5 WYMAN DRIVE llll
UPC 10330
No. 153L =groro�
HASTINGS, MN
RECEIVED 01/27/2017 03:50PM 9787450343 Salem Health Dept
01/27/2017 15:43 9782814869 WINDRIVER PAGE 02/07
0207078655 06114/2004
Commonwealth of Massachusetts Form 4--System Pumping Record D%
Massachusetts
System Pumping Record
System Owner System Location
Petrucci Rick Primary Borne
5 Wyman Drive S Wyman D 7e-
Salem, KA, 01970 Salam, NA, 01570
(918)-740-9184 x (578)-740-•9184 x
Petrucci
Type: Emergen Routine 1..i
Cesspool: No Yes Septic Tank: No EE�-))es=
Date of Pumping: J 1 'ZQ Quantity Pumped: GYi4 G Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
Date: Pumper Signature:
Condition of System/Other Comments `
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I.W.W.TY
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® can�we�,arekar� Dep Approved Form-12/07/95
12/09/2013 11: 21 9782814869 WINDRIVER PAGE 04/11
Commonwealth of Massachusetts Form 4--System Pumping RecordMnti
Massachusetts
System Pumping Record
System Owner System Location
Petrucci-v-<t—Al bin Primary Rome
5 IRIman Drive 5 'Wyman Drive
Salem, P%, 01970 Salem, MA, 01970
(97E)-740-915; x (978)-740-9184 x
Petrucci
Type: Emergent Routine
Cesspool: No � Yes Septic Tank: No Yes
bate of pumping.- Quantity Pumped: Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
Date: Pumper Signa
Condition of System/Other Comments
da
S.E.S:D.
® n�«a�,a�ycien vox bep Approved Form-12/07/95
S
0207455771 06tt4i2ou
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System OWE System Location
Petrucci Rick Primary Home
5 Wyman Drive 5 Wyman Drive
Salem, MA, 01970 Salem, lck' .01970
(978)-740-9184 x (978)-740-9184 x
Petrucci
Type;Yp Emergent Routine
Cesspool: No El Yes Septic Tank: No yes
Date of Pumping: LZ l�/y
Quantity Pumped: 1''O& Gallons
System Pumped By: Wind River Environmental,LLC Permit i#,
Contents Tronsferred to:
Contents bisposed at:
Crate: Pumper Signature:
Condition of System/Other Comments ®!�
CI
admm.nrcac:ea aixDep Approved Form-12/07/95
OT/ZO 39Vd N3✓tIJQNIM 698bT8Z8L6 ST:CZ bTOZ/6Z/ZT
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
Petrucci Rick — Primary Home
5 Wyman Drive 5 Cayman Drive
Salem, MA, 01970 Salem, FSA, 01970
(918)-740-9184 x (978)-740-9184 x
Petrucci
Type: Emergent Routine
Cesspool: No ✓ Yes Septic Tank: No Yes
Date of Pumping: Quantity Pumped: /CM Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
S-E-S D-
c—
. VRfQlJig MA.
Date: Pumper Signature:
Condition of System/Other Comments _
J
® Mn[Mourerydedpap r Dep Approved Form- 12/07/95
I
�t
Commonwealth of Massachusetts Form 4--System Pumping Record
Massachusetts
System Pumping Record
System Owner System Location
Petrucci Rick Primary Home
5 Wyman Drive 5 Wyman Drive
r
Salem, MA, 01970 Salem, MA, 01970
(978)-740-9184 x (978)-740-9184 x
Petrucci
Type: Emergent Routine
Cesspool: No Yes Septic Tank: No = Yesl l
Date of Pumping: =6 s. Quantity Pumped: tX0 Gallons
System Pumped By: Wind River Environmental,LLC Permit#:
Contents Transferred to:
Contents Disposed at:
A �•
Date: h 6 Pumper Signature:
Condition,of System/Other Comments
,max,
I I
J
Dep Approved Form-12/07/95
Z 369 689 514
` Receipt for
Certified Mail
- No Insurance Coverage Provided
Do not use for International Mail
(See Reverse)
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Street and No.
