Description--- / Massachusetts Department of Environmental Protection * Bureau of Resource Protection—Well Driller Program t % Well Completion Reports(General) Pump Intake Depth(ft) j Nominal Pump Capacity(gpm) ANNULAR SEAL I FILTER PACK From To Material 1 Weight Material 2 Weight WaterBatches Method Of Placement (gal) OChoose Material Choose Material Choose One WELL TEST DATA Time Pumping Time To Data Method Yield (gpm) Pumped Level (ft Recover Recovery(ft (HH:MM) BGS) (HH:MM) BGS) _ 7/412013 Air Blow With Drill Stem 30 04:00 345 0005 295 WATER LEVEL Date Measured Static Depth BGS(ft) Flowing Rate(gpm) 7/4/2013 50 30 COMMENTS WELL DRILLERS STATEMENT This well was drilled or altered under my direct supervision,according to the applicable rules and regulations,and this report iscomplete a knowledge. /-I , 1 /liLo-j Driller JAMES BRAZEAU Registration# 1173 Monitoring[M Supervising Drill Firm [MIESULLIVANDRILI-11 Rig Permit# 10016 Date Job Compl 7 `f-)3 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. r Footprint Power° k f ' 24 Fort Avenue, Salem, MA 01970 Public Repository Salem Public Library 370 Essex Street �q®�® Salem, MA 01970 ,�E ®I Re: Salem Harbor Station AUG 2 6 2013 Monthly Dust Complaint Log '� ) O.r gip; EM ,;OANu OF HEALTH To Whom It May Concern: There were no coal dust complaints in July 2013. If you have any questions please feel free to call Robert DeRosier, Station EHS Manager, at 978- 740-8402. Sincerely, ,),I Peer Pumiss �[ CEO Date Footprint Power Salem Harbor Operations LLC cc: R. DeRosier N. Malia Griffin City of Salem BOH lag w CITY OF SALEM, MASSACHUSETTS e ? BOARD OF HEALTH b 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR LRAA1DIN@SALEM.00M LARRY RAMDIN,RS/REHS,CHO,CP-FS HEALTH AGENT APPLICATION TO SCHEDULE DEEP HOLE OBSERVATION & PERCOLATION TEST Application to be completed by Soil Evaluator,Registered Sanitarian or Engineer Address of property to be tested: 16MMan-Strewt Map#: 2 Lot#: 26 Upgrade New Construction X Upgrade with increase in flaw N/A Property Owner Riverside Realty Trust Applicant (if different) Owner Address 208 Derby St., Salem, MA Phone # 978-375-6150 Applicant Address (if different) Phone # Soil Evaluator Name Michael Paige Phone# 978-927-5111 Is the Soil Evaluator a current licensed Massachusetts State Soil Evaluatorj�YT� 'N If yes, list license # 13167 (If no, individual cannot perform soi evaluations) Company Name Griffin Engineering Group, LLC Distance to nearest wetland resource area 160-ft Was a Notice of Intent Filed with Conservation? Yes No X Has the parcel been tested before? X If yes, date(s) of testing Q51 1.610 Will the property be DIG SAFE certified jefore soil testing is performed? /N Has a trench permit been filed with the ijy of Salem for the soil testing? Y Q Pik Exc,avju, Signature of owner or owner's agent Print name Signature of applicant (if different) Print name - ************************************************************************ Fee: $180 per lot for upgrade or repair, $225 per lot for new construction (Please make checks payable to the City of Salem) Plot plan of property required with return application that shows presumed location(s) for testing. INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED ************************************************************************ SOIL EVALUATOR MUST CALL FOR A TESTING DATE AFTER THE COMPLETED APPLICATION AND FEE HAVE BEEN RECEIVED IN THE BOARD OF HEALTH OFFICE ................................................................................................ FOR OFFICIAL USE ONLY Date Received: Fee: ID RECEIVED BY: ar? $,�aar y "t �, '„+��+" CITY;OF SALEM, MASSACEiUSETiS� µ ' .4e x OF HEALTH '�"�' F` y 'a +S``wx 'ez,ems 3 .'t • .120 WASHINGTON STREET 4TH'6FLOOR ( +SALEM SMA 01970 ,a. � TE 978-741 I BOO i.u..'13 FAx 978,745-0343 STANLEY USOVICZ, JR. x JOANNE SCOTT; MPH, RS, CHO + , MAYOR d f HEALTH AGEN,gTy yy M• ,' t s"*�r'�^ & 55.syy *ar Y. ti 'h tf3 b$ ^k " �}C r .a +Y ,b¢ ii .