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HomeMy WebLinkAboutWell Inspection 00 Farmstead Drive IF HANDWRITING: I . Place on a hard surface. 2. Bear down! you are making 5 copies. _OTABLE WATER.COLLECTION/ 1 XAMINATION REPORT +X � yl This Section for Lab. Division Use -81 RE-V.8/79 1. Type or print one set and send to the address below. Y NO. TOWN NO. PHYSICAL COMPLETE 2.Reports will be furnished only to local director of / health or state agencies. D�1T�F?Ely-ED DATE REPORTED State of Conn. Dept.of Health Services, Laboratory Div., P.O. Box 1689 Hartford, CT.06101 � 4VV��//Y��� 'OLLECTION NAME OF PROPERTY(Whey sample was t&ken) ADDRESS TO REPORT: tLLECTED BY(Nanw) COILECI"OFi'StJOIUATFCOLLE TED TIME COLLECTED SAMPLING POINT '— - Jme and Addrest of person to receive Laboratory Report well. Semi-Public Private ff Identification: - �� ^,None Filtered Chlorinated Softened: ' Treatment: y .S. L��•1�+},C7 t'f�r / i'r:.•:�'i Other(Specify) Li NAME OF LRP.THAT MADE LAST EXAtd UATL OF LAST EXAM .OPERTY OWNER'S NAME AND ADDRESS(if different from name and address above) _ Fold Here For Conformation to Laws Suspected of Causing Disease Other (Specfry or give detail her,-) :amination (Specify) (Give Details) mFlaints Color Odor _.-Taste Sediment Fora mling Other (Spa't'ity) fL—Ji LJ e Of Cons Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) pPIY orce Of Drilled Driven Well Dug Well Spring Other (Specuy) -- ;ter: WELL script DEPTH WELL DIAMETER CONi�ITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM ion Of ter Soi Ft. C� 'In. ssible Source Septic Tank Farm Industry Other (Spey ity)Pollution ecial Tests — - — uired: ^� <.t C�: .i t. .l )' ;�rSi•; ^.lam /• 4(( ditional Description If Needed: -�'L�—�- ---"---�--- -t i -- I 3nature DATE SENT d Title: t ABORA.TORY EXAMINATION REPORT: (To be filled out by Loboratory Division) Note: Chemical results are in Mg/L. PARENT COLOR TRUE COLOR ODOR �o l _^�1,Q NITRITE Sodium as Na h^. aganese as Mn ,as1_de5 `Ch/oi-ofohvn 41 clr/o' C I7 n 4-1 9 NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F 1.3 Nitrogen • rnstituents as AMMONIA Al�alinit as CaCO Carbonotr Detergent a ��--- trogen (t�) I s . ALBUMINOID Total Hardness - -- --ABS Hess as C aC0? Sulfata as SO - n orides as Cl lron as Fe ��— MEMBRANE FILTER TEST i Coliform Colonies/100ML. 7 Meet the requirements for a potable water. The results of the analysis of this sample- 1 t Meet the requirements for a potable water; however, the chemical or physic al constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source Of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate than,such contamination might reach the Supply to;he same extent. The water should be considered as unsafe for drinking until the source of this bacterialcontunlinatiun cant bo located and removed. AG Ct f�� rI wr�G« The e t at °, emica or physical c ;cue s its. These are as follows: Ark '�!'-4.,y�`ti" :ken :fir: gqM• "g -- - ]`:..w w-.cprpMggpe-.- �liL'.:: �..'...`_.. .-..-v.•�s �--.�. - I POTABLE WATER COLLECTION/ XI EXAMINATION REPORT '' "� ✓ ? x 7h i iojibor Lab. Division Use OL-81 RF1: 10„74 , L R ORY NQ OWW-NO-, PHYSICAL COMPLETE 1. Type or print one set andindto the address below. 2. Reports will be furnished only to local director of / M health or state agencies. DATE RECEIVED ATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where Sample was taken) ADDRESS TOWN REPORT: Ina Cf /a/ 4- Off'-•%04- & . .S. it.,i/ Sow COLLECTED BY(Name) COLLECTOR'SNO DATECOLLECTED TIMECOLLECTED SAMPLING POINT POINT/' 7�v Ll O a.. j 23-f� A M. , �L��r�., �G� -4ame and Addr ss of person to receive Laboratory Report Well Semi-Publ c Private (� Identification: Treatment: None Filtered Chlorinated Softened /.S�yt7 ,f'u///liter. ,9vC � ❑ ❑ 1-]�- -S• W!��Sor +^a ........................... E`. h., 6 0 7 y Other (Specify) ................ NAME OF LAB THAT MADE.LAST EXAM DATE O LAST A .rAl /� /o -7q PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) SC Fold Reason For Conformation to Laws Suspected of CausingDisease Other (Specify or Here y give details here) Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sediment,nt Foaming Other(Specify) Jf: Jse Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: 0 ❑ ;ource Of Drilled -, Driven Dug Well $pr�g Other(Specify) Voter: IL�1/" )ascription Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Voter Source: Ft. In. 