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.

AR3I2549

Eric NewmanARCADIS GERAGHTY&MILLER 20 January 1999

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

2/7

AR3I2550

.n-.p,.^ - - - - . . ' . - - . - Eric NewmanARCADiSGERAGHTY&MILLER .. - -- 20 January 1999

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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R J I 2 5 5 I

Eric NewmanARCADIS GERAGHTY&MILLER 20 January 1999

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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AR312552

An/-Anir Eric NewmanARCADISGERAGHTY&MILLER . 20 January 1999

• 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

. 5/7

JR3 12553

»n<~»i^,r- Eric NewmanARCADIS GERAGHTY& MILLER 20 January 1999

• 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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AR3I2551*

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.

,7/7\\palsrv1\data\aproject\bridgestone\progrep\annual report 98.doc . . - AR3I2555

ARCADIS GERAGHTY& MILLER

Appendix A

Well Permits and Well Abandonment Forms

AR3I2556

/./5854 SEQUENCE NO.

(DP USE ONLY)

(THIS NUMBER IS TO BE PUNCHEDIN COLS. 3-6 ON ALL CARDS)

STATE OF MARYLANDAPPLICATION FOR PERMIT TO DRILL WELL

please print or type

STATE PERMIT NUMBER

C E - 9,4 ~\ 21 91 5101' fill in this form completely7

Date Received (APA)\Q\%\ OWNER INFORMATION

Last tamcr

Street or RH

T

f-

/LyZip

55

I Wl ~ -DRILLER INFORMATION f MSD/MGfj(MWg7./? £ *•"/<£. <i h-tc./\eilt4r<f&S_____fol-3 13 fc -j

filler s Name _ / 77 License No. SO£- _, I.

^————'————^^————————'—————'————'—————'————'————— T.———— -——— "~ L ——————Firm Name j fI,, /7 /Vl-:A <-/ (gjr; X-.Q xc/ /• '''/g- f /*•« rc >w(Addrtis ^ ~~ y

i '. ; (• «-'i ?(.•.'

Signature ______ "s ____ Dalefl 2~

WELL INFORMATIONAPPROX. PUMPING RATE (GAL. PER MIN.) | | | | f ] A,/y LT< >s < "T1 DISTANCE FROM ROAD

__,, . ,__ ENTER FT OR MlAVERAGE DAILY QUANTITY NEEDED(GAL. PER DAY)

20USE FOR WATER (CIRCLE APPROPRIATE BOX)

| D ) HOME (SINGLE OR DOUBLE HOUSEHOLD UNIT ONLY) HEALTH DEPARTMENT APPROVALCecilFARMING (LIVESTOCK WATERING & AGRICULTURAL

L_l IRRIGATION)INDUSTRIAL. COMMERCIAL, STATE AND FEDERAL GOV.

22 I—J OTHER (REQUIRES APPROPRIATION PERMIT)PUBLIC OR PRIVATE WATER COMPANY (REQUIRES

P | APPROPRIATION PERMIT AND STATE HEALTH DEPARTMENTAPPROVAL)iTEST, OBSERVATION, MONITORING (MAY REQUIREAPPROPRIATION PERMIT)T

e 3 LOCATION OF WELL

\G\L-\<L\rU I I I I I I I I M W 111B8 COUNTY__________ 21

23 SUBDIVISION 42

SECTION I I I I LOTl I I I

IQIfl Plate tern52 NEAREST TOWN • _________ 71

MILES FflOM TOWN (enter 0 if in town) M

DIRECTION OF WELL FROMTOWN (CIRCLE BOX)

NORTH

ON WHICH SIDE OF ROAD(CIRCLE APPROPRIATE BOX)

NEAR WHAT ROAD

TAX MAP: at""? BLK:K: <5\NOT TO BE FILLED IN BY DRILLER

COUNTY NAME COUNTY NO.STATESIGNATURE _________________________' INSERT S

DATE ISSUED12043NORTHGRID

798

'-i12-06-99

CO SIGNATURE ' EXP. DATE00 EAST

GRID50_____r_______5S__________57_______/________93

APPROXIMATE DEPTH OF WELL I I I / I(J I C>l FEET

r-

SHOW MAJOR FEATURES OFBOX & LOCATE WELL ______WITH AN XSOURCES OF DRILLING WATER

APPROXIMATE DIAMETER OF WELL .2.

