ARCADIS GERAGHTY&MILLER
Transcript of ARCADIS GERAGHTY&MILLER
ARCADIS GERAGHTY&MILLERARCADIS Geraghty & Miller, Inc.3000 Cabot Blvd. West, Suite 3004
Eric Newman ' . . langhorneRemedial Project Manager * ' " " . " " ' Pennsylvania 19047U.S. Environmental Protection Agency, Region III Tel 21S 752 684°1650 Arch Street Fax 2157526879Philadelphia, PA 19103-2029
ENVIRONMENTALSubject: , • .1998 Annual Progress Report, Woodlawn Landfill SiteCecil County, Maryland Remedial Design/Remedial Action,Administrative Order, USEPA Docket No. Ill 95-05-DC
Date:Dear Mr. Newman: 20 January 1999
This Annual Progress Report has been prepared by Bridgestone/Firestone, contact:Inc. (BFS) and ARCADIS Geraghty & Miller, Inc. (AG&M) to document Douglas J. Schaibleactivities performed during 1998 associated with the Remedial Design/Remedial Action (RD/RA) at the Woodlawn Landfill Site (site) in CecilCounty, Maryland. Two copies of this report are being submitted to the U.S. Extension:Environmental Protection Agency (USEPA) in accordance with Section VI 215-752-6840E.4 of the Administrative Order referenced above.
1.0 Major Milestones Accomplished During 1998\
This section summarizes milestones accomplished during 1998 incompliance with the Administrative Order.
1.1 Implementation of the Long-Term Groundwater Monitoring Plan
1.1.1 Award of Subcontracts
The following subcontracts were extended/awarded in 1998:
Validation of Laboratory Validata, Inc.AnalysesTopographic & Property Survey: Taylor, Wiseman & TaylorLaboratory Analyses of .Soil and Groundwater: Severn Trent Laboratories (formerly AEN)
Lancaster LaboratoriesMicroseeps
Well Installation/Abandonment Eichelbergers, Inc.
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1,1.2 Geological and Hydrogeological Investigation
The following subtasks were carried out as part of this investigation:
1 1.2.1 Access Agreements
Access agreements were maintained with the residences on the residentialwell sampling program.
/. 1 2.2 Precipitation Gauging
Daily precipitation measurements were recorded by Cecil County personnelat the transfer station until September 26, 1998 when it was discontinued.
1 1.2.3 Residential Well Monitoring
* Residential Wells P-516 (before and after treatment), and P-207 were re-sampled in January of 1998 in accordance with the procedures providedin the Remedial Design Workplan.
• The three sampling events for Residential Wells P-309 and P-506(before and after treatment) were conducted in February, July, andNovember 1998.
1 1.2,4 Groundwa ter Monitoring
ARCADIS Geraghty & Miller conducted two groundwater sampling eventsin July and November 1998. During each event, groundwater samples werecollected from the 17 area-of-attainment wells listed in the July 14, 1998Long-Tern Monitoring Plan. The wells were sampled using the low-flowsampling techniques outlined in ARCADIS Geraghty & Miller's USEPAapproved Sampling and Analysis Plan (January 26, 1997) and in accordancewith the Technical Protocol for Evaluating Monitored Natural Attenuationof Chlorinated Solvents in Groundwater (Wiedemeier et al., 1996) wereutilized to collect the groundwater samples. Field notes and analyticalresults from each event were included in the monthly progress reports.
1.1.2,5 Data Validation
Analytical data packages for groundwater and residential well samples weresent to Validata in Norcross, Georgia to be validated. Data validationreports from Validata were included in each monthly progress report after
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receipt.
7.7.2.6 Monitoring.WellInstallation - .
During December 8 through December 23, 1998, one saprolite and two bedrockmonitoring wells were installed by a Maryland-licensed driller from Eichelbergers,Inc. of Mechanicsburg, Pennsylvania. One saprolite and one bedrock monitoringwell (MW-110A and MW-110B) were installed on the northwestern portion of thesite. The second bedrock well (MW-11 IB) was installed in the southeastern portionof the site. These locations were previously agreed upon by the USEPA and theMaryland Department of the Environment (MDE).
After the monitoring wells were installed, Taylor, Wiseman & Taylor ofWest Chester, Pennsylvania was contracted to survey the horizontal andvertical locations of the wells.
Also in December 1998, a total of 14 monitoring wells (ITP-1, ITP-3, B-2,B-5, F-l, F-7, F-9, F-10, ITS-3, MW-101A, MW-10IB, MW-102A, MW-107A and OW-3) and 6 piezometers (ITZ-1, ITZ-2, ITZ-3, ITZ-4, ITZ-5,and ITZ-7) were abandoned in accordance with applicable Maryland StateRegulations. The well construction details and core logs were provided inthe December 1998 monthly report. The well permits and wellabandonment forms are provided in Appendix A.
1.2 Ecological Monitoring Plan
On June 25, 1998, the Revised Habitat Impact Analysis and EnvironmentalRestoration Plan was submitted to USEPA. This report contains anassessment of impacts to vegetation, wildlife, groundwater, surface water,soils and land use resulting from construction of a single-barrier coversystem and a phyto-cover system. It also contains habitat protection, coverrestoration and wetland restoration measures; as well as a monitoring andmaintenance program for a single-barrier cover system and a phyto-coversystem.
1.3 Engineering Investigation
The following is a summary of the engineering investigations that wereimplemented:
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1.3.1 Final Cover Design
ARCADIS Geraghty & Miller, Inc. submitted final revisions to the FinalDesign Report - Landfill Cover System for the single-barrier cover on July15, 1998. The report %vas conditionally approved by USEPA on June 30,1998.
On July 20, 1998, a Modification to the Administrative Order wasadministered by USEPA to suspend BFS's obligation to continueimplementing the remedial action requirements of the Order. ThisModification was administered based on an agreement to complete aFocused Feasibility Study to re-evaluate alternative remedial strategies inconformance with the National Contingency Plan (NCP).
1,3,2 Focused Feasibility Study for the Landfill Cover System
In response to an agreement with USEPA to complete a Focused FeasibilityStudy to re-evaluate alternative remedial strategies in conformance with theNCP. on August 17, 1998, the report Focused Feasibility Study - LandfillCover System was submitted to USEPA. This report compared the finalcover prescribed in the ROD to an alternative soil cover. The reportultimately recommended that a soil cover, in conjunction with monitorednatural attenuation, be implemented at the site as an alternative to the finalcover prescribed in the ROD.
1.3.3 Focused Feasibility Study - Groundwater Remedy / GroundwaterModeling
The final Focused Feasibility Study - Groundwater Remedy, which provides anevaluation of monitored natural attenuation as an alternative to the pump and treatremedy prescribed in the ROD, was submitted to USEPA in January 1998. The finalgroundwater modeling report was included in the Focused Feasibility Study as anappendix. Monitored natural attenuation was recommended as the preferredgroundwater remedy at the site.
2.0 Deliverables Submitted to USEPA
• Monthly Progress Reports January-December,
• Letter to USEPA detailing the revised cleanup levels for the site January 12
• Draft Prc-Final Design Report submitted to the USEPA January 19
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• The Final Focused Feasibility Study - Groundwater Remedy January 21
• Annual Progress Report for 1997 January 30
• ARCADIS Geraghty & Miller letter report to MDE detailing our HELP modelevaluation of the COM AR specific cover system February 13
• Draft Preconstruction Habitat Impact/Environmental Restoration PlanFebruary 24
• Replacement pages for the Focused Feasibility Study - Groundwater RemedyFebruary 24
• Draft Final Design Report for the Landfill Cover System April 6
• Addendum 1 to draft Final Design Report - Landfill Cover System April 8
• Draft Well Abandonment Plan May 13
• Revised Long-Term Groundwater Monitoring Plan May 21
• Addendum 2 to draft Final Design Report-Landfill Cover System June 17
• Addendum 3 to draft Final Design Report-Landfill Cover System June 17
• Revised Habitat Impact Analysis and Environmental Restoration Plan June 25
• Final Long-Term Monitoring Plan July 14
• Addendum to draft Final Design Report for the Landfill Cover System (finalsubmission after conditional approval from USEPA) July 15
• Focused Feasibility Study - Landfill Cover System August 17
• Provided residents at Parcels P-506 and P-309 with analytical results from theFebruary 1998 residential sampling event.
• Evaluation of installation of additional'monitoring wells on site September 14
• Residents from Parcels P-506 and P-309 were provided with data from June1998 sampling event . . _ _ . . - - . . September 30
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• Clarifications for Wells in the Long-Term Monitoring Plan MemorandumNovember 11
• Seismic Velocity Analysis for Shallow Bedrock Along Seismic RefractionTransect SRS-3 Letter November 23
• Additional information concerning the cleanup levels of non-carcinogeniccompounds at the Wood lawn Landfill. December 17
3.0 Tasks Remaining to be Accomplished
This section identifies the tasks remaining to be accomplished forimplementation of the RD/RA.