'ossible Source Septic arlk For Industry Other (Specify) )f Pollution: ipecial Tests required: pr�et,.obta I��S 4G hygre,c�rEx�s additional Description If Needed ii nature d Title: /7 �j� 7Y- SENT o 0 r 01 z 3- 8-0 LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. PPARENT COLOR TRUE COLOR ODOR T NITRITE Sodium as No Maganese as Mn l r J>G Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F 122 -onstituents N itrogen as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS (N) ALBUMINOID Total Hardness as CaCO3 Sulfate as 50 oftee c K)t Mj0V t Aro-, 0. CPO 4 Hydrogen-ion Concentration (pH) .hlorides as CI Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. i CONCLUSIONS: The results of the analysis of this sample- Wet the requirements forma potable water. Meet the requirements fora potable water; however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source•of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: �(� yrU ✓�t G�.1�/ a 1 :r A1►p"f'glp+pgr � r5 I grin POTALLE WATER COLLECTION/ EXAMINATION REPORT oL-at or Lob. Division Use ! LA RA O Y O. j.9WN K8, 1. Type or print one set and send to the Address below. PHYSICAL COMPLETE 4/ y- 2.Reports will be furnished only to local director©f health or state agencies. DATE R TO: Conn. State-Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 GIVE (_: i E REPORTED COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS REPORT: f TOWN C0LLECTEDBY(Name) YI/�/�p 37 ram'' �" SGvjypssor COL LECTOR'S NO DATECOLLECTED TIMECOLLECTED SAMPLING POINT ' A0 7'(ulrt / T` �/-2-3-6o M. Name and Address of person to receive Laboratory Report `' �u Well Semi-Public Private I R. ul� � Identification: II_�,.�J/ /�1�O xu/��✓mot �4P Treatment: None Filtered Chlorinated Softened .�.LCJjt+�3� c r7 cv CG o) 1_T ❑ El y Other (Specify] "" L ❑ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Reason For Conformation to Laws Suspected of Causing Disease Other fspecif or Fold Y give details here) Here Examination: � (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sediment Foaming Other (Specify) Df: ❑ ❑ ❑ Jse Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: source Of Drilled We11 Driven Well Dug Well Spring Other (Specify) Water: L LI ❑ ❑ ❑ -3escription Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL Water Source: DATE OF LAST PLUMBING WORK IN SYSTEM Ft. In. 3ossible Source Septic Tank F�arm Industry Other (Specify) )f Pollution: 1LJI ❑ special Tests > . / c,/required: t"r'ya altt lJ�_S T Hy'Vdo[�v �C", 5 +dditional Description If Needed: i ignature .nd Title: AJDA�TE_'§-ENT 7-3— Sou ,PORT: (To be filled out by Laboratory Division) LABORATORY EXAMINATION R PPARENT COLOR Note: Chemical results are in Mg/L. TRUE COLOR ODOR NITRITE Sodium as No w o , Cif"c r Q, Maganese as Mn J Nitro9 en NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride onstituenTs as AMMONIA Alkalinity as CaCO Carbonate E-Fv-uCj'jo'lJP cfle p J iitrogen (N) 3 Detergent as ABS ALBUMINOID Total Hardness as C00O3 Sulfate as SOq dorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements fA potable water. Meet the requirements fora potable water- however, the chemical or physical constituents listed below appear abnormall high f water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. y g or a ground supply. The JDo not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that diseas producing organisms are present,does indicate that such contamination might reach the supply to the same extent. The water should be considered is unsafe for drinking ❑until the source-of this bacterial contamination can be located and removed. g The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: i MAY 2 ?,,198� VL'+9 J :R,EV,..1,2-74, , -- 1, Type or print one set and send the ddress b T RY TOW PHYSICAL" OMPLETE' 2.Reports will be furnished only to local director of health or state agencies. TE RECEIVED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101Ti � TEp COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: 04 v1 a z 9 /`der-f ` Cl� S � i iI(/S sa^ COLLE//CTED BY(Name) COLLECTOR'SNO DATECOLLECTED TIMECOLLECTED SAMPLING POINT Name and Addr ss of person to receive Laboratory Report t� (� Well Semi❑Pub c Private Identification: IL_�j„, l •`' `' '���� None Filtered Chlorinated Softened Treatment: ❑ ❑ ❑ Other (Specify)..................... LNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(lf different from name and address above) le-79 SU rv,� Fold Reason For' Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination ❑ (Specify) ❑(Give Details) Complaints Color Odor Taste Sediment Foaming Other(Specify) Of: ❑ ❑ ❑ ❑ ❑ ❑ Use Of Constont Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ ❑ Source Of Drilled Well Driven Well Dug Well Spring Other(Specify) - Water: It�.'� ❑ ❑ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP-SEAL, DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft, In. Possible Source Septic❑Tank Farm Industry Other (Specify) Of Pollution: ❑ ❑ ❑ Special Tests Required: C�f/►I.