(v /Yl/tA)
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a
Restricted Delivery Fee
Return Receipt Showing
to Whom&Date Delivered
Re corn Receipt Showing to Whom,
Date,and Addressee's Address
TOTAL Postage
&Fees
Postmark or Date
STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
[4.
TIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES loan front).
Z
you want this receipt postmarked,stick the gummed stub to the right of the return address
ng the receipt attached and present the article at a post office service window or hand it to m
rural carrier Ino extra charge).
you do not want this receipt postmarked,stick the gummed stub to the right of the return
ess of the article,date,detach and retain the receipt,and mail the article. m
t
you want a return receipt,write the certified mail number and your name and address on a
n receipt card,Form 3811,and attach it to the front of the article by means of the gummed
it space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT
UESTED adjacent to the number. C00
p
you want delivery restricted to the addressee,or to an authorized agent of the addressee,rse RESTRICTED DELIVERY on the front of the article.
er fees for the services requested in the appropriate spaces on the front of this receipt.If l Nrn receipt is requested,check the applicable blacks in item 1 of Form 3811. aave this receipt and present it if you make inquiry. 105603.98.8-02/9 ,
. L
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3 tap
CITY OF SALEM BOARD OF HEALTH I ' `
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT - Tel:(508)741-1800
Fax:(508)740-9705
April 13, 1995
Enrico Petrucci
5 Wyman Drive
Salem, Ma. 01970
Dear Mr. Petrucci
The following is a summary of action taken following the April 4, 1995 request for a septic
inspection. The inspection was to follow the system pump out by Currier Septic Service.
On April 7, 1995 at 8:30 A.M. I inspected the tank in Mr. Petrucci's presence.
Upon inspection I noted roughly two feet of water present in the tank.The system itself had been
excavated and placed deep in the ground making it impossible to visually inspect the whole
system at that time.
On April 7, 19951 called Currier Septic Service and spoke to Maria. She advised me that the
company had the system pumped dry three times. She also informed me that there could be a
problem wlth the system failing.
Currently this situation does not warrant Health Department intervention. The situation is strictly
a resident/contractor dispute.
I recommend that a neutral, licensed septic inspector review the situation and or system.
If you have any questions, please feel free to contact the Health Department at 741-1800.
For the Board of Health : Reply to :
ea�nne Scott ' Mark Tolman
lth Agent Sanitarian
cc: Currier Septic Service
Mayor's Office c/o Dan Geary
Certified Mail#Z 369 689 514
JS/sjk
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
COMMONWEALTH OF MASSACHUSETTS
CITY OF SALEM
EXTERIOR PAINT REMOVAL PERMIT
Property located at : 5 Wyman Drive
Owner' s Name: Enrico Petrucci
-Address of Owner: 5 Wyman Drive
Contractor's Name: Homeowner
Address of Contractor:
Phone Number: 740-9184
Date paint removal will occur: 6/1/96 to 7/31/96
Hours Paint removal will occur:
This license is granted in conformity with the Statutes and ordinances
relating to Exterior Paint Removal .
Permit # : 85-96
Application Date: 05/20/96
Permit Expires: 7/31/96 unless suspended or revoked.
HEALTH AGENT
- 4 �
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CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970
JOANNE SCOTT,MPH,RS.CHO NINE NORTH STREET
HEALTH AGENT - Tel:(508)741-1800
Fax:(508)740-9705
Application for Permit to Engage in
Exterior Paint Removal and Abrasive Blasting
Date:
Property l�at �/�� -- .�---
Ownces name: ga-a l'
Address of Owner(If different from above):
Phone number
Contractor/Name of person/agency,that will perform paint removal:
Address of contractor.
Phone number.