3.1 Qroundwater Monitoring Program
Groundwater monitoring will continue as specified in the July 1998 Long-Term Monitoring Plan and the November 1998 clarification memorandum.
3.2 Remedial Design
Upon completion of the revised ROD for the site by the USEPA, theremedial design/remedial action process for the site will be furtherimplemented.
4.0 Anticipated Schedule for Implementation ofRemaining Tasks
• Groundwater monitoring is scheduled to be conducted in February, May,August, and November 1999.
» The remedial design schedule is currently pending the final decisionregarding the proposed revised ROD.
A revised Project Schedule will be prepared in accordance with the revisedROD.
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Eric NewmanARCADIS GERAGHTY&MILLER ' 20 January 1999
If you have any questions, please do not hesitate to contact the undersigned.
Sincerely,
ARCADIS Geraghty & Miller Inc.
DouglagxT. Sch^ibleScientist III
Tina StackProject Manager
Suthan S. Suthersan, Ph.D., P.E. - - -Project Officer
Enclosures: Appendix A Well Permits and Well Abandonment Forms
Copies: - . . . . - , . . . - . - - •
Ms. Mimi Boxwell, U.S. Army Corps of EngineersMr. James Gravette, MDE (2 copies)Mr. Timothy A. Bent, CPG, Bridgestone/Firestone, Inc.Kevin A. Gaynor, Esq., Vinson & ElkinsMr. Joseph Lewandowski, ERM
This document was prepared fjor the sole use of BFS and the regulatory agenciesinvolved with this project. No other parties should rely on the information containedherein without prior written consent of ARCADIS Geraghty & Miller.
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ssf" „ JrCATOR 4 R 'i i 2 5 R 0 —— ?-^ —————OWNER
JC|1 i C , ..,' I , (MDE USE ONLY)1 2 3 6
STATE OF MARYLANDWELL COMPLETION REPORTFILL IN THIS FORM COMPLETELY
PLEASE TYPE -
THIS REPORT MUST BE SUBMITTED AFTERWELL IS COMPLETED.COUNTYNUMBER KK-llQB
ST/CO USE ONLY DATE WELL COMPLETED Depth of Well ,_-,, .,DATE Received .... „„ „„ FROMMM DD YY MM DD- YY - 22 26 -i —
S 13 15 20 (TO NEAREST FOOT) 28 29 30
PERMIT NO.PERMIT TO DRILL WELL"
c_' " 23" -31 32 33 34 35 36 37
^ •NER £? " • <-< f - J TWT. - .•- , ,'.; f_ - i- -, ' ''i *_
•SEET OR RFD .• • - las' name « ••..<.. - . / < • "rsl name TOWN . /v..- . /• J. i / .-. / c n .-.SUBDIVISION SECTION L OT
WELL LOGNot required for driven wells
STATE THE KIND OF FORMATIONS PENETRATED, THEIRCOLOR. DEPTH. THICKNESS AND IF WATER BEARING
DESCRIPTION (Useadditional sheets if needed )
?O*4* -0(ju<*iJl4>-&*0tA •.
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$i£*4• --it-- •- - '• • a w. tlpssffc" •* • v V' '"NUMBER OP.UNSUCCESSFOL WELLS : C/
WELL HYpROFRACTUREDyes no
CIRCLE APPROPRIATE LETTERA A WELL WAS ABANDONED AND SEALED
WHEN THIS WELL WAS COMPLETED£ ELECTRIC LOG OBTAINEDPTEST WELL CONVERTED TO PRODUCTION
WELL1 HEREBY CERTIFY THAT THIS WELL HAS BEEN CONSTRUCTED INACCORDANCE WITH COMAR 26.04.04 "WELL CONSTRUCTION" ANDIN CONFORMANCE WITH ALL CONDITIONS STATED IN THE ABOVECAPTIONED PERMIT. AND THAT THE INFORMATION PRESENTEDHEREIN IS ACCURATE AND COMPLETE TO THE BEST OF MYKNOWLEDGE.
DRILLERS LIC. NO. ft f' '-••• '•-
trl '• ' D "-' ^ -; i
RS SIGNATUREIATCH SIGNATURE ON APPLICATION)
LIC. NO. i v.;_j ii De_ LiL. itU_ v. * I''' *-S~r.'l ————— -.
SITE SUPERVISOR (sign, of driller or journeymanresponsible for sitework if different from permittee)
GROUTING RECORD ves noWELL HAS BEEN GROUTED |v| JNJCircle Appropriate Box ) 'tiJ lijTYPE OF GROUTING MATERIAL (Circle one)CEMENT |C|'JVI BENTONITE CLAY B C .
NO. OF BAGS 46/ '& NO. OF POUNDS i If "GALLONS OF WATER 1 3" ***DEPTH OF GROUT SEAL (to nearest foot) _
.•~ ' L. V
from ft. tn »_.' ft.48 TOP 52 54 BOTTOM 58(enter 0 if from surface)racing CASING RECORD
6ypes \ rx T x i.nsert \ |59 1 COropriate 1 T££i CONCRETE20de 1 A 'ni |"jf |rj | T 1telow / Mjr ' 1 W 1 U 1 1 1
——— A-r ————————— ———————MAIN Nominal diameter Total depthCASING toP (main) casing of main casingTYPE (nearest inch)! (nearest foot)
T i— O T 7*^60 61 63 64 66 70
E . OTHER CASING (if used).A.,~ .-f?-.--. diameter depth (feet)H .- i* ' ifo from to
SiN I M M ,
usnreen rype SCREEN RECORDu^peMliole gjT |B)Rj JHJO/ inswl v.- 5TEH. BfiASS OPEN/ appropriate , BRONZE < HOLETsa-r rpiu loin\ i ./ MKSCTCr OTHER
C 2M" DEPTH (nearest ft.) / '?1 2 f '• - ' . -•-, p[_- »?d 7O
^ 8 9 11 15 17 21
23 - 24 26 30 32 36SC3R 38 39 41 45 47 51E -^E SI OT SI7E 1 -- ' 2 •*— 3 ", ,NDIAMETER „ ,/ (NEARESTOP RI-.RPPN ^ T INCH1
56 60from to- ? /v
RHAVFX PACK , — ' 1 i ' / iIF WELL DRILLED — •WAS FLOWING WELL ———INSERT F IN BOX 68 68
MDE USE ONLY(NOT TO BE FILLED IN BY DRILLER)
T (E.R.O.S.) W Q
70 ' 72
TELESCOPE LOG A D '5 1 O C CpA*?iNfi INDICATOF /I f~i i 1 f ^"^ filyASIIMt. t~\ l\ \J I C. \J \J
C | 3 j /x-u/a/,-^.-L__J J^f< ry>
_ 7-* / V
>*vixT ' ' i iPUMPING TEST /
HOURS PUMPED (neare
PUMPING RATE (gal. pe
METHOD USED TOMEASURE PUMPING RA
WATER LEVEL (distance
BEFORE PUMPING-
WHEN PUMPING
TYPE OF PUMP USED (A air [p"27 T7"
C centrifugal | R27 27
| J |'e< S27 ' 27
it hour)8 9
11 15
TE ,
from land surface)
ft.
ft.22 25
or test)piston I T I turbine
. —— | otherrotary | Q [ (describe
submersible•:" ;Jt -.
. - PUMP INSTALLEDDRILLER INSTALLED PUMP YES C_m)(CIRCLE) (YES or NO) ——IF DRILLER INSTALLS PUMP, THIS SECTIONMUST BE COMPLETED FOR ALL WELLS.TYPE OF PUMP INSTALPLACE (A,C,J,P,R,S,T,0IN BOX 29.CAPACITY:. ,GALLONS PER MINLJ(to nearest gallon)PUMP HORSE POWE
LED) 29
(TE ^ S • '* : JS»" '•'_31 35
?R*¥9 . . ±1
PUMP COLUMN LENGTH r - -•-•--ft-* ..^(nearest ft.) -,r-
43 47CASING HEIGHT (circle appropriate box
/f- — I » and enter casing height)( +{/ above^ T LAND SURFACE
P below OZ- <n? f> '49 50 51
1 LOCATION OF WELL ON LOTL l SHOW PERMANENT STRUCTURES1 1 AND INDICATE NOT LESS THAN
TWO DISTANCES(MEASUREMENTS TO WELLK
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PLEASE TYPE
nioncrum Mubi afc SUBMITTED AFTERWELL IS COMPLETEDCOUNTYNUMBER -H-IIC;-
n TE0RUS °NLY DATE WELL COMPLETED Depth of Well FROM "PERMIT TO DRILLMM 00 w "^ OO-j. ,.7 , 22 ^_ gg ££_ g^ . 234<?