�f d(�c4S � rJr�i'O[rk r,�a ns Additional Description If Needed: Signature DATE SENT And Title: � j,'. ad y-�2�3- �0 LABORATORY EXAMINATION REPORT: (To be filled out 6y Laboratory Division) Note: Chemical results are in Mg/L.APPARENT COLOR TRUE COLOR ODOR T UMfthftWgjt NITRITE Sodium as Na Maganese as Mn Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F 9 Constituents as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS LtA �t P Nitrogen (N) � d —.v ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 :hlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML CONCLUSIONS: The results of the analysis of this sample- Meet the requirements for a potable water. Meet the requirements for a potable water; however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: ElThe Coliform density exceeds acceptable limits. The presence of the Coliform group, while not necessarily meaning that disease producing organisms are present,does indicate that such contamination might-teach the supply to the same extent. The water should be considered as unsafe for drinkiAg ❑until the source.of this bacterial contamination can be located and removed. The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: - kt f a�(it.LC,Y6'C� . v,i A-lsti.r.-'WA R P,01 ECTF N% T :5 D, ._. .: EXAMINATION'REPORT his ection for Lob. ivision Use OL-81 REV. 12-74 I.Type or print one set and sen to the address b LABOR ,Y WN NO PHYSICAL COMPLETE 2.Reports will be furnished only o local director ow health or state agencies. _E REC DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION =NAMEPROPERTY(Where sample was taken) ADDRESS WN I REPORT: Y 36 7yGtn� 4S. 6t1 id7c�.5er COLLECTED BY(Name) COLLECTOR'SNO DATECOLLECTED TIME COLLEC ED SAMPLING POINT M. Name and Address of person to receive Laboratory Report Well Semi-❑Public Private j�`y�7 Sv/�i� Identification: 111, None Filtered Chlorinated Softened 0 7y Treatment: I V•/ ❑ ❑ ❑ Other (Specify) ............................... L ❑ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Conformation to Laws Sus ected of Cousin Disease Other (Specify or Here Reason f°or' p g y give details here) Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor T�e $ed nt Foaming Other(Specify) 0f: ❑ ❑ Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: El ❑ Source Of Drilled W�FI Driven Well Dug Well Spag Other(Specify) Water: II—J-1 Description Of WELL DEPTH A_WELLIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source Ft. In. Possible Source Septic❑Tank Farm Industry Other (Specify) Of Pollution: El Special Tests Required: Additional Description If Needed Signature DATE SENT And Title: �, �e- LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. 4PPARENT COLOR TRUE COLOR ODOR T NITRITE Sodium as Na Maganese as Mn Chl.. rt3, rr✓t j;f, Nitrogen NITRATE Alkalinity as COCO3 Bicarbonate Fluoride as F 7' r-A) e-F g T%C.-J,I--toe--rl.�I�,e - , 7 Constituents 1( } C L,{, as AMMONIA Alkalinity os CaCO3 Carbonate Deter enT as ABS Nitrogen (N) g U. irfe ,i;#iec1, ALBUMINOID Total Hardness as CoCO3 Sulfate as SO4 }M' :hlorides as CI iron as Fe r, MEMBRANE FILTER TEST coliform Colonies/100ML Gl• CK) url/ CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water.. ' Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contaminationcan be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: i .< 4:�ceporrs--"wilt oe turnfsiled Only`to local-director - health-or state agencies. ! DATERAN LN E REPORTED } TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 fftfrCOLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN f REPORT: /f �AVY 1//lfurofE C� rf,V/yity sor COLLECTED BY(Name) / COLLEEsITOR'SNO DATE COLLECTED TIME COLLECTED SAMPLING POINT R. I ! Yam-7-3"i5o '4 Name and Address of person to receive Laboratory Report Well Semi-Public Private I R. Identification: Eu-- ❑ None Filtered Chlorinated/ Softened 3 �� .f's/�<va"+ {�tv� Treatment: ❑ Other- pecify--•-.-.._. if y)........... << (S .............................................. NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Conformation to Laws "Sus ected Of Causing Disease Other (Specify or Here Reason For' P g ❑ y give details here) Examination: ❑ (Specify) ❑(Give Details) Taste Sediment Foaming Other(Specify)Complaints Color Odor Use Of Constant Emergency IDIT101 LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ ❑ Source Of Drilled Well Driven Well Dug Well Spring Other(specify) Water: L Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic�Tank Farm Industry Other (Specify) Df Pollution: Special Tests / �/ Required: (�1" C D�ttvt f+Cj S T 4yv,<?,ra 6" Additional Description if Needed: Ii nature 4 d Title: / DATE SENT LABORATORY EXAMINATION REPORT: (TO be filled out by Laboratory Division) Note: Chemical results are in Mg/L. kPPARENT COLOR TRUE COLOR ODOR riaray .--- eqej K)o .(1 NITRITE Sodium as No Maganese as Mn Nitrogen NITRATE Alkalinity as CoCO3 Bicarbonate Fluoride as F' 1,7 t constituents rc/ vit'J10,0 C-j k' nitroggeen (N) AMMONIA Alk 1 Alkalinity as CaCO.3 Detergent as Carbonate Detert ABS ' - ALBUMINOID Total Hardness as CoCO3- Sulfate,as SO4 hlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. 