METHOD OF DRILLING (circio one) a

3037 *

BORED (or Augered) JETTED Jetted & DRIVENAIR-PERcu38ion ROTARY (Hydraulic Rotary)

CABLE REVerse-ROTarv DRive-POINT

other ________________________'.________:———

WRITE THE BOX NUMBERFROM THE MAP HERE

REPLACEMENT OR DEEPENED WELLS(CIRCLE APPROPRIATE BOX)

THIS WELL WILL NOT REPLACE AN EXISTING WELLTHIS WELL WILL REPLACE A WELL THAT WILL BEABANDONED AND SEALEDTHIS WELL WILL REPLACE A WELL THAT WILL BE USED ASA STANDBY-CONTACT LOCAL APPROVING AUTHORITY FOR .POLICY ON STANDBY WELLSTHIS WELL WILL DEEPEN AN EXISTING WELL

PERMIT NUMBER OF WELL TO BE REPLACED OR DEEPENED(IF AVAILABLE) 4, I——I——I——r~1——I——I———————f— 52

000OOP

DRAW A SKETCH BELOW SHOWING LOCATION OF WELL INRELATION TO NEARBY TOWNS AND ROADS AND GIVEDISTANCE FROM WELL TO NEAREST ROAD JUNCTION

Not to be filled in by driller (OEP USE ONLY)

OP. PERMIT NUMBER f

WRITE»*T1«-S PERMIT No.IN8OX 70 71 72 73 74 75 76 77 78 79

SPECIAL CONDITIONSNOTE = APPROVING AUTHORITIES SHOUl

JCMUP, MOW7V4

EMEfWENCr/TEMP NO IF ANY

1 5853 SEQUENCE NO

(THll NUMBER IS TO BE PUNCHEDIN COLS. 3-8 ON ALL CARDS)

STATE OF MARYLANDIDP USE ONLY) APPLICATION FOR PERMIT TO DRILL WELL


STATE PERMIT NUMBER

'fill in this fcmi completely7Date Rec^d (APA) B 3 LOCA7/OW OF WELL

yj <?1 OWNER INFORMATION-i j

LLFntNtme

0SUI* 72FILLER INFORMATION . ..-,.-~™. NEAREST™*

Dott«f»N*(n« , J 77 Uctma No,80

firm Nun*

'*«»ttnr .

/:,//.g. /% c evs

\Oat*

WELL INFORMATIONAPPROX, PUMPING RATE (GAL PER MM) ' ' ' ' ' ' '" ' ^ ^ ' "—' DISTANCE FROM HOAD

___ ,__ ENTER FT OR MlAVERAGE DAILY QUANTITY NEEDED |—rH—|—i—r2-]—I(OAI, PER DAY) I I I I I II I

U 20

USE FOR WATER (CIRCLE APPROPRIATE BOX)HOME (SINGLE OR DOUBLE HOUSEHOLD UNIT ONLY) HEALTH DEPARTMENT APPROVALFARMING (LIVESTOCK WATERING & AGRICULTURAL

I —— I IRRIGATION)• . I INDUSTRIAL, COMMERCIAL. STATE AND FEDERAL GOV.

! UJ OTHER (REQUIRES APPROPRIATION PERMIT)__ PUBLIC OR PRIVATE WATER COMPANY (REQUIRES[pl APPROPRIATION PERMIT AND STATE HEALTH DEPARTMENT1——' APPROVAL)

TEST, OBSERVATION. MONITORING (MAY REQUIREAPPROPRIATION PERMIT)

8 COUNTY 21TT1 MW IIOB

23 SUBDIVISION

SECTION I I I I LOT I44 46 48 50

MILES PROM TOWN (enter 0 if in town)76 77 78



NEAR WHAT^

TAX MAP: jg>_ SLK:NOT TO BE FILLED IN BY DRILLER

GacilCOUNTY NAME COUNTY NOTSTATESIGNATURE _____________________________ INSERT 3

DATE ISSUED

43NORTHGRID

0793 •> x//f.-- AjJf\ 12/6/9948 CO SIGNATURE ~ ' EXPrDAT600 EAST I

GRID f55__________57

o]o]83

APPROXIMATE DEPTH OF WELL II I / IQ \ U\ FEET24 2t

APPROXIMATE DIAMETER OF WELL ________________ INCHNEAREST

METHOD OF DRILLING (circi* on.)(or Aug«r»d) JETTED Jatted & DRIVEN«ry\ AiR-PERcm»ion ROTARY (Hydraulic Rotary)