• '3 'S 20 (TO NEAREST FOOT) 28 29 30 31 32 33 34 35 3 ^
OWNER fr't-'J »~ ' „ • . - _ ^^BSTREET OR RFD „ •? """*!" . • '.- '"3"lame TOWN'' • , '/• " . "~ / -• ^^SUBDIVISION SFCTION IOT
WELL LOGNot required for driven walls
STATE THE KIND OF FORMATIONS PENETRATED, THEIRCOLOR, DEPTH, THICKNESS AND IF WATER BEARING
DESCRIPTION ttJM«adition«i >n**tt it n»«a«a i
/vc Cr * *4**-,, 7Uf>"t*-C4>uL
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NUMBEH OR ^ Ic pSSFUt WELLS : *-* J fr tlMMVi, V
WELLHYORO^UREB g ^g
CIRCLE APPROPRIATE LETTERA A WELL WAS ABANDONED AND SEALED
WHEN THIS WELL WAS COMPLETED£ ELECTRIC LOG OBTAINEDPTEST WELL CONVERTED TO PRODUCTION
WELL1 HEREBY CERTIFY THAT THIS WELL HAS BEEN CONSTRUCTED INACCORDANCE WITH COMAR WWW "WELL CONSTRUCTION" ANDIN CONFORMANCf WITH AU. CONDITIONS STATED IN THE ABOVECAUTIONED PERMIT. AND THAT THB INFORMATION PRESENTEDHEREIN IS ACCURATE AND COMPLETE TO THE BEST OF MYKNOWLEDGE
DRILLERS LIC. NO. i f
DRILLERS SIGNATURE(MUST MATCH SIGNATURE C
LIC. NO, i "-***
. -£<. — S
A D — i
N APPLICATION)
["- ' •— * j
. ~- j.'J — SITE SUPERVISOR (ilgn. of driller or journeymanresponsible for srtawork if different from permittee)
GROUTING RECORD Ves noWELL HAS BEEN GROUTED , fvl'1 iNlCircle Appropriate Box) L— 1 LLZI44 44TYPE OF GROUTING MATERIAL (Circle one)CEMENT Cj MJ BENTONITE CLAY B C
45 46 .;/ <& 46 .,NO. OF BAGS 5 NO. OF POUNDS ft- ^GALLONS OF WATER J> &DEPTH OF GROUT SEAL (to nearest foot)from O ft. to / 7 ft.
<fl TOP 52 54 BOTTOM 58I enter 0 if from surface )rfl«sina CASING RECORD
/ types \ le'T'fl >' n"/ insert \ 1 a 1 ' 1 ^ U1 appropriate I STEEr" CONCRETE
^ ^ X ~* ^MAlN Nominal diameter Total depth
CASING toP (main) casing of main casingTYPE (nearest inch)! (nearest foot)
60 61 S3 64 66 70
E OTHER CASING (if used)A diameter depth (feat)H Inch from toC t ii ii iAS1N , ,, ,,
snraen type SCREEN RECORDor open hole 1 o 1 T 1 1 D 1 p 1 1 U 1 f\ 1
( appropriat8\ ^ ^_, , BBONZE HOLE •
C 2 | I DEPTH (nearest ft.)
\?L 3.3 3«/'r > Y -*—— ————— =— Z ———— ———— =—— L ——————^8 9 11 15 17 21
" 23 24 26 30 32 36SC3R 38 39 41 45 47 51E , . f~\E SLOT SIZE 1 • 2 -~ 3 **NDIAMETER , U (NEARESTDP RHRPPN ^ ' INCH)
56 60from to
,.„•
GSAV6LPACK i ' / I i -~ 'IF WELL DRILLEDWAS ROWING WELL ———INSERT F IN BOX 68 68
MDE USE ONLY(NOT TO BE FILLED IN BY DRILLER)
T (E.R.O.S.) W Q
-•M 72
CAS?NG°PE INDICATOR fl R !^ I
p 1 o 1<M> | J |y ... 1 . .
PULPING TESTHOURS PUMPED (nearest hour)
8 9
PUMPING RATE (aal. per min.) *11 15
METHOD USED TOMEASURE PUMPING RATE ,
WATER LEVEL (distance from land surface)
BEFORE PUMPING ft17 20
WHEN PUMPING ft22 25
TYPE OF PUMP USED (for test)| A | air | p [ piston | T [ turbine
1 —— 1 1 —— 1 1 —— 1 otllefC centrifugal R rotary Q (describe27 27 27 batoW>
J jet 1 S 1 submersible27 27
PUMP INSTALLED m kDRILLER INSTALLED PUMP YES I V(CIRCLE) (YES or NO) ^IF DRILLER INSTALLS PUMP, THIS SECTIONMUST BE COMPLETED FOR ALL WELLS.TYPE OF PUMP INSTALLEDPLACE (A,C,J,P,R,S,T,O) 29INBOX29. .- . - ,.Tl..rit _- *CAPACITY: ' „_,* „GALLONS PER MINUTE • *« "& -v.-* S«i.: 4(to nearest gallon) 31 xPUMP HORSE POWER
. V "-j. ' 41 •PUMP COLUMN LENGTH W-'"-- '"*•*-> •-*(nearaat ft.) ,,.,;. ,
43 47CASING HEIGHT (circle appropriate box
S\ — ^ and enter casing height)Hvi above J
•49 1 LAND SURFACEu_i_,.. \ "^ o (n03r0st)- below) -•—— fnot)
49 ' 50 51
S LOCATION OF WELL ON LOTSHOW PERMANENT STRUCTURESAND INDICATE NOT LESS THANTWO DISTANCES(MEASUREMENTS TO WELL)
/ xy \
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I' OWNERDCNV<»»7 , , ..
MARYLAND DEPARTMENT OF THE ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION2500 BROENING HIGHWAY. BALTIMORE. MARYLAND 21224, (4101 631-3784
WATER WELL ABANDONMENT-SEALING REPORT FORM
^SUBMIT COPIES OF COMPLETED FORM TO: '..."..... . . , . " _ - . - -'-.- .COUNTY ENVIRONMENT AGENCY (contact MDE." WMA if address needed)WELL OWNER . . ' . .MDE. WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
DATE WELL ABANDONED: - /~ ' ' V.J.' ^ • imonth/dayiyearL
PERMIT NUMBER OF ABANDONED WELL (if any) ~£ ~~ p~ /
* PERMIT NUMBER OF REPLACEMENT WELL ' .
' t ' I i
PERSON ABANDONING WELL: ' ftW' LT / <Wl &/C? «a va WELL DRILLERS LICENSE NUMBER: _ ^______T> • I el r' ,- r_i ' CIRCLEfMwTj/MSD/MGD
OWNER'S NAME: £&/tJ*cJtW* r/ fej/tyie. ^=^——————
WELL LOCATION:/"» - /
COUNTY: L,<ZC.i I—NEAREST TOWN: foRTT O*-f>oSi'~tTAX MAP .=2.3 BLOCKSUBDIVISION: _____SECTION: __________ LOT:
MARYLAND GRID COORDINATESE /oS7
BOX NUMBER 000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
_____ DRILLED _____ JETTEDBORED/AUGUERED _____ HAND DUG
. OTHER (specify) _____________ . LOG OF SEALING MATERIAL
USE CODE:
. DOMESTIC _____ MUNICIPAL/PUBLIC
.IRRIGATION _____INDUSTRIAL
. TEST/OBSERVATION
TYPE OF CASING:
_____ STEEL X PLASTIC_____ CONCRETE _____ OTHER (specify)
SIZE OF CASING: /T INCHES IN DIAMETER
DEPTH OF WELL: /£? FEET DEEP
WAS ANY CASING REMOVED? _L_ YES _____'.' NO, .if ves, lenetn removed, in feet: _e
MATERIAL
WASvCAsiNG RIPPED OR PERFORATED? __ YES ,A NOn fu - • \. i
FEET
FROM TO
SIGNATURE"- MASTER WELL DRILLER X)R SUPERVISING SANITARIAN LICENSED CIRCLE ONE DATE• __ _>. . . . .- -- , .: - . - , , . , - --'."-
828 JULY 1993
\ 'ELL OU'NEI
AR3 12563
MARYLAND DEPARTMENT OF THE ENVIRONMENT, WATER MANAGEMENT ADMINISTRATION2500 BROENING HIGHWAY. BALTIMORE. MARYLAND 21224. (410) 631-3784
WATER WELL ABANDONMENT-SEALING REPORT FORM
SUBMIT COPIES OF COMPLETED FORM TO:* COUNTY ENVIRONMENT AGENCY (contact MDE. WMA if address needed)
WELL OWNERMDE. WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
DATE WELL ABANDONED "^ ^ ' -• _______ i month/day 'yean
* PERMIT NUMBER OF ABANDONED WELL (if any) ~-y f~ 3
* PERMIT NUMBER OF REPLACEMENT WELL
PERSON ABANDONING WELL: C-A /CJ f._ ,<d\ /ft-y y" WELL DRILLERS LICENSE NUMBER: ___CIRCLEC MWDy MSD / MOD
OWNER'S NAME:r - • • -
WELL LOCATION:
COUNTY; G?€. £>/ *——NEAREST TOWN:TAX MAP .3 BLOCKSUBDIVISION: _____SECTION: __________ LOT:
MARYLAND GRID COORDINATESE IO
BOX NUMBER 000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
_____ DRILLED _____ JETTEDBORED/AUGUERED _____ HAND DUGOTHER (specify) _____________ LOG OF SEALING MATERIAL
USE CODE:
. DOMESTIC _____ MUNICIPAL/PUBLICIRRIGATION _____ INDUSTRIAL
. TEST/OBSERVATION
TYPE OF CASING:
STEEL >v PLASTICCONCRETE _____ OTHER (specify)
SIZE OF CASING: rT INCHES IN DIAMETER
DEPTH OF WELL. *7 FEET DEEP
WAS ANY CASING REMOVED? K YES _________ NOif yes, length removed, in feet; "2-
* vWASQASING'RIPPED OR PERFORATED? _ YES v NO
j
MATERIALFEET
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U/J ,' '•-•' - _^~________________________^>3>2~_____' MWP^MSP ' MODSIGNATURE-MASTER WELL DRICLER OR SUPERVISING SANITARIAN LICENSE = CIRCLE ONE
DENV 828 JULY 1993
V, L,~~ u\\ XL-i. ... . . „ ...