0 ao r/r CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water. Meet the requirements for a potable water; however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that diseas producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered As unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: lM. C_ 11.rf y lRFital u r . .. .�• .~L LLECTIONZ f= - ' EXAMINATION REPORT . V1 n - e t on or Lab. Division Use OL-81. REV. 12-74 1.Type or print one set and send to he address below. LABOR O PHYSICAL COMPLETE 2.Reports will be furnished only to local director of ��s rr p, health or state agencies. Jj DATE ED r; f 'ATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: I Bat f ` Far .S. Gvia�c/.so.� COLLECTED BY(Name)' COLLECTOR'SN TECOLLECTED TIMECOLLECTED SAMPLING POINT Name_and Addre s of person to receive Laboratory Report Well Semi-Public Private Fn 4v/c _ Identification: 0 L 1 None Filtered Chlorinated Softened l f yo 3w!/r t/s1w. /9t e' Treatment ❑ F-] ❑ ❑ / GEC�+I/ Other (Specify) -..-----------................ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM J- fig o PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For Conformation to Laws Suspected bf Causin Disease Other (Specify or Here g y give details here) Examination: ❑ (Specify) ❑(Give Details) Complaints Color -0d❑or Tae Sed nt Foaming. Other(Specify) Of: 0 Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ Source Of Drilled Well Driven Well Dug Well Spring Other(specify) Water: ❑ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING•W RK IN SYSTEM Water Source: Ft. In. Septic Tank Farm Industry Possible Source p Y Other (Specify) Of Pollution: ❑ Special Tests ff Required: or jja--,o c I t C!� S 4- tin ydyC;u Ott v Additional Description If Needed C Signature DATE SENT . And Title: Q LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR T NITRITE QvC�tirna�.ce�,Cfi► O.&O Sodium as No Magonese as Mn f Nitro9 en NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F Constituents as AMMONIA - Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINO[D Total Hardness as CaCO3 Sulfate as SO- Chlorides as Cl Iron as Feew a an�vn AtttJ�- MEMBRANE FILTER TEST p Coliform Colonies/100ML. ©. &0 Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- / '7-1 Meet the requirements for a potable water; however, the chemical of physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: F]The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that:disease producing organisms are present,does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are a:s follows: ❑Other: � ► 0AY 214 `nlfl/nr\re=�IVnf_RGP�iVRI v !vision 1IS a OL-81 REV. 12-74 ],Type or print one set and en to the address below. ORY N Oylhhyp "PHYSICAL COMPLETE 2.Reports will be furnished only to local director of _ jj J,!`✓ health or state agencies. DATE ,IED i ATE REPORTED T0: Conn. State Dept. of Health, Laboratory Div., P.O.- Box 1689 Hartford, CT 06101 .COLLECTION NAME OF PROPERTY(Where ample was taken) ADDRESS // TOWN REPORT: ! c�t�/�/ ,�' R/t�� '' . -�• !.t✓i�it3�S�pr COLLECTED BY(Name) COLLECTOR'SNO DATECOLLECTED TIMECOLLECTED SAMPLING POINT 4 0 1 yp 23`�' �?+ M. i Name and Addr ss of person to receive Laboratory Report Well Semi-Publ c, Private `� Identification: OCTT No❑ne Filtered Chlorinated Softened � /rt.+�f�d/d-. A� Treatment: S- lAj t"C+ foe Ot❑her (Specify).....................•................. ........ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(if different from name and address above) Fold Reason For _ Conformation to Laws Suspected of CausingDisease Other (Specify or Here ❑ y give details here) Examination: ❑ (Specify) ❑(Give Details) Complaints Color OQr Taste` Sediment Foaming O El ther(Specify) Of: Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: Source Of Drilled Well Driven Well . Dug Well Sp Other(Specify) Water: f� -*** Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source SepTan k Farm Industry Other (Specify) Of Pollution: Special Tests _1 Required: G+^ te�c�►Cl 'S ar ��/l:it►�dGBdi' vL� Additional Description If Needed Signature DATE SENT And Title: Y-- Z 3- 8-0 LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODORvale— Tk {} 1 NITRITE Sodium as Na Magonese as Mn Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F t. ! r f. Constituents as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) r 4lli Y iJ� 1m u, vr1 ft,c0S 0..01) ALBUMINOID Total Hardness as CoCO3 Sulfate as SOq Hydrogen-ion Concentration (pH) ::hlorides as Cl Iron as Fe MEMBRANE FILTER TEST Calif arm Colonies/100ML. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a_potable water. Meet the requirements for a potable water; however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. DDo not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: r El Other: �^/.