Dates and hours when paint removal will occur:
Type of exterior paint removal to be peiiorm ,
Wet abrasive blasting Mist abrasive blasting _ Exterior paint /
Lead testing Lead testing removal/Other VVV
performed by: performed by:
Address: Address: P/
' S�-R
Results received Results received ��£ U
by SHD / / by SHD
Plan submitted for Plan submitted for Please attach
containment and containment and written work proposal.
disposal of abrasive disposal of abrasive
materials, water, materials, water,
and particulate(circle): Yes/No and particulate(circle): Yes/No
SALEM HEALTH DEPARTMENT
9 North Street
�O J
Salem,MA 01970
Cleanup Procedures: Cleanup Procedures:
HEPA Vacuum(circle): Yes/No NEPA Vacuum(circle): Yes/No
TCLP testing to be TCLP testing to be
performed by: performed by:
Address: Address:
Variance granted: Yes/No Variance granted: Yes/No
Fee$50: Received / / Fee$50: Received / / Fee$25: Received
-_L understand-that procedures undertakento remove-paint from-exterior surfaces including
protection of surrounding areas,clean up, and waste disposal must comply with the regulations
and provisions set forth by the City of Salem Board of Health Regulation 23. A copy of
Regulation 23, which I understand I must comply with in its entirely, can be obtained at the
City of Salem Department of Health.
Signature ofapp' t./�[//���T����
Approved by:
----------------------------------------------------
For Board of Health Use ONLY
Date permit issued: / /
Permit#:
I
TO DATE TIME AM
"P. FROM f AREA CODE
i 0 N0.
OF /
[' EXT.`N a
tE., M - - FAX l --
iP E
M s
4 �
°E , a
G
M= E
+,Q - SIGNED
n
PHONED CALL RETURNED o❑ SWMTS TO EYOU 1:11 Ell WA IN AWILL GAIN LL. URGENT
RACK CALL
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CITY OF SALEM BOARD OF HEALTH
3J.
sr Salem, Massachusetts 01970-3928
X<^^' NINE NORTH STREET
JOANNE SCOTT,MPH,RS,CHO
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
April 13, 1995
Enrico Petrucci
5 Wyman Drive
Salem, Ma. 01970
Dear Mr. Petrucci :
The following is a summary of action taken following the April 4, 1995 request for a septic
inspection.The inspection was to follow the system pump out by Currier Septic Service.
On April 7, 1995 at 8:30 A.M. I inspected the tank in Mr. Petrucci's presence.
Upon inspection I noted roughly two feet of water present in the tank.The system itself had been
excavated and placed deep in the ground making it impossible to visually inspect the whole
system at that time.
On April 7, 1995 1 called Currier Septic Service and spoke to Maria. She advised me that the
company had the system pumped dry three times. She also informed me that there could be a
problem with the system failing.
Currently this situation does not warrant Health Department intervention.The situation is strictly
a residenUcontractor dispute.
I recommend that a neutral, licensed septic inspector review the situation and or system.
If you have any questions, please feel free to contact the Health Department at 741-1800.
For the Board of Health: Reply to:
Jgnne Scott / Mark Tolman
lth Agent Sanitarian
oc: Currier Septic Service
Mayor's Office c/o Dan Geary
Certified Mail#Z 369 689 514
JS/sjk
3
3j G G P FORM 4-Sy.4 F f PUMPING RECORD
c
oFEWD
MAY 2 4 1995
Omer � Commonwealth of Massachusetts Clio OF SALEM
G9rrier HEALTH DEPT.
Massachusetts
System Pumping Record
estem w•ner System
---To-cation
Date of Pumping: Quantity Pumped: 1,,J-00 gallons ,
Cesspool: No ❑ Yes ❑ Septic Tank: No ❑ Yes
System Pumped by: -- ... �f��.�........_. License #: .............................._._....... .................
Contents transferred to:
Date y ` - �s ' Inspector
J� 0
9
3,"F�,nMa o�'ar
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
ROBERT E. BLENKHORN 9 NORTH STREET
HEALTH AGENT November 29, 1984
(617) 741-1800
Mr. Enrico Petrucci
42 Winthrop Street
Salem, Ma 01970
Dear Mr. Petrucci:
The individual sewage disposal system plan for your Lot X123, Map 2
on Wyman Drive, prepared by R.L. Mailhoit Associates is approved.
Please inform the contractor you choose to install the system that
he must obtain a disposal works installer's permit from this office.
Two inspections of this installation will be required. The first when the
excavations for the leaching are made and a second final inspection when
construction of the system is completed, before Backfilling.
If you have any questions,, please feel free to call this office.