AR3I256I*
MARYLAND DEPARTMENT OF THE ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION2500 BROENING HIGHWAY. BALTIMORE. MARYLAND 21224. (410) 631-3784 .
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WATER WELL ABANDONMENT-SEALING REPORT FORM*********************»****************************************«r***********************************«**4>*«
TJBMIT COPIES OF COMPLETED FORM TO:"' ". . ' \ " "• ~ ' '.COUNTY ENVIRONMENT AGENCY {contact MDE. WMA if address needed)WELL OWNERMDE. WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM '
DATE WELL ABANDONED: / 2" .VZ - 9"?________ . (.month/day/year)
* PERMIT NUMBER OF ABANDONED WELL (if any) 3"--'
* PERMIT NUMBER OF REPLACEMENT WELL
PERSON ABANDONING WELLS- -* / sT — ''eji *•!b-&T*i<iS~ WELL DRILLERS LICENSE NUMBER: _____________~£ I I £ I J CIRCLECMWp/MSD/MGD
OWNER'S NAME: QT / <s( 5" XL > faA f r> g S"fov>-«- —— ———————
WELL LOCATION:
COUNTY: -NEAREST TOWN: Po f f D'g. JT A V I if A n ^/ •«&« T5T /" V ^ "TAX MAP £5 BLOCK 2. ' PARCEL -(aSUBDIVISION:SECTION: ___________ LOT:
MARYLAND GRID COORDINATESP./(XT?
BOX NUMBER 000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
_____JETTEDBOTJETJ/AUGUERED _____ HAND DUGOTHER (specify)__________' . "' LOG OF SEALING MATERIAL
USE CODE:
. DOMESTIC _____ MUNICIPAL/PUBLIC
.IRRIGATION _____INDUSTRIALX TEST/OBSERVATION
TYPE OF CASING:
STEEL xV PLASTIC.CONCRETE _____ OTHER (specify)
SIZE OF CASING: "7 INCHES IN DIAMETER~l*2
DEPTH OF WELL: ( -s FEET DEEP
WAS ANY CASING REMOVED? _il YES ' ." " NOif yes, length removed, in feet: ~2- £ rI ^ V
AS CASING KIPPED OR PERFORATED? __ YES **' NO/AS CASIN<' \ U\
MATERIALFEET
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73TO
•' MWD./'MSD/MGD_________- FASTER WELL DRILLER OR SUPERVISING SANITARIAN LICENSE # cRCLE ONE DATE
\V 828 JULY 1993 "" - - . _ .
: \\'L11_ ' i\\ \'EI
flR3!2565
MARYLAND DLPXRIMhNT < >l- FHh fc.NMRONME.NT. \V ATER MANAGEMENT ADMISTSTRA F1ON2500 BROENING HIGHWAY. BALTIMORE. MARYLAND 21224. i410) 631-3784
W\TER WELL ABANDONMENT-SEALING REPORT FORM
SUBMIT COPIES OF COMPLETED FORM TOCOUNTY ENVIRONMENT AGENCY i contact MDE. WMA it' address needed)WELL OWNERMDE WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
DATE WELL ABANDONED ,' ~ ' 'J Z - *•' i month. dav,veari•
\ \\ 'PERMIT NUMBER OF ABANDONED WELL (if any) ~- ' —— ' —— - ——————————
* PERMIT NUMBER OF REPLACEMENT WELL I I i j^ —— i
* PERSON ABANDONING W£LLS -''1<*''/e->"' L ' <Ut>*SJ-*S' WELL DRILLERS LICENSE NUMBER: 2 2JL.
* OWNER'S NAME: /5R'( C.i yvie /-, £e.S (W1 •«
* WELL LOCATION: ^/ '/
COUNTY' L, <2C./i_NEAREST TOWN: fort C^-poS»i~TAX MAP 2L.1 BLOTK 3~' PARCEL^47SUBDIVISION: 'SECTION: LOT:
MARYLAND GRID COORDINATES
BOX NUMBER , ,,
* TYPE OF WELL BEING ABANDONED:
DRILLED JETTED.."y .. BORED/AUGUERED HAND DUG
OTHER rspecifyi
* USE CODE:
DOMESTIC MUNICIPAL/PUBLICIRRIGATION INDUSTRIAL
--]><. TEST/OBSERVATION
* TYPE OF CASING:
STFF.I. V PLASTICCONCRETE OTHER (specifvl
SI7P OF CASINC, ^J INCHES IN DIAMETER
DFPTH OF WFI L /JB FEET DEEP
WAS ANY CASIMO REMOVED? > YES NO
^ 1
WAS CASING RIPPED OR PERFORATED'? YES X! NO .„ .
CIRCLE: WI>/ MSD / MOD
000000
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LOG OF SEALING MATERIAL
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DENV 828 JULY I9Q?