�a�t/ g;T�E t`cttf+_s Mf ATIO Rfi T i Section for Lab Division Use _ OL-81 REV. 12 74 +� O O,W PHYSICAL COMPLETE 7.Type or print one set and send to he addres [J 2.Reports will be furnished only to local director of J health or state agencies. DATE REC A EPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT. 06101 COLLECTION NAME OF PROPERTY(Where sample was.taken) I ADDRESS j TOWN REPORT: t3�r9 /�/USCfs'+aC.140 f=ar,�n5' °tcrf'Y Ss Gt.iydso,• COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED I TIME-COLLECTED SAMPLING POINT �Dct. y 2.3- v .V M. of 4_5,>11 0 c Name and Address of person to receive Laboratory Report Well Semi-Public Private FIdentification: ❑ R +�'� ❑Treatment: None Filtered Chlorinated Softened ❑ ❑ ❑ ❑ ._ ;�e 4v1KC�so� f ahn GIrG•7S/ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For' Conformatio to Laws. Suspected of Causing Disease Other (Specify or give details here) Here n Examination: ❑ (Specify) ❑(Give Details) 0 Complaints Color Odor Taste Sediment Foaming Other(Specify) Of: ❑ Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: Source Of Drilled Well Driven Well Water. Dug Well Spring Other(specify) 0 Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic❑Tank Farm Industry Other (Specify) Of Pollution: Special Tests -/ Required: �i a'e^O kyd-6corb wr Additional Description If Needed Signature DATE SENT And Title: LABORATORY EXAMINATION REPORT: (To be filled out by L-boratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR NITRITE Sodium as No Maganese as Mn ., Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F Constituents as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as C0003 Sulfate as SO4 ) } Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST O o0 Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- ElMeet the requirements for a potable water;however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: c.+ EXAMINATYON sE OFT This°Section' a Division Use 2 � G LABORATORY NO, TOW PHYSICAL COMPLETE OL-81 REV. 12-74 1.Type or print one set and sen to the address below. ,{ -r t2 2.Reports will be furnished only to local director of U"E 2 f �dx tsl health or state agencies. ;R IVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div.,. P.O. 'Box 1689 Hartford, CT 06101 h COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS N REPORT: S "If-r./Gok COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TIMECOLLECTED SAMPLING POINT c , 7e Name and Address of person to receive Laboratory Report ? ;,'l Well ) Semi-Publif Private f Identification: T : None Filtered Chlorinated Softened reatment {l fj/63 .1�✓i/�/!/ s � . ....❑................❑........ El ❑ J 0r❑her (Specify) NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM ?R,OPERTY OWNER'S NAME AND ADDRESS(If different from,name and address above) S Fold 2eason For' Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here xamination: ❑ (Specify) ❑(Give Details) ❑ "omplaints Color Odor Taste Sediment Foaming Other(Specify) )f: ❑ ❑ ❑ ❑ ❑ ❑ Ise Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) iupply: ❑ ❑ source Of Drilled Well Driven Well Dug Well Spr�g Or(Specify) later: FL= El Iescription Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK INSYSTEM` later Source: " Ft. In. 'ossible Source Septic Tank Farm Industry Other (Specify) If Pollution: El ❑ ❑ 11 pecial Tests + t required: or IfA,—t?k ��d� •�- ttr oC Ltr�vl,.g Ldditional Description If Needed. I nature DATE SENT nd Title: (f- z3 LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. PPARENT.COLOR TRUE COLOR ODOR Tom_ k NITRITE Sodium as Na Maganese as Mn X-1C Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F r _ :onstituents as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS litrogen (N) ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 hlorides\as Cl Iron as Fe �- MEMBRANE FILTER TEST Coliform Colonies/100ML. CONCLUSIONS The results of the analysis of this sample- Meet the requirements for a potable water. 7 Meet the requirements for a potable water;however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: q - r.-rype or-print one set`.<rnd hd to'th�e:addresa below: .�„ "''n"' — PHYSICAL'COMPLE I 2.Reports will be furnished o y to local director of health or state agencies. DATE R GEI ED TO: Conn. State Dept. of Health, Laboratory Div..; P.O. Box 1689 Hartford, CT 06101 t TE REPORTED COLLECTION NAME OF ROPERTY(Where:sample was taken) ADDRESS TOWN ' REPORT: O 2. rG 14 J?i .S'i lt1 i N t�.Sof COLLECTED BY,Name) COLLECTOR'SNO DATE COLLECTED TIMECOCLECTED SAMPLING POINT M. -,if,f Tcr40 Name and Address f person to receive Laboratory Report Well Sem blic Private Identification: LJu,�/ None Filtered. Chlorinated Softened Treatment: n�rf ❑ ❑ .S• f�l/!