�tr OLLLf GONSTRUC.TION P,ERMIT<' . Location 16 Wyman'Drive ....§n ..&0 :.. Owner;,, . t �•iPaul Lewandowski 3 +- $:$4T.404- ,.3 w.s.�-4vti` eW = j Addresst AZt i16§.5Wyman Dnvee-Salem ' P ,'c fr � - 0 ,f K,s,Q'�a ..0'` �"'.�✓ �i`��"n ,�yy.�(( �.'*,a��,'fxr�4�'�i'k l"k � �YM' a�y.�' JK� n„� 1, x: This permit'is.granted inconformity with the statutas and ordinances relating to, Well permits. Well construction permits are non transferable h A This permit shall be onsite at all times that work is,taking place•jPerrmiit shall expire one (1)year;from'.the date of issuance unles91revoked from causes 41,': This permit does not constitute a Water SupplyCeyrtifivcgate. �a tI.9'T u3 g F tr j•BAd.N*, -1 R"_, r, N Y,b,rp s }+3w�s +rorF +! „- 'i'• Permit # 3-02 A ,,•ss.. '6/63/02- : y, '� -. res ' iitla” 41 '*5` zs. .t Date aued = 6/03/02 , ? Ha (domestic well) (Viera Artesian:Well Co=Reg-#6) '.i,-,;-40 i 6 , 's e t ttl4 I'V4 A £ k'r� X 45, r} $ ealth.A' t . `Yf� raS' C� xa �,R t+'§• `a-.� � .nif;);�g]y�„6s j s r s.�t¢. '1'�F� i +p� t x ^ u+�" �� '�z �Y^ i � : ��r y a XY ut�eR.�;,1,�" yn,"1'0,✓ ,/,, 44 d ' E ¢ , € 9 3 } �� . f�t 1 ra �•f z t k' P ' t t S, ; d � 1{ t �. 0 ' Jk'1 t4R '`:. 3# 3' jfi-g "l '`9 `i�"v' .1'�3. ;'i# �`:' s # tYS$ f10V # ,. ,. ° Y .x CITY ORSALEWMASSACHUSET]"S WitB, 4;H R. f1i .I it m SALEM,' M A U I /U 0 TEL. 978-741-1 86b�Ai�i�hf 04 1 ft 14 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO _MAYOR HEALTH AGENT 'lit N _41K� WELL CONSTRUCTION,PERMIT Location 1 6 Wimia'ribriv I e -.Paul.Lewandowski,-,,A 2, Address.�-,i .-�o,�16 Wyman,Drive,:Salem.,,� - 4 3-OU004 "'t T 4 Thi§.�Oermit is granted in cq'nfo mg and �rdinan6es relatinVib. rmity .wif.h the .statute we permits. 4�W611�bo,ntt�r(j-cti-on-petmits are nbhAransferable� place!�-Permit shall ,- �-i s_,��j kbdf6m`�ause.: 47, ............ %PermiV4,t%k Daite-issu6V,- �03/02v-'�' 6) (domestic well) (Viera Artesian Well Co.— Reg.4 ent IOAgi�' �4' ,W- �ij ra"40464 74fil.f.,�� '� 4 .1P 4 r --'Tzt�!W UttV'w �4 A� May 31 02 08: 24a Joanne Scott Salem BOH 978 745 0343 p. 2 i i otvoli�� 0 CITY OF SALEM BOARD OF HEALTH Salcm, Massachusetts 01970 JUANNC SC01 1. MPH, R",. OH[_) 120 Washington Streel 4"flop,' HLALTH AG; ,Ni rd:(9)8)Y41-1800 Fax: (978)745 0343 Well Construction Permit Application Date: S/3t/da2 Fee: $40- Check payable to the City of Salem (no cash) Location: OYPTI✓Inl 16r-I've Salem, MA. 01970 Owner: fqut fG✓.1/tx! 13ij.51W Address /G "iv; r Tel.-7-Y6-7 54. Type of well: f ir-'a"d Well use: &j 41u, Well Contractor: VierA (.Ue!/Ca. Pump Contractor: /P,/,,cYAje</ -tiiav yCa Address: o,753&lade P. Geafyeyam,v/!fid!- Address: Po Ayr Rv Phone. 9v 3Sa - ran Phone:�03 �8-yan3.2 Reg. #: b Have abutters been notified? (y) /J How? --------------------------------------------------- -------------------------------- In the space provided below(or on back)show the location of the proposed we//in relation to existing or proposed above or below ground structures. A description of visible prior and current land use within(200)feet of the proposed well location, which represent a potential source of contamination. pp n�,ec�yCfe{� V i L0 A �t Ion It 1 tU - ----- ---- -------` o---- ------------------------- ---- ------------------------------------ - B.O H. use only. Check# ly -),0( Chockdate. Permit#: 3 d a �caxwr CITY OF SALEM, MASSACHUSETTS 3yQ' '� BOARD OF HEALTH '� .' 