SHOW MAJOR FEATURES OFBOX & LOCATE WELL ——————WITH AN XSOURCES OF DRILLING WATER1. fib-fa W«r2.3.WRITE THE BOX NUMBERFROM THE MAP HERE

REV«f»«-RQTarv DRiva-PQINT

othir —————————————————————————————————REPLACEMENT OR DEEPENED WELLS

(CIRCLE APPROPRIATE BOX)

N !> THIS WELL WILL NOT REPLACE AN EXISTING WELLTHIS WELL WILL REPLACE A WELL THAT WILL BE

N 000000

DRAW A SKETCH BELOW SHOWING LOCATION OF WELL INRELATION TO NEARBY TOWNS AND ROADS AND GIVEDISTANCE FROM WELL TO NEAREST ROAD

ABANDONED AND SEALED ..THIS WELL WILL REPLACE A WELL THAT WILL BE USED AS **A STANDBY-CONTACT LOCAL APPROVING AUTHORITY FORPOLICY ON STANDBY WELLSTHIS WELL WILL DEEPEN AN EXISTING WELL

PERMIT NUMBER OF WELL TO BE REPLACED OR DEEPENED(IF AVAILABLE) ., I I f I I I I I I I I I S2

Not tote tilted in by dritter (OEP USE ONLY)

APPROP. PERMIT NUMBER

VVWTE

Ajp

———— ———— fTTVIK I————I

FORCE __ NTHALS PERMIT No, [ Q| E8? «* 70 71 n ?3 74 75 78 77 78 79

SPECIAL CONDITIONSNOTE - APPROVING AUTHORITIES SHOULD USE

AR3I2558s /

EMERGENCY/TEMP NO r ANY ' //O

8 5852 SEQUENCE NO.(DP USE ONLY)

(THIS NUMBER IS TO BE PUNCHEDIN COLS. 3-6 ON ALL CARDS)

STATE OF MARYLANDAPPLICATION FOR PERMIT TO DRILL WELL


STATE PERMIT NUMBER

-12191419'"fill in this form corrptetety n

tDate Received (APA)

7If)13

OVVWEfl INFORMATION

A/First Name

L s/

70 State 72DRILLER INFORMATION uon,,, . .,..„. 52 NEAREST TOWN

Onlter£N«me ~ ~~7/' .'t--/-i f int-S'-ttz T'.-.iL,

77 License No. 80 Q ^

S 2Signature • • . • ' • ' . • , t Dale

WELL INFORMATION1 7 ——————————— , .. ,———,——,,———, - , DISTANCE FROM ROADAPPROX. PUMPING RATE (GAL PER MIN.)

AVERAGE DAJLY QUANTITY NEEDED r(GAL. PER DAY) I

14 . 20

USE FOR WATER (CIRCLE APPROPRIATE BOXI NOT TO BE FILLED IN BY DRILLER(D| HOME (SINGLE OR DOUBLE HOUSEHOLD UNIT ONLY) HEALTH DEPARTMENT APPROVALnri FARMING (LIVESTOCK WATERING & AGRICULTURALL_J IRRIGATION)n-| INDUSTRIAL. COMMERCIAL, STATE AND FEDERAL GOV.

22 LLJ OTHER (REQUIRES APPROPRIATION PERMIT)PUBLIC OR PRIVATE WATER COMPANY (REQUIRES

P | APPROPRIATION PERMIT AND STATE HEALTH DEPARTMENTAPPROVAL)

', OBSERVATION, MONITORING (MAY REQUIREAPPROPRIATION PERMIT)

S 3 LOCATION OF WELLMW 110A

8 COUNTY

23 SUBDIVISION

SECTION I I I I LOT46 48 SO

MILES FROM TOWN (enter 0 if in town)


I WATfttL.NEAR WHAT ROAD


ENTER FT OR Ml38 39

TAX MAP: 3 BLK: fCI, PARCB?'