AR3I2566
MARYLAND DEPARTMENT OF THE ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION-2500 BROEN'ING HIGHWAY.' BALTIMORE. .MARYLAND 21224. (410) 631-3784
»*****«»» *»•»**»**•»»-»»»»*»» »»»********»********»***»»**»******************•»•»*
\VATERWELLABANDONMENT-SEALINGREPORTFORM
SUBMIT COPIES OF COMPLETED FORM TO.- ,. . ' _ ..COUNTY 'ENVIRONMENT AGENCY icomact MDE. WMA if address needed)WELL OWNER . " ' - .; ; -•MDE. WATER MANAGEMENT ADMINISTRATION.. WELL PROGRAM
DATE WELL ABANDONED: 12 • ~2. i ~ tf :''______ (month/dayyear)
* PERMIT NUMBER OF ABANDONED WELL (if any) r"' I
* PERMIT NUMBER OF REPLACEMENT WELL
?' < t'hd&«<< WELL DRILLERS LICENSE NUMBER: 32-*PERSON ABANDONING WELLi-?^-^-?' < t'h&«<< WELL DRILLERS LICENSE NUMBER:D / , r- , CIRCLETMWg/ MSP / MOD
OWNER'S NAME: Of (^ fJ> ™< f~ / * S rane. ^=^ —— ——————/ ;WELL LOCATION:
COUNTY:NEAREST TOWN: Por~t~TAX MAP 3-3 BLOCKSUBDIVISION:SECTION: ____________ LOT:
MARYLAND GRID COORDINATES
BOX NUMBER 000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
X DRILLED ' JETTED_____ BORED/AUGUERED _____ HAND DUG_____ OTHER (specify) _____________ . - . - LOG OF SEALING MATERIAL
USE CODE:
. DOMESTIC _____ MUNICIPAL/PUBLIC
. IRRIGATION _____ INDUSTRIAL7< TEST/OBSERVATION
TYPE OF CASING:
' STEEL >• PLASTIC_____ CONCRETE _____ OTHER (specify)
SIZE OF CASING: / INCHES IN DIAMETER
DEPTH OF WELL: /7 O FEET DEEP
WAS ANY CASING REMOVED? _2__ YES _________ NOif yes. length removed, in feet: >~ -id •
-WAS CASING RIPPED OR PERFORATED? . __ YES ,-* NO~
MATERIALFEET
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.52- ("MWD/MSD/MGD
SIGNATURE-MASTER WELL-DRILLER OR SUPERVISING SANITARIAN LICENSED CIRCLE ONE DATE
8 2 8 JULY \99? ~ • ' ' ' " " " " - -
flR3!2567
M \R1L\ND DEPARTMENT OF THh ENVIRONMENT. \\ATER .MANAGEMENT ADMINISTRATION1500 BROENING HIGHWAY. BALTIMORE. MARYLAND 21224. (410) 631-3784
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WATER WELL ABANDONMENT-SEALING REPORT FORM
SUBMIT COPIES OF COMPLETED FORM TO:» COUNTY ENVIRONMENT AGENCY (contact MDE. WMA if address needed)
WELL OWNERMDE. WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
DATE WELL ABANDONED./"- '?-'"?¥_________ imonth,'dav/vear>
PERMIT NUMBER OF ABANDONED WELL (if any)
PERMIT NUMBER OF REPLACEMENT WELL
»7 - ••"""PERSON ABANDONING WELLiO ^ / - £•' &/b***J-K WELL DRILLERS LICENSE NUMBER: —__________
f) j L r . L. ' CIRCLE^'MWTTTIMSD/MGDOWNER'S NAME: /X /Uf -i H*t e Ft^
WELL LOCATION:
COUNTY:NEAREST TiTAXSUBDIVISION:SECTION: __________ LOT:
MARYLAND GRID COORDINATES „
BOX NUMBERN
000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
.......J*v DRILLEDBORED/AUGUERED
. __.. OTHER (specify)
USE CODE:
_____ DOMESTICIRRIGATION
>- TEST/OBSERVATION
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STEELCONCRETE
SI7.K OF CASING. 'T
DFPTH OF WELL ^ f3>
WAS ANY CASING REMOVEDif yes. length removed, in f
WAS, CASING RIPPED OR PER
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INCHES IN DIAMETER
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? > YES NOeet: 3 -£>f
tFORATED? YES >" NO
LOG OF SEALING MATERIAL
MATERIAL
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DENV 828 JULY I99?
AR3I2568
MARYLAND DEPARTMENT OJ.JHE "ENVIRONMENT. JVATER 'MANAGEMENT ADMINISTRATION2500 BROENTNG HIGHWAY. BALTIMORE". MARYLAND 21224. >4IU) 631-3784
"WATER WELL ABANDONMENT-SEALING REPORT FORM
.UBMtT COPIES OF COMPLETED FORM TO: . . . . ".. - ,COUNTY ENVIRONMENT AGENCY (contact MDE. WMA if address needed) •WELL OWNER : , ,.. . ; .. ^MDE. WATER MANAGEMENT ADMINISTRATION. WELL PROGRA^I
DATE WELL ABANDONED: . / P . ~ •' ~ "j ¥_______ i month/daw vear)
PERMIT NUMBER OF ABANDONED WELL (if any) -
PERMIT NUMBER OF REPLACEMENT WELL
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S*- 'g-S £• ' -rt&PERSON ABANDONING WELLS*- flurft- > /, / c- cy cxs* WELL DRILLERS LICENSE NUMBER:
OWNER'S NAME: DT>&<<&_I
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COUNTY:NEAREST TOWN: &><"fTAX MAP £3 BLOCKSUBDIVISION: ______SECTION: ___________ LOT:
MARYLAND GRID COORDINATES
BOX NUMBER 000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
DRILLED _____JETTEDBORED/AUGUERED _____. HAND DUG. OTHER (specify) ______' LOG OF'SEALING MATERIAL
USE CODE;
DOMESTIC _____ MUNICIPAL/PUBLICIRRIGATION _____ INDUSTRIAL
. TEST/OBSERVATION
TYPE OF CASING:
.STEEL r** PLASTIC
.CONCRETE _____ OTHER (specify)
SIZE OF CASING: <* INCHES IN DIAMETER
DEPTH OF WELL: 7- FEET DEEP
WAS ANY CASING REMOVED? 1. YES _________ NOif yes. length removed, in feet:
MATERIAL
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WAS CASING RIPPED OR PERFORATED? ___ YES __2 - NOn f> !\ ;' --T — — -' - '' "' ' -" - -^
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.MWDAMSD'MGD
SIGNATURE -MASTER1VELL DRILLER OR SUPERVISING SANITARIAN LICENSED CIRCLE ONE DATE•v
V 828 JULY 1993 ' ~~- - ~ ' ' . . . . ' " "
flR3!2569
'.1 \K1L\M) DEP \RTMENT < T THL ENVIRONMENT. \\ATER MANAGEMENT ADMINISTRATION
WATER WELL ABANDONMENT -SEALING REPORT FORM
SUBMIT COPIES OF COMPLETED FORM TOCOUNTY ENVIRONMENT AGENCY icomacl MDE, V.MA if address needed)WELL OWNERMDE. W ATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
DATE WELL \BANDONCD . .• - ^ " '' i month, dav veuri
! M ! r-! IPERMIT NUMBER OF ABANDONED WELL MI an\> --/: ———————— •• — ——— : —— : —— ; ————————
PERMIT NUMBER OF REPLACEMENT WELL ! L 1 • — iPERSON ABANDONING WELL:C foY/<ZS [- / £_/1i.//>ev-Ve_'"' WELL DRILLERS LICENSE NUMRFR: 35*—
* OWNER'S NAME: fiAl cl<m iTtmii, /~ / / eoTlrvi -C.
* WELL LOCATION: r
COUNTY: C €,<t.lL.NEAREST TOWN: p^ri~ T e.poSli~TAX MAP 13 BLOCK £L ' PARCEL 4>7SUBDIVISION:SECTION: LOT:
MARYLAND GRID COORDINATES
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* TYPE OF WELL BEING ABANDONED:
^ DRILLED JETTED__ _. _ _ BORED/AUGUERED HAND DUG
... ._ OTHER ispecilvi
* USE CODE:
.DOMESTIC MUNICIPAL/PUBLIC___ _ IRRIGATION INDUSTRIALX TEST/OBSERVATION
* TYPE OF CASING:
STEEL X PLASTIC_ . ... CONCRETE OTHER i specifv)
\tSI7F. OF CASING C^ INCHF.S IN DIAMETER
DF.PTH OF WHI.L. *7 -S FEF.T DEEP
* WAS ANY CASING REMOVED' X YES NOit vcs. leneih removed, in r'ect: *i- -fa~
WAS CASING RIPPED OR PERFORATED? YES NO . ._,.
CIRCLE:(TvlWD/ MSP / MOD
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SIGN \rURll-M.\STr.R \\ ELL DRILLER OR SL'PER\ ISINCi SANITARIAN LICENSE -~ CIRCLE ONE
DENV SZS JULY
QR3I2570
MARYLAND DEPARTMtiNL <JF THE ENVIRONMENT. \\ATER MANAGEMENT ADMINISTRATION2500'BRDENING HIGHWAY. BALTIMORE-MARYLAND 2\224. [410) 631-3784
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DATE WELL ABANDONED: ..' 2~ ' -*- ' ""' * ________ I month/ day; v ear)
PERMIT NUMBER OF ABANDONED WELL (if any]
PERMIT NUMBER OF REPLACEMENT WELL
PERSON ABANDONING WELblJtit*''/ £~ii.ljZ/b **" WELL DRILLERS LICENSE NUMBER:/ CIRCLE^ MW,5 / MSP / MOD
OWNER'S NAME:,d r -"••" <"-*" -" *" ' " " v '——<=
WELL LOCATION:
COUNTY:NEAREST TOWN: 7^ psip&Si fc______TAX MAP P>3 BLOCK ZL J PARCEL 2JeJ-SUBDIVISION: _______________________SECTION: ___________ LOT:
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BOX NUMBER 000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
. DRILLED _____. JETTEDBORED/AUGUERED _____ HAND DUGOTHER lspecify) __________ . ... . ' " •-' LOG OF SEALING MATERIAL
USE CODE:
. DOMESTIC _____ MUNICIPAL/PUBLICIRRIGATION _____INDUSTRIAL
. TEST/OBSERVATION
TYPE OF CASING:
.STEEL X PLASTIC
. CONCRETE _____ OTHER (specify)
SIZE OF CASING: _____ INCHES IN DIAMETER
DEPTH OF WELL: ^ T FEET DEEP
WAS ANY CASING REMOVED? >__ YF5; ...;.. . - NOif yes. lenath removed, in feet: 1 'C-'T
.••" tWAS'.CASING RIPPED OR PERFORATED?,__ YES ____X. NO
MATERIALFEET
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_________ / ! t. ' : ' "" — " ____________ j - — -MWp/MSD'MGD' '~ C--~ '-/SIGNATCRF:-MASTER WELL DRILLER OR SUPERVISING SANITARIAN LICENSE .=. CIRCLE ONE DATE
\ 828 JULY 1993 ~" ...'''.'. --'-
AR3I257
MAR'1 L \\D DEPARTMENT OF THE ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION 1:500 BROENING HIGHWAY. BALTIMORE. MARYLAND 21224. i4 I O > 631-3784 •
\\ATER WELL ABANDONMENT -SEALING REPORT FORM
SUBMIT COPIES OF COMPLETED FORM TOCOUNTY ENVIRONMENT AGENCY n.-omaa MDE. \VMA if address needed)WELL OWNERMDL, WATER M \NAGEMEXT ADMINISTRATION. WELL PROGRAM
DATE WELL ABANDONED. -~~ - •" ' ~* * . month/day, vean
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PERMIT NUMBER OF ABANDONED WELL nt any>_ ~rZ.- ; ' —— ' —— '- ————————————————
* PERMIT NUMBER OF REPLACEMENT WELL j —— 1 j —— I
PERSON ABANDONING WELL - ' / -J /- •' <•/? C/ bv «f **' WELL DRILLERS LICENSE NUMBER: 3?*~~
OWNER'S NAME:/5^WVtJy/Wie- " I ACJ^vte.