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 syr, TEL. 978-741-1800 Gmne FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT Commonwealth of Massachusetts City of Salem WELL WATER SUPPLY CERTIFICATE Location 16 Wyman Drive Owner Paul Lewandowski Address 16 Wyman Drive This certificate is granted in conformity with the statutes and ordinances relating to water use certificates. Certificate # : 03-02 Date issued : 08 / 12 / 02 Salem Board of Health recommendsearl water testing Y Y For coliform bacteria, nitrate and nitrite. ' V Health Agent Massachusetts Department of Environmental Management q o y Office of Water Resources 1 .J TYPE OR PRINT ONLY Well Completion Report 1.WELL'IOCATION "v GPS (OPTIONAL)r LATITUDE !" sd r " LONGITUDE's2x&Vrtt Address at Well Location: �G LtJ�1/Yj�N Property Owner: QJ N O(A) i Sly/ Subdivision Name: Mailing Address: /6 ��Ati e. City/Town: S iiC ENl �noA. City/Town: SAeC46, M,4 Assessors Map Assessors Loot #/: NOTE: Assessors Map and Lot If mandatory if no street address available Board of Health permit obtained: : .Yes LTJ Not Required ❑ Permit Number Date Issued 21 WORK PERFORMED " ( 3 PROPOSED USES 400AMI 4°DRILLING METHOD „ � New Well El Abandon En Domestic ❑ Irrigation Cable , =❑"Auger El Deepen ❑ Recondition ❑ Monitoring ❑ Municipal Air Homme q❑ Direct Push [IReplace ❑ Other El Industrial EJOther E:1Mud(Rota _ ❑ Other 5,WELL LOG = Unconsolidated Consolidated 6;$ITt _SKETCH (Uae p rmenen[landmarks wuh disisnces).. Permeabillly T m n • �� 1�e. e C > A a From (it) To (ft) Hign row a v other Rock Type " 60 7:-WELL CONSTRUCTION ' JS,;CASiNG "a { 41••= C From (ft) ,;" To,(8) , .`, Casing Type;and'Mate ial.,' Size 0;D (in) WelhSea(Type Total Depth,"Drilled"' " !Z6'' C :D'ate.DnllingComplete - Z•- STS S Or � - 3 - -oZ � 9.-SCREEN77 . ., , From (it) To (ft) Slot Size Screen.Type and Material Screen Diameter 10. FILTER PACK i.GROUT)ABANDONMENT;MATERIAL" ' '* s ,14 ADDITIONALVELL`INFORMATION r Developed? ❑ Yes No From (ft) To (ft) Material Description'- Purpose Fracture Enhancement? ❑ Yes No ; aq Method �[ Disinfected? © Yes ❑ No 12: WELL-TEST,DATA`(PRODUCTION,WELLS) 13:STATIC WATEFfLEVEL'(ALL:WELLS) Yield Time Pumped Drawdown to Time Recovery,to Depth Below -Date Method (GPM) ' _(hrs& min) (Ft. BGS) (hrs & min) (Ft. BGS) Date Measured Ground Surface (FT) 14 PERMANENT:, _(IF AVAILABLE)w ,"; ,.a s? ° ' A&INAMEIAOD_HESS OF PUMP INSTALLATION COMPANY,;' , - _ ^'i PumpDtion k �r _ esc'npHorsepower, PGmp Intake-Depth ° E"�Y (ft), - Nominal Pump Capacity (gPm) ' I i6 COMMENTS '' _ •^ _ _ , 17 WELUDRILLER S $TATEMENT4 V. This well was drilled anpr r abandoned un my upervision, according to applicable rules and regulation's; and thi$ r port is comple nd o e best of my knowledge. Driller:\ �U�7� f ^ �' ' / Supervising Driller Signature: p Registration #:I / i Firm: �r l�f n ( "- ( n ,Date: - �n''®� Rig Permit#: NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion. •BOARI).OF HEALTH.COPV • --f-AUG-2,11002-- CITY U- AUG-212002- -GlTY.O.