CecilCOUNTY NAME COUNTY NO.STATESIGNATURE _____________________________ INSERT S

DATE ISSUED12079 843NORTHGRID

50

, \V , i- 3 2-06-99CO SIGNATURE £XP. DATE

00SS

EASTGRID

APPROXIMATE DEPTH OF WELL 7ITF1FEETSHOW MAJOR FEATURES OFBOX & LOCATE WELL ______WITH AN XSOURCES OF DRILLING WATER

APPROXIMATE DIAMETER OF WELL _________U X lNofEST2.

METHOD OF DRILLING (circle one) 3BORED (or Augered) JETTED Jetted S DRIVENAIR-ROTary } AIR-PERcussion ROTARY (Hydraulic Rotary)3/"AIR-R9Taryj

WRITE THE BOX NUMBERFROM THE MAP HERE

REVerse-ROTarv DRiva-POINT

other ____________________-.——————————————REPLACEMENT OR DEEPENED WELLS N 000

(CIRCLE APPROPRIATE BOX) DRAW A SKETCH BELOW SHOWING LOCATION OF WELL INTHIS WELL WILL NOT REPLACE AN EXISTING WELL

0THIS WELL WILL REPLACE A WELL THAT WILL BEABANDONED AND SEALED , .

OOP

i LCi RCT R'

N . ,lftft i**

RELATION TO NEARBY TOWNS AND ROADS AND GIVE /-r,DISTANCE FROM WELL TO NEAREST ROAD JUNCTION ' / *—•-W **

__ . -^POLICY ON STANDBY WELLSTHIS WELL WILL DEEPEN AN EXISTING WELL

THIS WELL WIL.L REPLACE A WELL THAT WILL BE USED AS" ' "I , .

"rf 1Ur\ ul^U

A STANDBY-CONTACT LOCAL APPROVING AUTHORITY FOR ^ _ W» ~~~ > irt*«

| DPERMIT NUMBER OF WELL TO BE REPLACED OR DEEPENED(IF AVAILABLE) 41 1 52

\

Not to be filled in by driller (OEP USE ONLY)

'PROP. PERMIT NUMBER63

WRrreFORCE F_ NTTIALS, PERMIT No. CE— 94— 29

67 68__________________70 71 72 73 74 75 76, 77 78 79

~'AL CONDITIONSNOTE = APPROVING AUTHORITIES SHOULD US

c 1 7?"1—iMDE USE ONLY)1 2 3 «

STATE OF MARYLANDWELL COMPLETION REPORTFILL IN THIS FORM COMPLETELY

PLEASE TYPE

THIS REPORT MUST BE SUBMITTED AFTERWELL IS COMPLETED.COUNTYNUMBER K-:: lilt

ST/CO USE ONLY DATE WELL COMPLETED . Depth of We,, _„_. . .DATE Received .... FROMMM DO w .MJ*; °°Q J 7 22 Ty 26 ,-,--

• 13 IS 20 (TO NEAREST FOOT) 28 29 30

OWNER p/- '•-—.'-•••- •' • — -"'•, i.STREET OR RFD f""* .-. •*,;., . ,-i/c.i •"slnam> TOWN - »v.//- .V, ..

94 - 295C.31 32 33 34 35 3j |

•.- ^^

SUBDIVISION SECTION LOTWELL LOG

Not required for driven well*STATE THE KIND OF FORMATIONS PENETRATED. THEIRCOLOR. DEPTH. THICKNESS AND IF WATER BEARING

DESCRIPTION (III*Additional tntitt ii nt*o*a)

At l/t f '-yi A j-fJ .

/Vt*- AA - t

j/£jr<4*rutj&L ~

— **.