* WELL LOCATION:/"3 /? , /
COUNTY- {-£{-'(—NEAREST TOWN: f # r~t i)&f#-S f~tTAX MAP J2 3 BLOCK ' PARCEL J "?stmnivrstON:SECTION: LOT:
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BOX NUMBER cN 4>5''7
* TYPE OF WELL BEING ABANDONED:
r>4 DRILLED JPTTF.DBOREn/At:nuERF.D HAND DUG
,,,, OTHER Kpecifvi
* USE CODE:
DOMFJ5TIC MUNICIPAL/PUBLICIRRIGATION INDUSTRIAL
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* TYPE OF CASING.
STEEL X PLASTICCONCRETE OTHER (specifvl
/ "SI7F OF CASING / INCHES IN DIAMETER
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WAS ANY CASING REMOVED1 \ YFS NOif veq. it-noih removed in feet- >-^c^r-
tWAS TASING Rtpppn OR PERFORATED? YES -< NO . ,
CIRCLETT ET/ MSD / MGD
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AR3I2572
MARYLAND DEPARTMENT OF THE ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION-2500 BROENTNG HIGHWAY. BALTIMORE. MARYLAND 21224. i4lO) 631-3784
WATER WELL ABANDONMENT-SEALING REPORT FORM
UBMIT COPIES OF COMPLETED FORM TO: ' .. . . . . * . . ..-SUBMIT«nCOUNTY ENVIRONMENT AGENCY' (contact MDE. WMA if address needed)WELL OWNER . -MDE. WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
DATE WELL ABANDONED:,--- - •' ' r ______ .imonth/dayyean
. PERMIT NUMBER OF ABANDONED WELL lit' any) I"~ ~ _
* PERMIT NUMBER OF REPLACEMENT WELL
• I / r , 1 CIRCLE:CMWJ3/MSD/MGDOWNER'S NAME/5"^/ a f g fev-c: t, A C > /-gyve.
PERSON ABANDONING WELL: ' '** /c<-' t- '~*CJ'v-r f WELL DRILLERS LICENSE NUMBER:/t f
WELL LOCATION:
*,LCOUNTY:NEAREST TOWN: , - • , ^ • - • __________TAX MAP Q^_ BLOCK d. PARCEL "7SUBDIVISION:SECTION: ___________ LOT:
MARYLAND GRID COORDINATES _,
BOX NUMBER 000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
. DRILLED ' JETTED
. BORED/AUGUERED ______HAND DUG
. OTHER (specify) _____________ LOG OF SEALING MATERIAL
-USE CODE: FEET
. DOMESTIC • MUNICIPAL/PUBLIC
. IRRIGATION _____ INDUSTRIAL
. TEST/OBSERVATION
TYPE OF CASING:
.STEEL X PLASTIC
.CONCRETE _____OTHER (specify)
SIZE OF CASING: _J_____ INCHES IN DIAMETER
DEPTH OF WELL: %'/ FEET DEEP
MATERIALFROM TO
WAS ANY CASING REMOVED? " '_YES__ NO .if ves. lensth removed, in feet: '<*• - - ~-
ItWAS CASINGrRTp'PED OR PERFORATED? ___ YES >-; NO
.. - j ,'." AJ
_CjvIWD>MSD'MGD
SIGNATURE-MASTER WELL DRILLER OR SUPERVISING SANITARIAN" " LICENSE f= CIRCLE ONE DATE
V 828 JULY 1993 - . - " • ------ . '
AR3I2573
»IAKti_,\MJ UtPAKIMLM OH I Hh t.NV IRUNMEN T. WATER MA.YAGEME2500 BROENING HIGHWAY, BALTIMORE. MARYLAND 21224. i41
XT ADMINISTRATION0) 631-3784
WATER WELL ABANDONMENT -SEALING REPORT FORM
SUBMIT COPIES OF COMPLETED FORM TOCOUNTY ENVIRONMENT AGENCY icomua MDE. WMA if address needed)WELL OWNERMDI: WATER MANAGEMENT ADMINISTRATION, WELL PROGRAM
DATF. WELL ABANDONED ' <-' •*>-**' i month, dav vean•
!— 1 —1PERMIT NUMBER OF ABANDONED WELL [if any.ij r- 3 ' ————— ' ————— ' ———————— ' ~ l —— i ——
PERMIT NUMBER OF REPLACEMENT WELL 1
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* PERSON ABANDONING WELL:1- *'/ /- 1 <^bd iyeSf-'' WELL DRILLERS LICENSE NUMBER: •"•?> —~* /
* OWNER'S HkME-£)£ie*6&gfvn-C /£='/g.*2S-f**H&.
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MARYLAND GRID COORDINATES
BOX NUMBER . <
* TYPE OF WELL BEING ABANDONED:
%- DRILLED JETTEDBORED/AUGUERED HAND DUGOTHER .specify^
* USE CODE:
DOMESTIC MUNICIPAL/PUBLIC. . . .. IRRIGATION INDUSTRIAL_>%._ TEST/OBSERVATION
* TYPE OF CASING:
__..._._......... STEEL X- PLASTICCONCRETE OTHER fspecifVl
* SI7E OF CASING / INCHES IN DIAMETER
DEPTH OF WELL. 77 FEET DEEP
WAS ANY CASING REMOVED1 ; YES . NO
WAS CASING RIPPED OR PERFORATED1 __ YES X NO
CIRCLE:(MWDVMSD/MGD
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SHOW WELL LOCATION HHBY X WITHIN BOX ^J
LOG OF SEALING MATERIAL 1
FEETMATERIAL
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1
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CMWLVMSD/MGD " / " -'"'/JSIGNATURE-MASTER WELL DRILLER .OR SUPERVISING SANITARIAN LICENSE = CIRCLE ONE DATE
DENV 828 JULY I1W?
A R 3 I 2 5 7 L +
MARYLAND.DEPARTMENT OF THE ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION2500 BROENING HIGHWAY. BALTIMORE. MARYLAND 21224. (410) 631-3784
WATER WELL ABANDONMENT-SEALING REPORT FORM
SUBMIT COPIES OF COMPLETED FORM TO: 4_ .... ..............COUNTY ENVIRONMENT AGENCY (contact MDE. WMA it' address needed)WELL OWNER .. .-MDE. WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
DATE WELL ABANDONED: / > ' *-~' '.'£________ imonth/dav/vear)
PERMIT NUMBER OF ABANDONED WELL (if any) jTT~ZL~'
PERMIT NUMBER OF REPLACEMENT WELL
./"}-',' <— . /,PERSON ABANDONING WELL:-—-f)c4f/ Cl£Si<£Ab&SS&S WELL DRILLERS LICENSE NUMBER: ^_r~_______
-2 . f- . J CIRCLE:(MWJ>/ MSP/ MODOWNER'S NAME: ' f~ ' fJ~' ' *-» "- - - ——
WELL LOCATION:
COUNTY: C>£g- 4 L.NEAREST TOWN: fartTAX MAP ,?3 BLOCK :£T PARCELSUBDIVISION:SECTION: ___________ LOT:
MARYLAND GRJD COORDINATES „
BOX NUMBERN
000000
MATERIALFEET
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
7< DRILLED _____ JETTED_____ BORED/AUGUERED _____ HAND DUG______OTHER (specify) ___________ ...... ... - . LOG OF SEALING MATERIAL
USE CODE:
_____DOMESTIC ;_____MUNICIPAL/PUBLIC_____ IRRIGATION _____ INDUSTRIALXT TEST/OBSERVATION
TYPE OF CASING;
_____ STEEL X PLASTIC_____ CONCRETE _____ OTHER (specify)
//SIZE OF CASING: _L______ INCHES IN DIAMETER
DEPTH OF WELL: ^° FEET DEEP
WAS ANY CASING REMOVED? _2I_ YES
FROM TO
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WAS CASING RIPPED OR PERFORATED? __ YES .:.->£ NO/% fi ;\ ;
- Z6 -SIGNATURE-MASTER \\'ELL DRILLER OR SUPERVISING SANITARIAN LICENSE # CIRCLE ONE DATE
I \ . _ - -
8 2 8 JULY 1993 ' — ^ . . . .