Very truly yours,
FOR THE BOARD OF/ HEALTH
RO ERT E. BLENKHORN, C.H.O.
Health Agent
REB/g
cc: Richard McIntosh, Bldg. Inspector
Paul Niman, Dir, of Public Services
��`' Essex Survey Service Inc.
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o =-j COWST12UCTIOW NOTE 5
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�'-'- 1. FROM {3LW. TOSEPTIG TAutc�o¢ A3 �LIOVI,I off
C'✓0.K7 Ar �M i , PL1N) 3LIALL !SE 104. 01A. CA-ST 12OW PIPt
cow IIM11.12
�OM�(:i * WITH T%QeWrJOINT'5- PITGMED A MIN. OFY4 FOOT.
;5 Fints -• • - - �' ' FenM SEPTIGTAUK. TO Dt3T 60�- --%uALL at
IM. VIA:- OR PITCMreo 0
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D1�rr, F>OxTo LrsACLtINa, AZZEA XIALL.
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( D G e PROFILE 6 DMTA I L'9) � U FO 0
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2. I OI'3T. 6o,L nHALL- 13E OF STD. MFGrR. J Q
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AA'+ K.eLv,�.e� Ewra=� niw. 3. Selo-rl c TAWK-:- Ill �
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D CL2.e•TE Ili qq- ~
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\ � ~ - CAPp.GIT`� OF TANr. 1 L50 Ca4LLAl-+b•
tsilr►lt&wlc i'�IY /. •r" 4. LE4CW AeeA-.
4.1 STQIP OF ELL TO PQ 3Ub ,Ol L9 Er OTHEQ.
•-`*0wt;v UN9UITAeJLE MATERIAL.
t �kti ia� 4.2 FILL I1.1 LtAcw AtzeA To ess CLeANSWAAP
,SA.Ni F-t CP-AV E.L7 - FelbE OF ALL FOR %QW
MATEt21AL- TClryE APP4OVE0 PRIOQ TO PLAMN'>'WT- -
_ FILL SHALL DE ALLOWED TO SETTLE W PLAGE
511, (b) MOwTUD Oe M GOMPACTEO FW
APPR:OVtO MEGN. MGA*1'. FILL OLIALL ►1A1J! Cr
.SPCTA0H .4--A A MAX. PE2C. OF 1•WC- M1N. IW PLdCE.
� ��C�/ranyliiyrr4Cb.rrs A.� JTOFIE U'!ED I►l LClcM A2EA 3L1QLL dE
cgwa.► o�oyarawl OF 5I Z E-5 s H(::\v IW DETAILS Ek SNA L L `
TQdL.E Otf�ItXdW�f'pNt! P)E WASWED FEEL of ALL f`OREIGN .`t�'d1I
/ iO r*AAS1gCIry '; MA17LR PRIOR TO PLACEMENT- Le-,e QI �
I - - oDll
PA931WCw 'Loo Aleve(AA9l.+o 7-11-(.0)
S. SPE�IALCL�NDtTlO*J S'•
�• "" ��.•• // 1�/ /�j// a 'S.1 ALL WOQZC 3UALL flE TO TLlE LI NE`! Et t
I E1A14J JEQ/ I %. T4H CgRADE3 t"OWW OR TO '5UCW OTWeIZ
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� \ f7fPulroo� 7Jr57nnl<F_ _ _ __ \--
cteq� eap ISO K�r7f t� - "• Euc, NEecL AND/oa T"& 15oA¢D OF We�LTw. Q
5.2 I-)O CHANGIE7 OR 4DDI TIONS T70 TME
OF T1J13 WILDIUCI SHALL 6e MADE Q
WITHOUT PRIOR APPROVAL OF 'Tblt �' 1
BOAlzo OF 4eauTN,
O;,a i G'•;t�-� t : /'L r,II I 1 , c t... .- _ 5.'3 TNF- C,OHTI ACTOa 13LMLL NOTIFY T1-IE 1
PeaoPr-R Iu5PEe.TOR'S Ei ALLo\V 31KL1 -Timm J
37 o- - �,° 1'M�WCOVe�ov.r 9 ` ^-1� { A3 REQUIRED FOQ I4IOPECTION9. �C
r _ ----- �"r TE5T R E9ULT e4 OE31 G N DATA 1--�
�a I 570& V""
I.TEST PERFORMED PJi K„ I-.r-tP I�MOrT EY�JC
t
q �F11I .7 3uRvt{ SeRvlce,luc. (olnlS + 1N I 0
`3 rE Y � /v QoT:,Tawf ^�Lw� V��T ,' t i7Y� TLE PRE 0EWCI- OF r Nknipn/ �:�'7. /-n_ ,k: Fol
(Pv Q
Twit L r`r 1 1504120 OF WEAITLJ. �J 0
1 V �\ 2.561E IL-IFOQM ATION� rdt
q 1 `,t - \ TC7c PIT FCW-. M,N/iN. TOTAL OGOTN q¢ouNo WATE¢ U.