FEETFROM

C5>

30

IX

TO

30

r

checkif waterBearing

r

NUMBER OpI&SlJcCESSFUL WELLS: O. -t+t* *W

WELLHYDR^KEO g (g

CIRCLE APPROPRIATE LETTERA A WELL WAS ABANDONED AND SEALED" WHEN THIS WELL WAS COMPLETEDE ELECTRIC LOG OBTAINEDPTEST WELL CONVERTED TO PRODUCTION

WELL1 HEREBY CERTIFY THAT THIS WEU HAS BEEN CONSTRUCTED INACCORDANCE WITH COMAfl W W W "WEU. 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. i fvf D ' '-~ i

DRILLERS SIGNATURE(MUST MATCH SIGNATURE ON APPLICATION)

LIC. NO. 1 L_\l D.1. L-sL 1

SITE SUPERVISOR (wgn. of dnller or journeymanresponnbl* fo/ sittwork if differont from perminee)

GROUTING RECORD Ves noWELL HAS BEEN GROUTED |Y|; |M|Circle Appropriate Box) -=34 44TYPE OF GROUTING MATERIAL (Circle one)CEMENT |CJM BENTONITE CLAY |B|C

NO. OF BAGs"16/ NO. OF POUNDS/'- lGALLONS OF WATER * YDEPTH OF GROUT SEAL (to nearest foot)from & ' ft. to J? Y ft.

(enter 0 if from surface)rncinn CASING RECORD

/ types \ 1 c T 1 Ir In 1/ insert \ |o 1 | Jv/JO 1I appropriate 1 STEEL CONCRETE\ code J n P! Lj| 1 0 1 T\^ 1 _^/ HLA&nC OTHER

MAIN Nominal diameter Total depthCASING top (ma'n) casing of main casingTYPE (nearest inch)! (nearest foot)PL- o4 6360 61 63 64 66 70

E OTHER CASING (if used)- -. -* -T-- .«.• diameter i- depth (feet)

A ""' ' O '8N , u ii i

srrsfln typfl SCREEN RECORD

/arjpropnateN ^ BRONZE - HOLE\ betow / ( PTO 1 0 1 T 1V^ ./ rtraTTC OTH6W

C aT DEPTH (nearest ft.) 'r i / , o_ 1 f ^ ** VK«^^ ^^ *5^ 8 9 11 15 17 21

" 23 24 26 30 32 36SC3R 38 39 41 45 47 51E _E RI.OT SIZE 1 TT ?. ** 3V:'NDIAMETER „-,,/ (NEARESTHP srnFFW ' Y INCW

56 ' 60from to

L y -7 v7GRAVftPACK i W ' i i . ' iF WELL DRILLEDWAS 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

C ! 3 ;

PUMRNGTEST /HOURS PUMPED (nearei

PUMPING RATE (gal. peMETHOD USED TOMEASURE PUMPING RA

WATER LEVEL (distance

BEFORE PUMPING

WHEN PUMPING

TYPE OF PUMP USED ([ATI** [FQ centrifugal R27 27

27 27

st hour)3 9

11 15

TE ,

from land surface)ft.

ft.22 25

for test) *piston I T I turbine ,

. —— . otherrotary Q I (describe

27 betow)

submersible

PUMP INSTALLED g kDRILLER INSTALLED PUMP YES ^^V(CIRCLE) (YES or NO) ^ ^IF DRILLER INSTALLS PUMP, THIS SECTIONMUST BE COMPLETED FOR ALL WELLS.TYPE OF PUMP INSTALPLACE (A,CJ,P,R,S,T,0IN BOX 29.* ,CAPACITY:GALLONS PER MINI(to nearest gallon)PUMP HORSE POWtPUMpllSijUMN LEN(nearest ft.)C SINQ HEIGHT "(c( + ) above)•xJS f U

— below \49

A LOCATION 0f SHOW PERMANJi AND INDICATE \T TWO DISTANCES1 (MEASUREMENT

/ /<;

i /

LED __) . » .* " ' ... 'r '„$

31 35

-RSI . j. *1 1

ircle appropriate box *id enter casing height)VND SURFACE

-, - (nearest)50 51

F WELL ON LOTENT STRUCTURES•JOT LESS THAN

STOWELL)

>> N/• X

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


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

«_J- ---^

\"\

\.-- - - -li OWNER

-0)/x^V/ v.7/ •J'-'

/.$*

p 1 f '-//~ "^ 1 f V> w .WOE USE ONLY)1 i J <

blAlt Uh MAHYLANUWELL COMPLETION REPORTFILL IN THIS FORM COMPLETELY

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

ije jt/u ^(jn*4™-*£i*

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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


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 \

*•-""" ' 1 ^

' " \ C* f * 5 ^ *vS»

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


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


_____ 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

FROM TO

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 .

