HomeMy WebLinkAbout2021 Jul- eDEP Massachusetts Department of Environmental Protection
eDEP Transaction Copy
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AUG 0 .' 2021
HEALTH DEPT.
Username: EBELAIR
Transaction ID: 1298388
Document: Groundwater Discharge Monitoring Report Forms
Size of File: 573.65K
Status of Transaction: Submitted
Date and Time Created: 728/2021:2:46:03 PM
Note: This file only includes forms that were part of your
transaction as of the date and time indicated above. If you need
a more current copy of your transaction, return to eDEP and
select to "Download a Copy" from the Current Submittals page.
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2.Tax identification Number
MONITORING WELL DATA REPORT
12021 QUARTERLY 2
3. Sampling Month &Frequency
A. Facility Information
Important:when
filling out forms on 1. Facility name,address:
the computer, use 1MAYFLOWER PLACE
only the tab key to a.Name
move your cursor-
do not use the [579 BUCK ISLAND ROAD
return key. b.Street Address
YARMOUTH 1MA 102673
Irit SI c.City d.State e.Zip Code
Iry2. Contact information:Ail
MARK WEINBERGER
a.Name of Facility Contact Person
2035574777 mweinberger@maplewoodsl.com
b.Telephone Number c.e-mail address
3. Sampling information:
16/29/2021 1R1 ANALYTICAL
a.Date Sampled(mm/dd/yyyy) b.Laboratory Name
NICOLE SKYLESON
c.Analysis Performed By(Name)
B. Form Selection
1. Please select Form Type and Sampling Month&Frequency
Monitoring Well Data Report-2021 Quarterly 2
I-
- All forms for submittal have been completed.
2. 1This is the last selection.
. r
3Delete the selected form.
gdpdls 2015-09-15.doc• rev. 09/15/15 Groundwater Permit Daily Log Sheet• Page 1 of 1
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Groundwater Permit
L.,. MONITORING WELL DATA REPORT 2•Tax identification Number '
2021 1QUARTERLY 2
3. Sampling Month&Frequency
C. Contaminant Analysis Information
• For"0", below detection limit, less than (<)value, or not detected, enter"ND" <
• TNTC=too numerous to count. (Fecal results only)
• NS= Not Sampled
• DRY= Not enough water in well to sample.
Parameter/Contaminant MW-1 MW-2 MW-3D MW-3M MW-3S MW-4D
Units Well#: 1 Well#: 2 Well#: 3 Well#:4 Well#: 5 Well#:6
NITRATE-N IND ( ND ND ND ND IND
MG/L
TOTAL NITROGEN(NO3+NO2+TK ND ND ND ND ND ND
MG/L
TOTAL PHOSPHORUS AS P !0.41 I 0.058 0.013 ND 0.026 0.028
MG/L
ORTHO PHOSPHATE ND I ND ND ND ND ND
MG/L
mwdgwp-blank.doc•rev. 09/15/15 Monitoring Well Data for Groundwater Permit•Page 1 of 1
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2.Tax identification Number
MONITORING WELL DATA REPORT
'2021 QUARTERLY 2
3.Sampling Month &Frequency
C. Contaminant Analysis Information
• For"0", below detection limit, less than (<)value,or not detected, enter"ND" <
• TNTC=too numerous to count. (Fecal results only)
• NS = Not Sampled
• DRY= Not enough water in well to sample.
Parameter/Contaminant MW-4M MW-4S MW-5 MW-6 MW-8D MW-8S
Units Well#: 1 Well#: 2 Well#:3 Well#:4 Well#: 5 Well#:6
NITRATE-N ND ND ND 0.050 ! ND IND 1
MG/L
TOTAL NITROGEN(NO3+NO2+TK ND ND ND ND ND ND
MG/L
TOTAL PHOSPHORUS ASP 1 ND 0.050 10.050 0.051 ND 0.17
MG/L
ORTHO PHOSPHATE "ND ( ND I ND I ND ND ND
MG/L
mwdgwp-blank.doc•rev. 09/15/15 Monitoring Well Data for Groundwater Permit• Page 1 of 1
-'± ✓UI GChU VI I\GJVUI1,G I I VIGVIIVl l_ VI Vl11 IUYYChIGI I.JIJVl ICll l.'G 1 Iv I,.I Chill I. I GI11 Ill IYUI1111G1
Groundwater Permit
2.Tax identification Number
•
Facility Information
Important:When 1MAYFLOWER PLACE
filling out forms on
a.Name
the computer, use
only the tab key to 1579 BUCK ISLAND ROAD
move your cursor- b.Street Address
do not use the 'YARMOUTH MA 102673
return key. c.City d.State e.Zip Code
Certification
f rat
"I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.
Based on my inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the
'Mil information,the information submitted is,to the best of my knowledge and belief,true,accurate and complete.I am aware that the
are significant g nt penalties for submitting false information,including the possibility of fine and imprisonment for knowing violations."
[ELIZABETH BELAIR 17/28/2021
Any person signing a.Signature b.Date(mm/dd/yyyy)
a document under
314 CMR 5.14(1)or
(2) shall make the Reportin' Packa'e Comments
following QUARETRLY WELL LAB WAS NOT RECIVED ON TIME TO SUMBIT AND WAS OMMITTED FROM
certification THE JUNE DMR.
If you are filing
electronic-ally and
want to attach
additional
comments, select
the check box.
gdpdls 2015-09-15.doc• rev. 09/15/15 Groundwater Permit•Page 1 of 1