Q
Kj�V
Ci.NAy, 89.56 Ro„ o„
X
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HERE6Y GERT�FY Tl-ia-7 THE.�u�LVING,7 �Lda\vN HtStEDN ARi Tb EE IAfATiDO�ST}pE GjRAUND AS SHO\vN ANO Tue'T TueY - 1 V -7 � WO
CZJN FORM TO -THE ZI�f-IILI 3. TYPP OFFJUIL0IN ,F• �7�1;•/y .
C,1 ��\Vg OF THE OG r AT THE TI N1E OF GOn15 i RUCTION. � Q LL
I FURTLJL--IZ CERTIFY TN/&'T THE. PREMb15 SWO\vN WEREON AIZe NOT LACGTED \ViTu1N A FLOOD N°OFR�E aooMa ::� NQ OFP11soPLt C, u
NAZAKD ZONE AS DEIJNEAJED ON THE MAP OF COn. ML>WITY N` • r 1�IASsncyU3ETT9r
� 1�. De�ICau FLDW 5 S GAL. PEI PER90N PE¢.DA`4.
EPFECTiVG 6Y THF DevAR,/,AENT OF W005,wcn AND L)2il.AN DevC-LGpF-me NT MA6%.DwLY FLowtowmrH1 - G1ALLow-5
NSVF-ANCE�DMINISTRIJTIO r-t. SLIEET NS
�T E Q�ISTEREO ZpND 3UZVElbtZ
OLTE. OTQ ETOMAT GRVA7LlE� YE9 ab
a1: WOTE: TWE 10.5LIANCE OF A PERMIT TO C0W5T12LJCT 09Z- O1•5PO7AL No 3D-2
I � , M4e�. {zEGIt'3Tt=RED __ NEpJ=bY A OF COMPLit tWCE AFTER CON 5T2UCnO c, DCbiGN Pteac. G2AT8 1 ',� MIH.PI.:.R Zrr-4
ce¢TIFY THAT I HAVE nOPE-12V15ED THE CON5T2UCTZON OF TF-IE. �ut3JEC.T pIJPOSL\,L LeAGW L1¢.EA
FACILITIES AND TNA' TNeY tIAV@ bC-EN CONST2lSGTED ACCORDiwJG TO THE APPRIJ\/ED OL-IALL NOT E5E CON6TQUED As A GIvARANT�� � _ COMM. N °-
PLANS AND TI-FLE rJ_ OF TWe 5TATEEI•JVIRONME►JTAL CODS. Sep-[ THE `rem zs \v1L1 F c =N es OH SATI3FACTC�RILY. R><quiReD +
SEP-rIG 5`( OTBM SHOULD 0E bE2VICED ANN L)ALLY• PROVIDED `*G+OG c.,-
D 1G,N 15 POR A MAXIMUM[ Dn1LJ Plow OF ,&L-LOI-45
I
No L MOW INNNo
ENGINEERS
CONLSTRUCTION MANAGERS
57 SYLVAN STREET, DANVERS, MASS. • (617) 777-3631
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Enrico Petrucci 27FEB 26198b
Wyman Drive CITY OF SALI T4
Salem, MA 01970 HEALTH ADEPT,
RE: Water Supply & Sewerage Disposal for House Low
To Whom it May Concern:
Referenced lot requires a drilled well approximately 400' - 500' deep
in order to provide sufficient water to meet state._.and city flow require-
ments. Well is to be located as shown on site plan drawings. Dimensions
are approximately:
20' from front right corner of house
30' from right property side line
30' from street line
Well driller shall verify that above distances meet with local ordinances.