****»***»**»*»*»»*»»t-»«-*»***»*»*******+***+****#**»***»**********+*+***+******+*****+*********+*****»+»<

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"--'


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


_____JETTEDBOTJETJ/AUGUERED _____ HAND DUGOTHER (specify)__________' . "' LOG OF SEALING MATERIAL

USE CODE:


.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

SHOW WELL LOCATION H|BY X WITHIN BOX ^^

LOG OF SEALING MATERIAL

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*-•• ' •', -J..." - —— -" 3 ' ~ ''"MWDyMSD-MGD t.-~2O-fcfSIGNATURE-MASTER WELL DRILLER OR SUPERVISING SANITARIAN LICENSE ft —CIRCLE ONE DATE

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


?' < 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:


BOX NUMBER 000000


X DRILLED ' JETTED_____ BORED/AUGUERED _____ HAND DUG_____ OTHER (specify) _____________ . - . - LOG OF SEALING MATERIAL

USE CODE:


. 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

FROM TO

.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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SUBMIT COPIES OF COMPLETED FORM TO:» COUNTY ENVIRONMENT AGENCY (contact MDE. WMA if address needed)


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


.......J*v DRILLEDBORED/AUGUERED

. __.. OTHER (specify)

USE CODE:

_____ DOMESTICIRRIGATION

>- TEST/OBSERVATION

TYPE OF CASING:

STEELCONCRETE

SI7.K OF CASING. 'T

DFPTH OF WELL ^ f3>

WAS ANY CASING REMOVEDif yes. length removed, in f

WAS, CASING RIPPED OR PER

JETTEDHAND DUG

MUNICIPAL/PUBLICINDUSTRIAL

X PLASTICOTHER (specify)

INCHES IN DIAMETER

FEET DEEP

? > YES NOeet: 3 -£>f

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— — -- 332— ' MWD7MSD/MGD /~"^-<^'~<i(?SIGNATURE-MASTER WELL DRTkLER OR SUPERVISING SANITARIAN LICENSE a ~——CIRCLE ONE

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) -


__L

S*- 'g-S £• ' -rt&PERSON ABANDONING WELLS*- flurft- > /, / c- cy cxs* WELL DRILLERS LICENSE NUMBER:

OWNER'S NAME: DT>&<<&_I

WELL LOCATION:

COUNTY:NEAREST TOWN: &><"fTAX MAP £3 BLOCKSUBDIVISION: ______SECTION: ___________ LOT:


BOX NUMBER 000000


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

O 75"ff

FEET

FROM

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:


BOX NUMBER / C-7 <


^ 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

000000

SHOW WELL LOCATION 1BY X WITHIN BOX ^P


FEETMATERIAL

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^ J -M o 75""a

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'«! —,^~, ,- — —''-' ", .„>. '-'-', __ __ __ ^ --— MWCU'MSD'MGD .' -2-C1-"?

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

*•»»»»***»•«•»»»** »*»**»»»*************»»*****»»»* + ****t*t*****»**»T*********t*«*


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: ..' 2~ ' -*- ' ""' * ________ I month/ day; v ear)

PERMIT NUMBER OF ABANDONED WELL (if any]


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:

MARYLAND GRID COORDINATES - r-E/QJ I . .

BOX NUMBER 000000


. 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

FROM TO

_________ / ! 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

I

•1!

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:


BOX NUMBER cN 4>5''7


r>4 DRILLED JPTTF.DBOREn/At:nuERF.D HAND DUG

,,,, OTHER Kpecifvi

* USE CODE:

DOMFJ5TIC MUNICIPAL/PUBLICIRRIGATION INDUSTRIAL

-...."Xv... TEST/OBSERVATION

* TYPE OF CASING.