- SALEM BOARD OF HEALTH CIA la,�l N P L I r Massachusetts Department of Environmental Management 114015 Office of Water Resources TYPE OR PRINT ONLY Well Completion Report 1. WELL LOCATION GPS (OPTIONAL) LATITUDE E W A' "" tLONGITUDE - m. Address at Well Location: /MAN Property Owner. A01 LF&,;A1Vi')0C0 SK/ Subdivision Name: Mailing Address: /6 " 6J MAN /,.e. , City/Town: S AL e C/Vt MA. City/Town: SA4C �L� ' Assessors Map Assessors Lot#: NOTE: Assessors Map and Lot # mandatory if no street,address.available Board of Health permit obtained: },Yes Not Required ❑ Permit Number 3-Oa Date Issued u q 2.WORK PERFORMED}-__w %13.PROPOSED USE d s ,j ;d 41 13RILLING METHODa�. « New Well ❑abandon Domestic ❑ Irrigation12-Cable ,aj ❑ Auger ❑ Deepen El El Monitoring El Municipal Air Hammer-N� LJ Direct Push ❑ Replace ❑ Other ❑ Industrial ❑ Other ❑ Mud Rota 'a ❑ Other. S. WELL LOG- 5` Cr Unconsolidated Consolidated 6;SITESKETCH (Use yermsnent lardm rks with distances)= H Permeability a — a m ro From (ft) To e. (ft) High Low n n c� g m Other Rock Type 4OF O Ca �oU .� `Z I 7. WELL CONSTRUCTION%' 8'CASING PN*A qtr° ' ' A Total Depth Drilled ��Z�' From (ft) To (ft) Casing Type' nd Material Size O.D. (in) 4 Well Seal Type - Date Drilling Complete C ZZ. 5TH Z /7 0e - 3 — 0 2 . . 1, %9. SCREEN .�. ,�, .. _. �r-�..:. »..cza ,m- sc49 A From (ft) To (ft) Slot Size Screen-Type and Material Screen Diameter 10. FILTER PACK/GROUT/ABANDONMENT,MATERIAL , r 11 ADDITIONAL WELL INFORMATION ; From (ft) To (ft) Material Descriptions Purpose Developed? E] Yes No Fracture �/ t Enhancement? EJ Yes L^I No } Method ��(( Disinfected? © Yes ❑ No 12t WELL TESTI DATA (PRODUCTION WELLS) " Y t s 13.STATIC WATER LEVEL(ALLi WELLS)T- Yield.."Mree Pumped Drawdown to Time Recovery,to Depth Below Date Method (GPM) ,j(hrs&min) (Ft. BGS) (hrs & min) (Ft. BGS)' Date Measured Ground Surface (FT) 4/7o yS,^^,� yo 6- 3 -OZ �o ,gym 14: PERMANENT PUMP(IF AVAILABLE) VW-V _ _- . 15NANEIAODBESS OF,PUMP INSTALLATION COiNPANY ,24 Pump Description Horsepower Pump Intake Depth (ft) Nominal Pump Capacity (gpm) 16. COMMENTS.. 17:WELL'bRILLER'S STATEMENT* This well was drilled an r abandoned un my upervision, according to applicable rules �r� �� and regulations, and thi r port is comple nd erreCo fife best of my knowledge. Driller: ,W.v.L}S Supervising Driller Signature: Registration #:I I 16I P- Firm: / ECC r, JRig Permit#: IZIr�I �I NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion. . . - . . r.oF. ire , ., '"`EIOARD:OFHEALTH..COPYr ;fit, <, :r i.� • �_. .. " `F ".",'., - - . . . r .. . rr ♦ lo. • f. f�± e. . ... .. . • sler. ..x. xr, :.1- S irse • .,nci , e. s. I f r r I t auo �oo� CITY OF SALEM BOARD OF HEALTH : �s s Salem Board of Health 120 Washington Street 4'Floor Salem,MA.01970-3523 • 978-741-1800 fax 978-745-0343 To: Policy Well&Pump Fax: (603)898-9581 From: Jeff Vaughan, Sr. Sanitarian Date: 8/6/02 Re: Well info Pages: (including cover) CC: 0 Urgent 0 For Review 0 Please Comment 0 Please Reply 0 Please Recycl a ir MI Notes. Ze J-e 4,-�1.7,le 73,�' . . . . . . . . . . . . . . . . . . . . . . . MaM 31 02 08: 25a Joanne Scott Salem BOH 978 745. 0343 p. 5 JUL 312002 CITY OF SALEM BOARD OF HEALTH CITY OF SALEM BOARD OF HEALTH Salon, Massachusetts 01970 Ju/\NNr. i(;O I I MPH.Nl.i:1 j) - 120 WashliFlon SING 4i1, Iloor H L AL I I AGF NI 1.1:(978)741.1800 Fax:(978)745 0343 Well Water Supply Certificate Application The issuance of a Water Supply pp y Ce ifi rt cote by the Board of Health shall certify that the private well may be used as a drinking water supply. A Water Supply Certificate must be issued for the use of a private well prior to the issuance of an occupancy permit for an existing structure or prior to the issuanr(; of a building permit