Well as shown on drawing is 123 feet from the edge of the septic leaching
field. Minimum separation distance per Title V - State Sanitary Code is
100 feet.
All domestic waste water from the site is to be disposed of through the
septic tank and leach field shown on the design drawings.
Very truly yours,
Richard L. ZaAkit, P.E.
RLM:tla
4 y iF"i b P�fa:� S A m)t t o qtt ^S1 g A x xr dh�.,j
t e s 3 M ) r vsY 'y.
� � $ i 'sY rP' i�`� ��#�"�� ���3 4f%P 21�j'��V . rrrry ,�, w gym•
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Stevens Mkter Analysis .
38 Montvale Avenue • Stoneham MA 02180 ♦ Mass (617) 438 61x14 • Salern N.H (603) 893-3106
LABORATORY NUMBER 2541' SAMPLE DAM, 4/15/86
- . . ,
SUBMITTED BY: WILMINOTON.PUMP SUPPLY
,639 Woburn Street
Wilmington, MA 01887
SAMPLE •SO,URCE ,'Sample Received - Wyman Drive, Saiemt' MA - JOB #6
„ - r
ANALYSIS : According, to. Standard Methods of
Water and Wastewater T:
AnaTyas; 'l5Yh •Ed :
Total Coliform . . . I per 100 ml
Chlorides . . . I I I 42 mg/L
pH _ 7.2 mg/L
Hardness 146 mg/L'''
Manganese . 0.01. mg/L <'
Sodium` 9.4 mg/li'
Iron 0.32 mg/L
Nitrate . • . . . • . 0.38 mg/L
Nitrite . s
',• less than 0.10 mg/L Fy`"
COMMENT: The results , of these .analyses meet the required
federa`1 and state standards for drinking water . ;p
However , the iron . concentration exceeds the
recommended standard: 4,
Although iron is, not harmful to your health , it 1
can affect the taste , color and odor of your t
water, If _desired , iron can be removed with
filters sold by water treatment specialists .
\ Wate,r, qualiEy can varyrsignificantly fom time '
to ' time due to. various: local conditions . It is x,
advisable fo have your, water tested - in approxi- ,x
mately six to twelve months to dter a any 1^ s
change .in, wa'ter quality: '
Chem
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CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01470
ROBERT E. BLENKHORN 9 NORTH STREEI
HEALTH AGENT
(617)741-1800
September 16, 1986 ,
Mr. Enricco Petrucci
42 Winthrop Street
Salem, Mass. 01970
Dear Sir:
The private sewage disposal system installed at 6 Wyman Drive (Lot No. 23)
was inspected on September 10 and 12, 1986 by Brian Lockard, Registered
Sanitarian of this Department. In accordance with Part I , Section 15.02,
paragraph 8 of Title 5 of the. State Environmental Code this letter shall
certify that the system has been placed in compliance with the terms of
the permit and the approved plans.
If you have any questions please feel free to call this office at 741-1800.
Sincerly,
FOR THE BOARD OF HEALTH
ROBERT E. BLENKHORN, C.H.O.
HEALTH AGENT
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O�.COPDIt4�
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CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
ROBERT E. BLENKHORN 9 NORTH STREET
HEALTH AGENT
1617174 1-1800 July 18, 1985
Jim Viera
Viera Artesian Well Company
253 Andover Street
Georgetown, MA 01833
Dear Mr. Viera:
This is a permit to the Viera Artesian Well Company to install an Artestian Well
at 6 Wyman Drive (Lot #23) , owner Mr. Petrucci .
All work is to be done in accordance with the )City of Salem Board of Health Regu-
lation 1 .A, Private Well Water Suppy Regulation (see enclosed copy) and Title 5
Commonwealth of Massachusetts Environmental Code Minumum Requirements for the Sub-
surface Disposal of Sanitary Sewerage. The Board of Health should be contacted for
site observation during construction and for final approval of the installation.
