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HomeMy WebLinkAbout2021 Jul- eDEP Massachusetts Department of Environmental Protection eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. 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. r 4 ':yl ✓UIGQU VI I\GJVUI NG 1 I VlGGlIVI I - VI VUI IUYYQIGI ✓IJVIIQIyG I IVl`.'I Q111 I. f G111 111.1,141114/GI; . Groundwater Permit IIIIIIIIIIIIIIIIIIIIIIIIIIIIII 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 ✓UI GOU VI I%GJVUI VG I I VIGI.,I.IVI I- VI,..UI IUVVOLVI ✓1JV11011J.G I I VW 0111 I. I 0111111 IVU1111./01 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 LI ✓1.11GQU VI I\dGJU VI VGwater 1 I VIGPVlll1ermitVVVU- I 1 IUY ✓ YQLGI IJV0 I11 l,G I I llyl all, I. f UI1111.11U1114G1 Groun 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