✓ACX.Soi f h rL Other (Specify;)--T El .. ❑ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS Or different from name and address above) Reason For' ConfFold ormation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) Compl aints Color Odor Taste Sediment Foaming Other(Specify) Of: El ❑ ❑ ❑ Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply:' ❑ ❑. iource Of Drilled Vjell Driven Well DugWell Spring Other (Specify) Voter: IL�Jy' ❑ lescription Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL Eater Source Ft. In. W DATE OF LAST PLUMBING WORK IN SYSTEM : lossible Source SepticI ank Farm Industry Other (Specify) If Pollution: ❑ pecial Tests required: additional Description If Needed: ignature DATE SENT ;nd Title: 6�' `/- �.�—• �o LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. PPARENT COLOR TRUE COLOR ODOR T1l NITRITE Sodium as No Magonese as Mn .Gc Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F 9 onstituents as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS 'itrogen (N)- ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 dorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. d CONCLUSIONS: The results of the analysis of this sample- Meet the requirements for a potable water. Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditionsindicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed.- ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: AND ANALYSIS REPORT PysLICWATERSUPPLY SAMP 1A / LABORATORY NUMBER (1-6) J �T OF ANALYSIS W DATE RECEIVED DATE RE O x L R=TAJORGA IRADfSTIFLUI 009618 ELECTokv ION-SECTION (To be filled in by Collector) - RES. ELC OR SPRING NAME - LOCATION AND/OR ADDRESS OF SAMPLE COLLECTION POINT TOWN OF UTIL(fY TOWN NO. TYPE OF A,-,,ER(At Sample Collection Point) 1. Raw or untreated ❑2. Treated water at ('' 3.,Water from distribution 4. Water from distributionn Water at source treatment station ILLZAA (One source only) ❑ (Mixture of 2 or more sources) TREATMEtJT OF WATER REPRESENTED BY THIS SAMPLE e ❑Chlori- Poly- pH adjust- Filtra- $often Iron-manganese Fluori- Taste&odor nation ❑phos ate ❑merit ❑tion ❑in ❑.removal ❑dation ❑Strainers ❑.control NAME AND ADDRESS OF TESTING LABORATORY r NAME AND ADDRESS OF PERSON TO RECEIVE ANALYSIS REPORT NO. AND STREET rr.. CITY AND STATE -(Zip Code) Return samples and Collection Data to: CONNECTICUT STATE DEPARTMENT OF HEALTH 10 CLINTON STREET,HARTFORD, CONN: TELEPHONE_:566-5626 CHLORINE RESIDUAL (Field Test) FLUORIDE(Field Test) pH(Field test)- COMPLAINTS(it any)" ❑Color El Odor ❑Taste ❑Sedi- [:1Foam {� menf In El ADDITIONAL INFORMATION(Special tests required,etc.) EXPLANATION OF COMPLAINTS 1) C3tC'0. i1nVE rl1EL� O 6 m?dc11e aged Inl o men ire a s�,r))', / ('` CanCer in t�je. 1 aSi 7S years . 1�,le o�.er W0"r, r71j e COLLECTOR'S COLLECTOR'S NAME COLLECTOR'S TITLE DATE OFCOLLECTION TIME OF COLLECTION SAMPLE NO. - PLE COLLECTED BY.: 1. Env. Health Services ❑ 2. Water Utility Personnel ❑ 3. Certified Lab. Personnel ❑4. Other DATA PROCESSING UTILITY CODE SOURCE [YPI DATE OF COLLECTION [TESTING LABORATORY COLLECTOR 7 ' 8 9 ' " 1 141 18 I 19' 20 ' 21 ' 22' 23 24 '25 ' 26 27' 28 ' 29 30 LABORATORY SECTION _ (Andlysis results to be filled in by State Laboratory Division) PHYS. APP. COL. TRUECOL ODOR'(Description) (Degree) TURBID pH C. NC. C M. MEMBRANE FILTER TEST ' BACT. ;31 I 3l I 2' 33 34 35 36 137 38 t 39 40 q1 COLIFORM COLONIES/1W ML. CARD# L B NU UMBER NITRITE(as.NJ „NITRATE(as N') AMMONIA(as N) ALBUMINOID(as N) 1 2131- 4 � 5 � 6 7 g ' 9 ' 10 11 ' 12 13i14 '. • 15 ' 16 ' 17+ --0 IS! 19 , 2 CHLORIDE(CI), SODIUM(Na)' ALKALINITY(Ca COS)BICARB,ALKALINITY(CaCO3)CARBON TOTAL HARDNESS(Ca G03) E 21 ' 22 23 24 25 ; 26 ' 27 28 am 29, 30 191 0 32 33 34 35 ' 36 1 37 MR IRON(Fe) MANGANESE(Mn) - FLU:ORIDE.(F) ODE ER,GENT(ABS) PH.OSPHATE.(PO4),- J 38 39 40 0 41 :42 43 • 44 45 46 • 47 48' 49 50i51 SULFATE(SO4)- TDS CALCIUM(Ca) #c.A/6to O t to��� ,µ 52' S3; 54 55 ' 56 57 158• 59'' 60 '61 •62 l�"d'j� e, • .tt � y _ 1 to e A/©ri 3cultrr�rr,p rr,a 4-`cz-*.C. �1, O -G+ V u r�t't�ct��. 44,c_S lot, i�#C-0 a ll�110- 4A A' _ 1`► z rock!" =UM UMBER ALUMINUM (Al) ARSENIC (As) BARIUM-(Ba) B RYLLIUM(Be) i4 5 16 ' 8 9 10 111213 14• 15 � 11 1718i 19 CHROMIUM(Cr) COPPER(Cu) CYANIDE(Cn) LEAD(Pb) ON 20 21 22 I 23 24 25 I 26, 27 28 129 30 ' 31 :...x �� �"s 32 0 39 '-34 ': 35 36' 37 ; 38 E MERCURY(Hg) NICKEL(Ni) SELENIUM(Se) SILVER(Ag) THALLIUM (711) "'1 39 • i 4 •44 45 • 54 • 55 56 52 53 'W TIN(Sri) ZINC(Zn) ANTIMONY(Sb) 57•$8: 59 60 61 • 62 163 C ❑ 1. The results of the analysis of this sample are SATISFACTORY and meet the standards set by the Public Health Code. \ 5 ❑ 2. The results of the analysis of this sample are UNSATISFACTORY and do not meet the standards set`by the Public Health Code. \ COMMENTS Z, Q ' (Yes=1; No=2) UVLLC4!1UM UA 1 A AMU ANALY515 REPORT PUBLIC WATERSI fl Y SAMPLE 0r-$6::REV. 7/17 ..' � y N 8_ a - (1-6) :EXTENT OF ANALYSIS(X) ° pnTE'REPO 235 RTEo c ]CH, ORGAN R D: EST FLUOR 1 �I COLLECTION SECTION (To be'filled in by CoI'lector) NAME OF UTILITY RES OR SPRING NAME LOCATION AND OR ADDRESS OF SA LE COLLECTION PaNT 'TOWN OF UTIL .Y TOWNNO.: TYPE 6F