for new construction which is to be served by the well. The following must be submitted to the Board of Health to obtain a Water Supply Certificate : .copy of the Well Construction Permit *ropy of the Water Well Completion Report as required by the DEM Office of Water Resources (313 CMR 3.00) 'copy of the Pumping Test Report 'copy of the Water Quality Report —------------------------------------------ ------------------------------------------------------------- Location of well. 16 �4111 M,nnq„0 h(-, Salem, MA. Owner of property: LetyjNiLay& Tel p p IV-9951' 7004 Owner's address:110/,,/T AA1 & Date --------------------- --- -- ------------------- B.O.H. use only Permit # 61 - 0a May 31 02 08: 25a Joanne Scott Salem BOH 978 745 0343 P. 4 rpmp, CITY OF SALEM, MASSACHUSETTS BOARD 01- HEALTH n " 120 WAgHINGI'ON STREET. 4tH FLoon OFLENI. MA 019:0 TEL 978-7a 1-I BOO FAX 5378-745-0343 STANI_w V3ovn:v, JH. .JOANNE SCOTT. MPH. ISS. CHO MAYOR HCALTII A,-.N I Salem Board of Health Pumping Test Report Name of well owner:%jill I,.EIAtgj0UJ 51 t Address ,�r¢ t/t/✓/ i� N/ Well location (referenced to atleaet two permanent structures or landmarks): Date pumping test was performed i Depth at which pump was set for the test: o?06 Location of the discharge line. Aft' n /ngn r" Static wa(e) level immediately before pumping commenced', Discharge rate:_ /D _C_VM (if applicable, time the discharge rate changed) Pumping water levels and respective—times after pumping commenced Maximum drawdown during the test Duration of test: a)pumping time: b) recovery time during which measurements were taken: Recovery water levels and respective times after cessation of pumping: /lli.VyyGS Reference point used for all measurements &dh Please fill out form completely and return to the Salem Board of Health along with the Water Well Completion Report. Pump test report is a requirement prior to issuing a Water Well Supply Certificate. manganese— 0, 133 .4, of' IwaPr+ V, )76�-455lum 7DS ygo /o M9�� YT.R^4'Ti�23�R'�'Y..'P.'lYi'Y4'v""".w.�v_ _m_RRSYZES@iA.ffi'.&"44i'Yi'3S'�yY.v.,m.um-,am�a^u'+m-m.e.m,..w'moi.FS.Y:Fl2R:Yla'Ya'S:RSR'.R.Y.F3.Y.T:.R.`4:'Z'A�'$'Ri'Y\RY'"m•^•vao..g'.3.`A5:F 44 S'£'£.`4'.'� d M k frac ite 6tate ana truca t, 31nc. Main Office/Laboratory At: Tramway Marketplace 22 Manchester Rd./Rt. 28 Route 16 & 25 Derry, NH 03038 West Ossipee, NH 03890 (603) 432-3044 1-800-699-9920 (�ertifirate of Anazlpis for Prinking Water SENT TO : POLICY WELL & PUMP TEST NO. : 0206-00464-001 PO BOX 900 WINDHAM, NH 03087 SAMPLE SALEM MA LOCATION: DATE & TIME SAMPLED: 6/18/2002 9 : 00 �1 EPA PARAMETER RESULT RECOMMENDED (mg/1) MAX. LEVEL - -- - - ---- --- --- --- - ----- VOCs SEP REPORT Antimony <0 . 002 0 . 006 mg/l Arsenic <0 . 003 0 . 050 mg/l Barium 0 . 014 2 . 0 mg/l Beryllium <0 . 002 0 . 004 mg/l Cadmium <0 . 002 0 . 005 mg/l Chromium <0 . 01 0 . 10 mg/l Fluoride 0 . 52 4 . 0 mg/l Lead <0 . 005 0 . 015 mg/l III Copper <0 . 1 1 . 30 mg/l Mercury SEP REPORT 0 . 002 mg/l Nitrate <0 . 20 10 . 0 mg/l Nitrite <0 . 050 1 . 0 mg/l Nitrate/Nitrite (Total) <0 . 50 10 . 0 mg/l Selenium <0 . 005 0 . 05 mg/l Thallium <0 . 001 0 . 002 mg/1 Alkalinity 57 . 4 C3a,�o��None Set Chloride 171 250 mg/l Color 5 15 CPU Calcium 83 . 6C�7 /.`* Magnesium. 17 9 None Set Hardness 28q mdra,)None Set Iron 86 0 . 30 mg/l ese 0 . 133 0 . 05 mg/l f-- Odor ND 3 TON pH 7 . 87 6 . 5 - 8 . 5 Units Potassium 1 . 4 d Lar,v� sci�le Sediment ABSENT Sulfate 32 . 5 250 mg/l Cyanide, Total SEP REPORT 0 . 