SR3I2575
MARYLAND DEPARTMENT OF THE ENVIRONMENT, WATER MANAGEMENT ADMINISTRATION25m BROENING HIGHWAY. BALTIMORE. MARYLAND 21224. i410) 631-3784
V\ -\TER WELL ABANDONMENT-SEALING REPORT FORM
SUBMIT COPIES_OF COMPLETED FORM TO. COUNTY ENVIRONMENT AGENCY i contact MDE. WMA it' address needed)
WELL OWNERMDE. WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
DATE WELL ABANDONED •'' ~ '>••-'? _______ imonth/'da> yean
PERMIT NUMBER OF ABANDONED WELL (if any) JX" TZ-~->"
PERMIT NUMBER OF REPLACEMENT WELL —— j——j
•/1 ' ' /— J.PERSON ABANDONING WELLH -J' >~< ?1 £.( besj~S WELL DRILLERS LICENSE NUMBER:
2 .- /. , J r~~ * _, J . 'OWNER'S NAME
WELL
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2 . I I r" „ .L ' CIRCLECMWD./IMSD/MGDl.tj£/a(f£3ri™<* If £-3Tyv>-g. •-
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MARYLAND GRID COORDINATESE/<2£
BOX NUMBER 000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
, DRILLED _____ JETTED, BORED/AUGUERED _____ HAND DUG, OTHER (specify) _____________ LOG OF SEALING MATERIAL
USE CODE:
. DOMESTIC _____ MUNICIPAL/PUBLIC, IRRIGATION _____ INDUSTRIAL. TEST/OBSERVATION
TYPE OF CASING;
.STEEL X. PLASTIC
. CONCRETE _____ OTHER (specify)
/'SIZE OF CASING. / INCHES IN DIAMETER
DEPTH OF WELL. V7 FEET DEEP
WAS ANY CASING REMOVED1 _^ YES^________ NOif yes. length removed, in feet: _^T
MATERIAL
WAS .CASING RIPPED OR PERFORATED1 __ YES > NO
FEET
FROM TO
0
SIGNATURES-MASTER WELL DRILLER OR SUPERVISING SANITARIAN LICENSE # CIRCLE ONE
DENV 328 JULY 199?
AR3I2576
MARYLAND DEPARTMENT OF THE ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION2500 BRQEMNG HIGHWAY. BALTIMORE. MARYXAND 21224. (410) 631-3784
WATER WELL ABANDONMENT-SEALING REPORT FORM
SUBMIT COPIES OF COMPLETED FORM TO: "T ~_ . . ,, •=,COUNTY ENVIRONMENT AGENCY icontact MDE. WMA if address needed)WELL OWNER ' • ...--.MDE. WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
[month/day -year)DATE WELL ABANDONED:../•?•' -^ >-t/X/
* PERMIT NUMBER OF ABANDONED WELL (if any)
* PERMIT NUMBER OF REPLACEMENT WELL
* PERSON ABANDONING WELLw/7 gfrVg. •? L- / ft cJ&SS **^ WELL DRILLERS LICENSE NUMBER:"D . I _ r~ - / J CIRCLEkMWg/MSD/MGDOWNER'S ————
WELL LOCATION:
COUNTY:NEAREST TOWN
_: f3fr1~
TAX MAP -3.3 BLOCK 3- PARCELSUBDIVISION:SECTION: __________ LOT:
MARYLAND GRID COORDINATESE.
BOX NUMBER 000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
DRILLED _____ JETTED. BORED/AUGUERED _____ HAND DUGOTHER (specify) ________' . . - LOG OF SEALING MATERIAL
USE CODE:
. DOMESTIC _____ MUNICIPAL/PUBLIC
. IRRIGATION _____ INDUSTRIAL
.TEST/OBSERVATION
TYPE OF CASING:
STEEL "*• PLASTICCONCRETE ___^_ OTHER (specify)
n ———————————————SIZE OF CASING :__J _____ INCHES IN DIAMETER
DEPTH OF WELL: FEET DEEP
* WAS ANY CASING REMOVED'^ \2^ YES __________ NOif ves, ienath removed, in feet: ' •-£1 .V
WAS CASING RIPPED .OR PERFORATED?" __ YES ,K. NO
MATERIALFEET
FROMO
TO
SIGNATURE-MASTER WELL DRILDER OR SUPERVISING SANITARIAN LICENSED ' CIRCLE ONE DATE
828 JULY 1993 ' -- ' , " . - " . - - • • -
AR3l'2577
MARYLAND DEPARTMENT OF THE ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION:SUO BROENING HIGHWAY . BALTIMORE. MARYLAND 21224. i4IOi 631-3784
f************************************************************************-*'*'*'*'*-*-'
W.\TER WELL ABANDONMENT-SEALING REPORT FORM
SUBMIT COPIES_QF COMPLETED FORM TO," "" COUNTY ENVIRONMENT AGENCY i contact SIDE. WMA n address needed)* WELL OWNER
MDE, WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
DATE WELL ABANDONED .' .- ' ? 2 ' Cl ?_______ i month/day-year)
* PERMIT NUMBER OF ABANDONED WELL (it any) 0 "3
PERMIT NUMBER OF REPLACEMENT WELL id.PERSON ABANDONING WELLJU^ T cS t~ / C -iZ/Q&r-riS" WELL DRILLERS LICENSE NUMBER:
;? , / / /- , / / CIRCLErMWDy MSP / MODOWNER'S NAME: fif?># <* e.5?S*-g /V*e3yvn£. V3=31————————
WELL LOCATION:
COUNTY:NEAREST TOWN: PtrTJ-TAX KXAP _?, Rrrw-vSUBDIVISION:SECTION: __________ LOT;
MARYLAND GRID COORDINATE
BOX NUMBER 000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
DRILLED _____ JETTEDBORED/AUGUERED _____ HAND DUGOTHER (specify) _____________ LOG OF SEALING MATERIAL
USE CODE:
DOMESTIC _____ MUNICIPAL/PUBLICIRRIGATION _____ INDUSTRIAL
, TEST/OBSERVATION
TYPE OF CASING:
, STEEL •?*• PLASTIC, CONCRETE _____ OTHER (specify)
SIZE OF CASING._J______ INCHES IN DIAMETER
DEPTH OF WELL 0- % FEET DEEP
WAS ANY CASING REMOVED.1 _2L YES ________ NOif ves. length removed, in feet; 3--&T
' i . . IWAS CASING RIPPED OR PERFORATED" __ YES /^ NO
MATERIALFEET
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' MSP/ MGDSIGN VTL'RE-MASTER WELL DRILLER OR SUPERVISING SANITARIAN LICENSE = CIRCLE ONE
DENV 328 JULY 199?