WATER(At Sample Collection Point) ' ❑1. Raw or•untreated ❑2,.Treated water at -3. Water from distribution ❑4. Water from distributte o ,on' Water at source treatr4ent station (One source only) (Mixurf 2 or more sources) TREATMENT OF WATER REPRESENTED BY THIS SAMPLE_._ Chlori- Poly- pH adjust- Filtra- Soften- Iron-manganese Fluor,= Taste&`odor. None nation ❑phosphate ❑ment ❑Lion D Ing ❑removal ❑dation ❑Strainers ❑ control' NAME AND ADDRESS OF TESTING LABORATORY l NAME AND DRESS OF PERSON TO RECEIVE ANALYSIS REPORT NO.ANDS EET CITY AND STATE (Zip Code) Return samples and Collection Data to: LCONNECTICUT STATE DEPARTMENT OF HEALTH 10,CLINTON STREET, HARTFORD,.CONN. TELEPHONE:5665626 CHLORINE RESIDUAL (Field Test) FLUORIDE (Field Test) pH(Field test) COMPLAINTS(if"any) mg./1. mg.11. Seth- Foam. , ❑Color ❑Odor ❑Toste ❑ment. Eli ❑Other ADDITIONAL INFORMATION(Special tests required,etc.) EXPLANATION OF COMPLAINTS COLLECTORS COLLECTORS NAME COL SAMPLE NO. LECTOR'S TITLE" DATE OF COLLECTION TIME OF COLLECTION pp to SAMPLE COLLECTED- Y: Fit +t. 1. Env. Health Services ❑ 2. Water Utility.Personnel ❑ 3. Certified Lab. Personnel ❑4i Other h ' 0AT OCE P;R SSIN UTILITY CODE SOURCE YP 'DATE OF_C ELECTION TESTING LABORATORY COLLECTOR 7 ' 8 ;-9 ' )0 11 ; 12� 13'•' 14 15,' 16 17 18 19' 20 , 21 '. 22' 23 24 ' 25 ' 26 ' 27' 2$`' LABORATORY SECTION (Analysis results to be filled in by_State Laboratory Division) C o A rlf� �) PHYS. APP. C L. TRUECOL. ODOR(Description) (Degree) TURBID H CON COM. s= // /�J tt-t- MEMBRANE FILTER TEST ;$ACT. .3/ I 32 33 a34 $ '35± '• 21 6 17 t9 ! 1 COLIFORM COLONIES/100 ML. i 43 j CARD# LAB NUMBER NITRITE(as N) NITRATE(as N) AMMONIA(as N) ALBUMINOID(as N) l 2 3 1 4 , 5 1 6 7 8 9 ' 10 1 ' 1Q 13 i14 151 16 17 CHLORIDE(CI), SOD (Na) ALKALINITY(CaCO3)BICARB.AL ALINITY(CaCO3)CARBON TOT L HARDNESS(C COS) E 21 'tf' @3•24 25 ' 16 111� 28 29' 4 13 • 32 3 •V 35 ' ' •3 34 36.- 7 IRON(Fe) MANGANESE(Mn); FLUORIDE(F) D GENT(ABS) HOSPHATE(PO4) oil=4Q (rd� U •3g 40 a 41 :42 Mom, 43 • 44 1 45 46 • 47 48• 49 SOi S 1 SULFATE(SO4) TDS CALCIUM(Ca) r 1 52' 53 ; 54 55 ' 56 ' 57 1 58 59 ' 60 '61 62 'p- CARD# -LAB-NUMBER- ALUMINUM (A]) - ARSENIC(As) - - BARIUM(Ba). _ - BERYLLIUM(Be) 1 2 ' 3 ' 4 i 5 6 ' 7 8 9 i0 11 i 12 i 13 14 15 , 16 17• 18 �- 19 CADMIUM (Cd) CHROMIUM(Cr) COPPER (Cu) CYANIDE(Cn) LEAD(Pb) j 0 20 •21 ' 22 1 23 ML4 • 25 26 27 1=1 28 ' 29 •30 ' 31:off5m, 32• 33 ' 34 ,: 35 • 36' 37 ' $8 MERCURY(Hg) NICKEL(Ni) SELENIUM(Se) SILVER;(Ag) `THALLIUM-(1-1) 39 • 40 p 41 42 43 •44 ' 45 46 • 47 ' 48 ' 49 w= 50 •5 t 52 '53 54 55 '`56 TIN(Sn) ZINC'(Zn) ANTIMONY(Sb) ILI 57 58 59 60 emu, 61 62' 63 Z ❑ 1. The results of the ana�Y�Is of this sample re $A TI,.S,`FACTOIRY and meet the t:andards set by the Public.Health Code.e� T r �l"id ti 4 T Y L"4 i V .r J1 2. The results of the4nalysis of this sample are UNSATIS TORY and do not meet the standards set by the Public HealthC�ode: d COMMENTS (Yes=1; No=2) �3 EXteSSive MUMS-may Cause et emog if consumed by infants under Pne Year raf a. ?OTABLE WATER COLLECTION/ � EXAMINATION REPORT ✓' i for Lab. Division Use OL-st �� -t2,74 1. Type or print one set and send 4 the dress b3ictW, AB TOR Y TOWty ry PHYSICAL COMPLETE 2.Reports will be furnished only to local director of / health or state agencies. DATE RECEIVED°,, HQ DATE Rp RTED T0: Conn. State Dept. of Health, Laboratory Div., P.O. Box 16$9 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: ®Qvi✓J �'CirM37�FG d -� �j r✓rC�S�'I� OLLECTED BY(Name) ICOLLECTOR'S NO DATE COLLECTED TIME COLLECTED SAMPLING POINT l9 I0 r-1V1(L 171©cl `/- 23- 8a M. fame and Addr ss of person to receive Laboratory Report Well Sema b c Private I � Identification: II_L7(' R. o 7vlw None Filtered Chlorinated Softened /Sy© Treatment: J v/�Jt/.Ytivc ❑ El_ ❑ ❑ Oar T9 pecify)... ............................................................. .S• 1.{Jl�ic�3or� f�6tih �E�7rj/ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM 'ROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) .��'a eoC Fold eason For Conformation To Laws Suspected of Causing Disease Other (Specify or give details here) Here xamination: ❑ (Specify) El(Give Details) ❑ yomplaints Color Odor. Taste Sediment Foami❑ng Other (Specify) 1f: ❑ ❑ ❑ ❑ ❑ lse Of Constant 'Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) ,upply: ❑ ❑ •ounce Of Drilled Well Driven Dug Well $pri❑'ng Oar(Specify) later: / )escription Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Voter Source: Ft. In. 