200 mg/l Coliform Bacteria ABSENT ABSENT /100 ml E. Coli Bacteria ABSENT ABSENT /100 ml -- -------- ---- ------------------------- ------------------ ---- --- - --- - < LESS THAN OUR LOWEST CALIBRATION POINT > GREATER THAN OUR HIGHEST CALIBRATION POINT 1 FLAGS PARAMETERS THAT EXCEED PRIMARY SIDS : CAUSES TEST FAILURE. 2 FLAGS PARAMETERS THAT EXCEED SECONDARY STDS : DOES NOT FAIL TEST. * MICROBIOLOGICAL ANALYSIS RUN PAST 30 HOURS OLD MAY NOT BE VALID. NOTE : SUBSEQUENT SAMPLES FROM THE SAME WATER SOURCE MAY 4RY, Authorized by Granite State Analytical, Inc. Main Office/Laboratory 22 Manchester Rd. /Rt. 28 Derry, NH 03038 (603) 432-3044 Lab Contact: Donald A. D'Anjou, Ph. D., Laboratory Director DATE: 06/27/02 Policy Well&Pump P.O.Box 900 Windham,NH 03087 CERTIFICATE OF ANALYSIS FOR DRINKING WATER SAMPLE ID# 0206-464-1 DATE&TIME COLLECTED: 06/18/02 0900 SAMPLED BY: Client DATE RECEIVED: 06/18/02 SAMPLE LOCATION: Salem,MA DATE ANALYZED: 06/24/02 ANALYZED BY: DD VOLATILE ORGANICS METHOD 524.2 RESULTS RESULTS COMPOUND UG/L MCL COMPOUND UG/L MCL DICHLORODIFLUOROMETHANE' <0.5 O-XYLENE <0'5 CHLOROMETHANE' <&5 DIBROMOCHLOROMETHANE' <05 VINYL CHLORIDE' <0.5 2 CHLOROBENZENP <0.5 100 BROMOMETHANE' <0.5 1,1,1,2-TETRACHLOROETHANE' <0,5 CHLOROETHANE' <0.5 ETHYLBENZENE' <0.5 700 TRICHLOROFLUOROMETHANE' -0.5 TOTAL XYLENES' <0.5 10000 1,1-DICHLOROETHYLENE' <0.5 7 STYRENE' <05 100 METHYLENE CHLORIDE' <0.5 5 BROMOFORM' <0.5 TRANS-I,2-DICHLOROETHYLENE' <0,5 100 ISOPROPYLBENZENE' <0.5 1,1-DICHLOROETHANE- <0.5 BROMOBENZENE' <0.5 2,2-DICHLOROPROPANE' <0E 1,1,2,2-TETRACHLOROETHANE' <0.5 CIS-1,2-DICHLOROETHYLENE' <0.5 70 1,2,3-TRICHLOROPROPANE- <05 BROMOCHLOROMETHANE' <0.5 N-PROPYLBENZENE' <05 C LO 0.6 2-CHLOROTOLUENE' <0.5 1,1,1-TRICHLOROETHANE' <0.5 200 4-CHLOROTOLUENE' <0.5 CARBON TETRACHLORIDE' <0,5 5 1,3,5-TRIMETHYLBENZENE' <05 1,1-DICHLOROPROPYLENE' <0.5 TERT-BUTYLBENZENE' <0.5 BENZENE' <0.5 5 1,2,4-TRIMETHYLBENZENE' <0,5 1,2-DICHLOROETHANE' <0E 5 SEC-BUTYLBENZENE' <0.5 TRICHLOROETHYLENE' <0.5 5 13-DICHLOROBENZENE' <0.5 1,2-DICHLOROPROPANE- <0.5 5 4-ISOPROPYLTOLUENE' <0.5 DIBROMOMETHANE' -0.5 1,4-DICHLOROBENZENE' <0.5 75 BROMODICHLOROMETHANE' <0.5 1,2-DICHLOROBENZENE' 1 600 CIS-1,3-DICHLOROPROPYLENE' <0.5 N-BUTYLBENZENE' <0.5 TOLUENE' 1.2 1000 METHYL TERT-BUTYL ETHER(MTBE)' 0.e TRANS-I,3-DICHLOROPROPYLENE- <0.5 1,2,4-TRICHLOROBENZENE' <0.5 70 1,1,2-TRICHLOROETHANE' <D5 5 HEXACHLOROBUTADIENE' <0.5 TETRACHLOROETHYLENE' <0.5 5 NAPHTHALENE <0.5 1,3-DICHLOROPROPANE' <&5 1,2,3-TRICHLOROBENZENE` <05 M,P-XYLENE <05 TOTAL THM'S' 0.6 100 1,2-DIBROMOETHANE -0.5 0.05 - 1,2-DIBROMO-3-CHLOROPROPANE <05 0.2 ACETONE <10 2-BUTANONE(MEK) <10 4-METHYL-2-PENTANONE(MIBK) <10 2-HEXANONE <10 DIETHYL ETHER <&5 TETRAHYDROFURAN <10 CARBON DISULFIDE <0.5 NITROBENZENE <10 TERT-BUTYL ALCOHOL(TBA) <10 ETHYL TERT-BUTYL ETHER(ETRE) <0.5 DIISOPROPYL ETHER(DIPE) <0.5 TERT-AMYL METHYL ETHER(TAME) <0.5 Quality Control. Surrogate Recovery: 4-Bromofiuorobenzene 97% Surrogate Recovery: 1,2-Dichlorobenzene-d4 100% `NELAC Accredited Analysis Authorized By: Donald A.D'Anjou,Ph.D. Laboratory Director This certificate shall not be reproduced,except in full,without the written approval of Granite State Analytical,Inc. ug/L=micrograms per liter,ppb <=less than MCL=Maximum Contaminant Level Page 1 of 1 JUN..