Very truly yours,
F R THE BOARD OF HEALT
R BERT E. BLENKHORN, C.H. .
HEALTH AGENT
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CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
ROBERT E. BLENKHORN 9 NORTH STREEI
HEALTH AGENT
)617) 741-1800
September 16, 1986
Mr. Enricco Petrucci
42 Winthrop Street
Salem, Mass. 01970
Dear Sir:
The private sewage disposal system installed at 6 Wyman Drive (Lot No. 23)
was inspected on September 10 and 12, 1986 by Brian Lockard, Registered
Sanitarian of this Department. In accordance with Part I , Section 15.02,
paragraph 8 of Title S of the State Environmental Code this letter shall
certify that the system has been placed in compliance with the terms of
the permit and the approved plans.
If you have any questions please feel free to call this office at 741 -1800.
Sincerly,
FOR THE BOARD OF rrHEALTH
ROBERT E. BLENKHORN, C.H.O.
HEALTH AGENT
REB/m
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DMSEON OF WATER RESOURCES
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In Accordance with the Provisions of ,
Massachusetts G.L. Chapter 21 Section 16 '`
James F. Viera '
Georgetown, MA w. ,
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is Authorized to Dig or Drill Wells in the
j Commonwealth of Massachusetts During the Period gry
JULY 1, 19 85 to JUNE 30, 1986
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tJUL 2 5 '1985
CITY OF' SALEM
HEALTH DEPT.
Town of 5A C EM
Masschusetts
Board of Health
Permit No. Date 7 S
APPLICATION FOR WELL AND PUMP PERMIT
Application is hereby made for permit to drill or repair a well. Application is
also made to install ( ) major renovation ( ) or major repair ( ) of pump system.
Location: Address (,!�?✓MAN 02/0'eor Lot Number Z3
Owner EayP1C'a P:ETQUcC/ Address &tA(Ll✓ l) S'T S'R,tEM MA
Well Contractor 111EPA &!.Eek ('o Address QEo2e�Ej-, ✓ '
Pump Contractor Address
WELL CONTRACTOR ( To be filled in at time of pump test )
Type of Well NplelEr/ Well Used For DoME377C
Diameter of Well G Size of Casing 6
Depth7o# Bedrock / Depth of Casing into Bedrock /9
Was it Seal-Tested? ' YES (K ) NO ( ) Date of Testing_ Z�g/k
Depth of Well 31a5-, Well Ended in What Material koc,
Depth to Water 410 r Delivers 1510 Gallons Per Minute
Drawdown—325
25 feet after pumping 1�7 hours at g0, G.P.M. Sketch map of
well location with tie down lines on reverse side of this orm.
Date of Completion
L CONTRACTOR'S SIGNATURE
PUMP INSTALLER ( To be filled in before installation )
Size and Name of Pump Type of Pump Used
Water Pump Delivers G.P.M. Size of Tank
Pipe Material Used in Well: Cast Iron ( ) Galvanized ( ) Plastic ( ) If plastic,
test strength
Well Pit ( ) or Pitless Adaptor ( )
Was sleeve used to protect pipe? YES ( ) NO ( ) Type or Name of Well Seal
Date
PUMP INSTALLERS SIGNATURE
Date water analysis report was submitted to Board of Health
Date release was given to owner of record and Building Inspector
HEALTH INSPECTOR
..a DJUL 2 51985
CITY Or SAL_ A
HEALTH DEPT.
THE PROFESSIONAL EXPERTS ��N
IN THE SEPTIC AND
DRAIN INDUSTRY. _ P M - FORM 4-SYSTEM PUMPING RECORD
5� 5�
MAY 2 4 1995
Dennie currier Commonwealth of Massachusetts Oi T OP SALEM
David Currier
<"
Massachusetts HEALTH °EST.
$arrQa�
System Pumping Record
,,,stem Owner Systern Location
Date of Pumping: y - y S Quantity Pumped: JJ-00 gallons
Cesspool: No ❑ Yes ❑ Septic Tank: No ❑ Yes Er
System Pumped by: am ........ License 4: ......... ....... _ .... ..
Contents transferred to:
Date y ' �s ' Inspector