AR3I2578
MARYLAND DEPARTMENT OF.THE ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION:500 BROENING HIGHWAY. BALTIMORE. .MARYLAND 21224. (410) 631-3784
^************************************************T**********^*^***'** + **'ic1['tHr')titH
WATER WELL ABANDONMENT-SEALING REPORT FORM
_SUBMIT COPIES OF COMPLETED FORM,TO: . . . ,! ' - ' -COUNTY ENVIRONMENT AGENCY icomuct MDE. WMA if adorer needed)WELL OWNERMDE. WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
DATE WELL ABANDONED: /— -'.-"='.-^ ' ; unonth/da> year)
* ' PERMIT NUMBER OF ABANDONED WELL (if any) f 02 'A
* PERMIT NUMBER OF REPLACEMENT WELL \
/? ' , / ,. r~PERSON ABANDONING WELL: /? "/ ^ £T / /"/gJ ys WELL DRILLERS LICENSE NUMBER:
_ _ CIRCLE(1vl D/MSD/MGDOWNER'S rWELL LOCATION:
COUNTY:NEAREST TOWN:TAX MAP - BLOCKSUBDIVISION:SECTION: __________ LOT:
MARYLAND GRID COORDINATES
BOX NUMBER N 000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
^ DRILLED ______ JETTED_____ BORED/AUGUERED _____ HAND DUG_____ OTHER (specify) _______' " " ' . . . . . LOG OF SEALING MATERIAL
USE CODE:
.DOMESTIC _____MUNICIPAL/PUBLIC
. IRRIGATION _____ INDUSTRIAL
. TEST/OBSERVATION
TYPE OF CASING:
STEEL PLASTICCONCRETE OTHER (specify)
SIZE OF CASING: 'J INCHES IN DIAMETER
DEPTH OF WELL: ^ 0 FEET DEEP -
WAS ANY CASING REMOVED? A— YES. - NOif yes. leneth removed, in feet: "3-
MATERIAL
_WAS CASING RIPPED OR PERFORATED? __ YES .-^ NO
FEET
FROM TO
MWD/JMSD'MGD_______ _SIGNATURE-MASTER WELL DRILLER OR SUPERVISING SANITARIAN LICENSE = CIRCLE ONE DATE
iV 828 JULY 1993 — '•' - • -- . . - . - • • -
AR3I2579
\I\K1LA\D DEPARTMENT uF THL LNVTROSMENT. WATER MANAGEMENT ADMINISTRATION:*OU BROENING HIGHWAY. BALTIMORE. MARYLAND 21224. (410) (331-3784
Vv ATER WELL ABANDONMENT-SEALING REPORT FORM
SUBMIT COPIES OF COMPLETED FORM TOCOUNTY ENVIRONMENT AGENCY icomact MDE. WMA if address needed)WELL OWNERMDL:. WATER MANAGEMENT ADMINISTRATION. WELL PROGRAM
- - ? -» Q ,DATE WELL ABANDONED • *~ •* . " ' imm«h;H:w.ve:iri
•j 1
1 iPERMIT NUMBER OF ABANDONED WELL (if any) {Of- A ' —— —— L ————————— ;
* PERMIT NUMBER OF REPLACEMENT WELL
* PERSON ABANDONING WELL**-'/' *'7<%r £- ' ~e/fyr*3 «*"' WELL DRILLERS LICENSE NUMBER: Z???*
OWNER'S NAME: / CLSavte FS A SfvYt-ei* WELL LOCATION:
COUNTY: C- £&•/*-NEARESTTOWN: .. . Mrff~ Q+paft'tTAX MAP 23 BLOCK ,2- t PARCEL i6 JSUBDIVISION:SECTION: LOT:
MARYLAND GRID COORDINATES
BOX NUMBER . <
* TYPE OF WELL BEING ABANDONED:
__ X- DRILLED JETTED_ ...... . BORED/AL'GUERED HAND DUG
OTHER (specify^
* USE CODE:
DOMESTIC MUNICIPAL/PUBLIC_.._............... IRRIGATION INDUSTRIAL
" TEST/OBSERVATION
* TYPE OF CASING:
STEEL X" PLASTIC___ CONCRETE OTHER (specif
* SIZE OF CASING. 'T INCHES IN DIAMETER
I1FPTM OF WFM &£- FFFT DFFP
WAS ANY CASING REMOVED' *• YES NOit vfs len^lh removed, jn feet- ?~*4 < -a
WAS OAStNC, RIPPFD OR PFRFORATFD? YFS X- NO . , , . .
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LOG OF SEALING MATERIAL
FEETMATERIAL
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SIGNATUKE*MASTER \\ELL DRIDLER OR SUPERVISING SANITARIAN LICENSE = CIRCLE ONE DATDCNV 823 JULY 1993 —•'
MAKiLA.NU UtRAKlMh.N I Ur i Hh ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION2500 BROE.NING HIGHWAY. BALTIMORE. MARYLAND 21224. (410) 631-3784
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WATER WELL ABANDONMENT-SEALING REPORT FORM
SUBMIT COPIES OF COMPLETED FORM TO: ~ - ... . . . . . . . .COUNTY ENVIRONMENT AGENCY (contact MDE. \VM.A it' address neededi
' WELL OWNER . - . . . . -MDE. WATER MANAGEMENT ADMINISTRAtlON. WELL PROGRAM
DATE WELL ABANDONED: ,• >.' ' >~~ f '________ (month/day/year)
PERMIT NUMBER OF ABANDONED WELL (if any) / O 1' A
* PERMIT NUMBER OF REPLACEMENT WELL
PERSON ABANDONING WELL: W"> *Wtf J, L «LS\ <-//}£**, *S WELL DRILLERS LICENSE NUMBER:^
OWNER'S NAME:
WELL LOCATION: '
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COUNTY:NEAREST TOWN: .____TAX MAP 2-3 BLQCK^' / PARCEL 26 7SUBDIVISION:SECTION: ___________ LOT:
MARYLAND GRID COORDINATES _fE .
BOX NUMBER-f- -
000000
TYPE OF WELL BEING ABANDONED: SHOW WELL LOCATIONBY X WITHIN BOX
" DRILLED ______ JETTEDBORED/AUGUERED _____ HAND DUGOTHER (specify) _____________ . , . - . . . LOG OF SEALING MATERIAL
USE CODE:
. DOMESTIC _____ MUNICIPAL/PUBLIC
. IRRIGATION _____ INDUSTRIAL
. TEST/OBSERVATION
TYPE OF CASING:
STEEL ,X PLASTICCONCRETE OTHER (specify)
SIZE OF CASING: / _____ INCHES IN DIAMETER
DEPTH OF WELL: 7 ' FEET DEEP
WA.S ANY CASING RFMOVFD'.' X YES NOif yes. lenath removed, in feet: 2- T__ .
- - - t 'WAS CASING RIPPED OR PERFORATED? __ YES X- N'O
MATERIALFEET
FROM TO
SIGNATURE-MASTER WELL DRILLER OR SUPERVISING SANITARIAN LICENSED CIRCLE ONE DATE
\ 828 JULY 1993 ~ ' '
AR3I258I
MARYLAND DEPARTMENT OF THE ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION2500 BROENING HIGHWAY, BALTIMORE. MARYLAND 21224, (410) 631-3784
1WATER WELL ABANDONMENT-SEALING REPORT FORM
SUBMIT COPIES OF COMPLETED FORM TO. ^^*
*
*
DATE
it
*
*
*
*
*
*
*
COUNTY ENVIRONMENT AGENCY (contact MDE. WM,WELL OWNERMDE. WATER MANAGEMENT ADMINISTRATION. WE
WELL ABANDONED: •' :2 - Z 3 " " P ,r
PERMIT NUMBER OF ABANDONED WELL fif any) / J
PERMIT NUMBER OF REPLACEMENT WELL
PERSON ABANDONING WELL: v?// .'..-_"• - ' "^^
OWNER'S NAME;D£? • J «- :Aj* '.„ ~ •' K CT/rn .
WELL LOCATION:COUNTY: . rT."f_/i-NEAREST TOWN: fat £)« >c Sf /TAX MAP 3 3 BLOCK^ / PARCEL 2,6/7SUBDIVISION:SECTION: LOT:NEAREST ROAD:
MARYLAND GRID COORDINATESR/6.T7
BOX NUMBER
TYPE OF WELL BEING ABANDONED:
J>C DRIFTED JETTED. , . . . , . BORED/AI rnUERF.D HAND DUG
OTHER fSp«i<y)
\ if address needed) ^ f
LL PROGRAM
nonth/day/year)
/'£
/ f . — -- __0* — ' WELL DRILLERS LICENSE NUMBER: 2*-
»-•
USE CODE:
DOMESTIC MUNTCIPAIJPUBLICIRRinATTON INDUSTRIAL
_..... TEST/OBSERVATION
TYPE OF CASING:
_ , _ STEEL "^ PLASTICCONCRETE OTHER fspecify)
SIZE OF CASING. " INCHES IN DIAMETER
DEPTH OF WELL; •' — FEET DEEP
WAS ANY CASING REMOVED? *. YESif vcs, Icns'h r^mivml, in fceti ^ ' '
WAS CASING RIPPED OR PERFORATED? YES
NO
NQ
CIRCLEf MWD/MSD/MGD
000000 JB^SHOW WELL LOCATION BBY X WITHIN BOX ^^
LOG OF SEALING MATERIAL
FEETMATERIAL
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CMWP/MSD/MGD / " ~2-~C' ~~ '' ?SIGNATURE-MASTER WELL DRILLER OR SUPERVISING SANITARI fl R 3 j 2 5 8 2DENV 828 JULY 1993 j, WELL OWNER