-28-2002 FRI 11 :53 AM TOXIKON FAX NO, 17812757478 P. 03/05 Toxikon Date; 28-Jun-02 CLIENT: GRANITE STATE ANALYTICAL Client Sample ID: 0206-464 Lab Order; 0206227 Tag Number: Project: 0206 Collection Date: 06/18/02 9:00:00 AM Lab ID: 0206227-OIA _— — Matrix: WATER Analyses Result Limit Qual Units DF Date Analyzed MERCURY E245.1 Analyst: JR Mercury NO 0.00020 mg/L 1 06/261022:50:30 PM ICP METALS,TOTAL WASTEWATER 200.7 Analyst: At 8 N.6 0.0020 L 1 06/24102 7:13:00 PM otasslum 1.6 1.. V 0 mg1L 1 06124102 4:2100 PM CYANIDE, TOTAL E335.1 Analyst: CK Cyanide NO 0.010 mglL 1 06!27/02 Qualifiers: ND-Not Detected at the Repotting Limit S-Spike Recovery outside accepted recovery limits 1-Anatytc detected below quantitation limits R RPD outside accepted recovery limits B•Analyte detected in the associated Method Blank E.value above quantitation range �— +-value exceeds Maximum Contaminant Level Page 1 of 2 WORK ORDER C: 0 L_�- •y�/ IS Wiggins Ave.,mrd, 73o rd,Ma Ut CHAIN Of CUSTODY RECORD DUE DATE : �: 02- QL c TeWhona:(781)2753330 z Fax:(781)2757478 N ANALYSES m :OMPANY: SAMPLE TYPE CONTAMR TYPE ro \DORESS: 1.WASTEWATER P-PLASTIC 2.SOIL G-GLASS N 3,SLUDGE V-VOA 2HONE4: ( ) FAX* ( ) 4.OIL 5.DR+ 04G WATER PROJECT MANAGER: s.WATER(Gw enwrswr) OTH 2ROJECT iD/LOCATION: _ 7. ER sP£ctaL D 3 wt�ON SAMPLE SAMPLE CONTAINER SAMPLING PRESERVATIVE tNSTRUCTIONS/ —3 COMMENTS IDENTIFICATION TYPE SIZE TYPEM DATE TIME J ox 6-1 fl= 3 z o _ 5 �s� p j 6-� i3d� N� o •� �{ T a r x z o m N J A v m AMPLED BY: DATE: QUOTATION k: TIME: ❑ RUSH ..... BUSINESS DAY TURN AROUND E INOUISHED BY: DATE: } �E6EIVE 70IME' 2 d G OUTINE o t. =; TIME: � l Sample disposal information o l,7NQUISNED BY: DATE: - zd - r.�-- CEIVED F LAB BY: DATE' - _ Are(here any other known or suspected TIME: �. TIME: - - �J oontaminants in these sarnpies otttei than s 3 o cn CO R TEMPERATURE those l Siad above? t WOD F HIPMENT �.----"�J Yes_ No_it Yes. 1st Known j�:'.-�.s'.��,e ��ss.� ��.ve:�.�ts�sasts:�� _ �rs:��.s:�:�ss.�s'revs.��.s:ss:�.��ss��;sR.sssr.�:•em.�xs�ssr.�sy�� R gra hitt Otatt 2(ttaivtdca t, ]Inc. Main Office/laboratory At: Tramway Marketplace 22 Manchester Rd./Rt. 28 Route 16 & 26 Derry, NH 03038 West Ossipee, NH 03890 (603) 432-3044 1-800-699-9920 CITertifirate of AitalVsts for Prtxtktn$ Writer SENT TO : POLICY WELL & PUMP TEST NO. : 0206-00464-002 PO BOX 900 WINDHAM, NH 03087 SAMPLE SALEM, MA LOCATION: SAMPLE # 12308 DATE & TIME SAMPLED : 7/01/2002 10 : 00 EPA PARAMETER RESULT RECOMMENDED (rn9/1) MAX. LEVEL - ----- - - - - ---- - - - -- - - ASBESTOS SEP REPORT Total Dissolved Solids SEP REPORT - ------------ - ------------- - -- ---- -- --- < LESS THAN OUR LOWEST CALIBRATION POINT > GREATER THAN OUR HIGHEST CALIBRATION POINT 1 FLAGS PARAMETERS THAT EXCEED PRIMARY STDS : CAUSES TEST FAILURE . 2 FLAGS PARAMETERS THAT EXCEED SECONDARY STDS : DOES NOT FAIL TEST. * MICROBIOLOGICAL ANALYSIS RUN PAST 30 HOURS OLD MAY NOT BE VALID. NOTE : SUBSEQUENT SAMPLES FROM THE SAME WATER SOURCE MAY VARY. Authorized by JUL709-2002 TUE 11 41 AM TOXIKON FAX N0, 17812757478 P, 04/07 Toxikon Date: 09-✓ul-02 CLIENT: GRANITE STATE ANALYTICAL Client Sample ID: 6-464.2 Lab Order: 0207045 Tag Number: Project: 464.055. 057 Collection Date: 06/18/02 9:00:00 AM Lab ID: 0207045.OIA Matrix: DRINKING WATER Analyses Result Limit Qual Units DF Date Analyzed el LAL DISSOLVED SOLIDS E160.1 Analyst: YLK s -Toisl Dissolved Solids(Residue, 430 10 m 1 07/09102 Filterable) Qualillers: ND•Not Detected at the Reporting Limit S-Spike Recovery outside aeccptcd recovery limits 1•Analyte detected below quantitation limits R•RPD outside accepted recovery limits B-Analyte dateotcd in the associated Method Blank E-Value above quantitation tango •-Value exceeds Maximum Contaminant Level Page 1 of 3 UARMCHAIN OF CUSTODY RECORD WORK ORDER 75 Wiggles Ave., Bedford,MA 0 1730 Telephone:(781)2753330 - Fax:(797)27S747e DUEDATE Z- SCJ _Uz— r COMPAMY: 7 SA7i�PLE TYPE CONTAINER erre ANALYSES ADDRESS: � ,� 1 1 i Q I 7.WASTEWATER P-PLASM c _ dj-, 2.SOL G-GLASS PHONE#: r 3.SLUDGE V-VOA _ ( ) FAX#: ( ) 4.M P.O. #: . 