STEEL X PLASTICCONCRETE OTHER (specifvl

/ "SI7F OF CASING / INCHES IN DIAMETER

OFPTH OF WELL ^ ¥ FP.ET DEEP

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

000 I000 I

SHOW WELL LOCATION ^^B 1BY X WITHIN BOX ^1^ 1


FEETMATERIAL

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( — 5/wv r o sy

\ \

i

,b( . ,. . - -- ———— 33 ^- MWD^MSD MOD /-ZO-^VSIGNATURE- MASTER WELL DRILLER OR SUPERVISING SANITARIAN LICENSE = — CIRCLE ONE IIATF —

AR3I2572

MARYLAND DEPARTMENT OF THE ENVIRONMENT. WATER MANAGEMENT ADMINISTRATION-2500 BROENTNG HIGHWAY. BALTIMORE. MARYLAND 21224. i4lO) 631-3784


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"~ ~ _


• 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


. 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

**? ' ~~~ f ' ' -^ ~ « -^

* PERSON ABANDONING WELL:1- *'/ /- 1 <^bd iyeSf-'' WELL DRILLERS LICENSE NUMBER: •"•?> —~* /

* OWNER'S HkME-£)£ie*6&gfvn-C /£='/g.*2S-f**H&.

» WELL LOCATION: r

COUNTY: (2>CC / L-NEARRTTTOWN: f ft O -f f/ fTAX MAP 33 'BLOCKS ' PARCEL^ 7SUBDIVISION:SECTION: LOT:


BOX NUMBER . <


%- 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

•-

000000

SHOW WELL LOCATION HHBY X WITHIN BOX ^J

LOG OF SEALING MATERIAL 1

FEETMATERIAL

FROM TO

1

i

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


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~'


./"}-',' <— . /,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


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

0

if ves, length removed, in feet: «*- -f - Tt

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)


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

Wllll^VJ TT £_1_1_, ;_______ *^_ ' . ' ™> \S i W C,1_.L_ L I\J.J_,I_,J I\.O J IX .C.1 OC, I'M UIVIDJQIV. m --- ________________

2 . I I r" „ .L ' CIRCLECMWD./IMSD/MGDl.tj£/a(f£3ri™<* If £-3Tyv>-g. •-

COUNTY: _„_. . ______NEAREST TOWN: P& ft Ocfoj:/1TAX MAP A3 BLOCK 3 PARCELSUBDIVISION:SECTION: __________ LOT:

MARYLAND GRID COORDINATESE/<2£

BOX NUMBER 000000


, 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


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)


* 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


DRILLED _____ JETTED. BORED/AUGUERED _____ HAND DUGOTHER (specify) ________' . . - LOG OF SEALING MATERIAL

USE CODE:



.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


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

FROM

O

TO

' 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


_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:


BOX NUMBER N 000000


^ DRILLED ______ JETTED_____ BORED/AUGUERED _____ HAND DUG_____ OTHER (specify) _______' " " ' . . . . . LOG OF SEALING MATERIAL

USE CODE:

.DOMESTIC _____MUNICIPAL/PUBLIC


. 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 ————————— ;


* 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:


BOX NUMBER . <


__ 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 . , , . .

CIRCLE^MWtw MSD/ MOD

000000

SHOW WELL LOCATION ^ ftBY X WITHIN BOX ^^F


FEETMATERIAL

FROM TO

*$~*

\ ' \

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

*»*»»*»»**»***»»»*******»*»»*»»*+****»**»»*»*»*****»*»**»*»**»********»»**»***»**»*******«***«»**+*****»


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


PERSON ABANDONING WELL: W"> *Wtf J, L «LS\ <-//}£**, *S WELL DRILLERS LICENSE NUMBER:^

OWNER'S NAME:

WELL LOCATION: '

j r- / CIRCLEy^JWp / MSP / MGDg>?Wig, f-f - ———————

COUNTY:NEAREST TOWN: .____TAX MAP 2-3 BLQCK^' / PARCEL 26 7SUBDIVISION:SECTION: ___________ LOT:

MARYLAND GRID COORDINATES _fE .

BOX NUMBER-f- -

000000


" DRILLED ______ JETTEDBORED/AUGUERED _____ HAND DUGOTHER (specify) _____________ . , . - . . . LOG OF SEALING MATERIAL

USE CODE:



. 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

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SIGNATURE-MASTER WELL DRILLER OR SUPERVISING SANITARIAN LICENSED CIRCLE ONE DATE

\ 828 JULY 1993 ~ ' '

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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. ^^*

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DATE

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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


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 ^^


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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

ARCADIS GERAGHTY&MILLER

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