5.ORMpPIG WATER PROJECT MANAGER: e.WATER(GWAPIWfSV) PROJECT ID&OCAMON: 7.OTHER(SPECIFY ,)IKON SAMPLE SAMPLE CONTAINER SAMPLING PRESERVATIVE / SPECIALG L IDENTIFICATION TYPE SIZE ITYPEJ 0 GATE TIME INSTRUCTIONS/ c COMMENTS ,= C C n 0 MPLED BY: QLER TATION #: UNQUISHED BY: EIVED BY: DATE: ' S O RUSH ..... BUSINESS DAY TURN AROUND , •� TIME: �, OROUTINE ICIQUISH BY: EIVED FO LAB : DATE: Sample disposal information C ME: Ale t ere any inthesek samples or suspected c THOO OF SHIPMET PRA those listed above? aVler �� (/��. Yes No n Y� 7a>w, .... 07/19/2002 16: 23 976-667-7671 STL BILLERICA PAGE 011/02 Fax message A Date: July 19, 2002 STL Billerica To: Alan Gregory 149 Rangeway Road Company; Granite State Analytical N. Billerica, MA 01862 Fax: (603) 434-4837 From: Aimee Cormier Tel 978 667 1400 Subject: TEM water asbestos results Pages: 2 Fax 978 667 7871 wvvw.stl-inc.com Confidentiality Notice: The Information contained In the Facsimile message is privileged and conFldentlal informatlon Intended only for the use of the addressee. If the reader of this message is not the Intended recipient, or the employee or agent responsible to deliver It to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify, us immediately by telephone and please return the original message to us at the above address vie the U.S.Postal Service. 07/19/2002 16:23 975-667-7871 STL BILLERICA PAGE 02/02 d1 u STL eutDrrcs 149 Rangeway Road North Billerica, MA 01862 Mr. Alan Gregory Tel: 978 667 1400 Granite State Analytical Fax:978 667 7871 22 Manchester Road w .stlanc.com Derry, NH 03038 Dear Alan: July 1.9,2002 Please find enclosed results for one (1) sample, Project Ref: 0206.464-2, STL. Job 931275; which you submitted for asbestos analysis by Transmission Electron Microscopy(TEM). The results according to the USEPA Phase U Primary and Secondary Drinking Water Regulations EPA Method 100.2 (fibers longer than 10 microns)are listed under column A. ("<"is equal to the value of the detection limit) A Date&Time Date&Time SAMPLE ID (million fibers/liter) Filtered Analyzed 0206464-2 <0.192 07/02/02; 13:27 07/18/02: 16:03 The final maximum contaminant level Goal(MCLG)and maximum contaminant level(MCL)for asbestos in water is 7.0 million fibers/liter. STL Billerica is accredited by NYELAP(9 10838)and the Commonwealth of Massachusetts(#M-MA038)for asbestos analysis of water samples. The test results in this report meet all NELAP requirements for parameters for which accreditation is required or available. Any exceptions to NELAP requirements are noted above. Severn Trent Laboratories is not responsible for incorrect sampling procedures since these water samples were not collected by our lab personnel. STL is only responsible for the analysis and reporting of submitted samples. Accreditation in no way constitutes or implies product certification,approval, or endorsement by NELAC. This report relates only to the specific samples tested herein. The enclosed report shall not be reproduced except in full,without the written approval of STL. Should you have further questions,or need additional information,please feel free to contact Client Services or me any time. Sincerely & dl Ernest T.Dobi,Ph.D. Manager-Microscopy Services STL Werica Is a Dan of Severn Trent Laboralorlm Inc.