'ossible Source Septic❑lank Farm Industry Other (specify) +f Pollution: pecial Tests equ ired: &r,,f a--,Oj4ct 1i )r {¢-'s 4 17 i dditional Description If Needed. ignature DATE SENT Ind Title: . /-2..3` O LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. PPARENT COLOR TRUE COLOR ODOR T NITRITE c . NVUuA . Sodium as No Magonese as Mn Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F :onstituents as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS litrogen (N) ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 H w`�r hlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. CONCLUSIONS: The results of the analysis of this sample. Meet the requirements fort potable water. k'eet the requirements for�a potable water; however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinki6g until the source of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: .�✓...r.�. C�L j MAY Q r r � ► f�rill POTABLE WATER COLLECTION/ 33107 /7/3 EXAMINATION REPORT ' [� This Section for Lab. Division Use OL-81 REV. 12-74 1. Type print one,34t 1} 0&d to 0-ddress below. LABORATORY NO. !f NO. PHYSICAL COMPLETE 2.Reports will be furnished only to local director of /�1 , health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TO Q. l REPORT: (�C'CL%G� COLLECTED BY(Name) COLLECTOR'SNO DATECOLLECTED TIMECOLLE TED SAMPLING POINT M. Name and Address of person to receive Laboratory Report, Well Semi—Public Private 0 Identification: El 9 1 irC ` None Filtered Chlorin ted Soft�ed L�`Yr� -lr'/fs't�uc y�rtV� Treatment: ❑ ❑ wt..t. .............e c i fy).........................._...... S : e�ls��'� CC, kk 0 6ea�� Other (Specif ..................................... L_ ❑ NAME OF LAB THAT MADE LAST EXAM DATE Of LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Foil Reason Conformation to Laws Suspected of CausingDisease Other (Specify or Here ❑ y give details here) Examination: ❑ (Specify) ❑(Give Details) Complaints Car Oar Taste SedanT Foaming Other(Specify) Of: ❑ ❑ Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ ❑ Source Of Drilled Well Driv�Well lug Well Sprag Oar(specify) Water: Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMB[ G WORK IN-SYSTEM Water Source: Ft. In. Possible Source Septi-Tank Farm Industry Other (Specify) Of Pollution: Special Tests Required: Additional Description If Needed: Signature _ N SET DATE T And Title: fvt!t� ATE SENT, LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR 1 ODOR NITRITE Sodium as Na Magonese as Mn 9 c+ro to �'4rplrg+ c /,0 Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F Constituents droQ �p�� < /moo as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as CaCO3 Sulfate as SO e/YOCpw�bOr�5 Q.(TO 4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this somple- ❑Meet the requirements for a potable water;however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because; ElThecoliform density exceeds acceptable limits. The presence of the cOliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: J01 �' POTABLE WATER COLLECTION/ EXAMINATION REPORT i This Section for Lab. Division Use OL-81 REV. 12-74 + I. Type or print one set and send to the address belo Yr T N N�. Il I COMPLET 2.Reports will ge furnished onl to loco/ director of lit; health or state agencies. '(' >/ TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, tr'1 DATE RECEIVED DATE R PORTED COLLECTION NAM F R RTY(Where sample was taken) ADDRESS REPORT: TOWN COLLECTEDBY(Name) COLLECTOR'SN M1 ATECOLLECTED TIME COLLECTED SAM ING DINT �.k- ; ✓/� M. Name and Address of to receive Laboratory Report Well Semi Public Private Identification: /�—t(G> ✓f/ra_,a_-Y._ 1, C None Filtered ChOor�i�noted _ Softened e Treatment: ................................................................ Other (Specify) ............................. L E NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from Warne and address above) Conformation to Laws Suspected of Causing Disease Other (Specify ar give details her Feld Reason For Here Examination: a (Specify) ❑(Give Details) ❑ Complaints Car Odor Taste Sediment Foaming Other(Specify) Of: Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY{Specify)Supply Source Of Drilled Driven Wei Dug Well Spring Other(Specify) Water: Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL Water Source: DATE OF LAST'PLUMBING WORK IN SYSTEM Ft. In. Possible Source Septic ank Farm it dIK;try Other (Specify) Of Pollution: ED Special Tests Required: Additional Description if Needed: Signature And Title: _ / DATE SENT .G,. p ii 11Itotto 506-2534; LAI$UItATOILY Dlvl �(1()N, • !. 10 Clittion Street 7 I'.U. Box .1089, uArtford, C n. 4101 LABORATORY NUMBER: 3 ) F . HYDROCARBONS: Vapor Test Temp. °C 1� C ,� Column ` Tem2• •C Column Resul`$.expressed as Micrograms per Liter: Component lConcentratioAl Component lConcentratj METHYL ACETATE Methane Butane METHYL ALCOHOL Propane METHYL CELLOSOLVE METHYL iso-BUTYL KETONE ACETATE - �— METHYL ETHYL KETONE AMYL ACETATE 14ETHYL METHACRYIATE AMYI. ALCOHOL NETH=HE CHLORIDE j iso-AMYL, ALCOHOL __.. NONANE BENZENE iso-OCTANE BUTYL ACETATE PENTANE BUM ALCOHOL PETROLEUM ETHER PROPYL ACETATE iso-BUTYL ACETATE iso-BUTYL ALCOHOL iso-PROPYL ACETATE swBUTYL ALCOHOL iso-PROPYL ALCOHOL CARBON TETRACHLORIDE iso-PROPYL ETHER CHLOROBENZENE _ II112,2,-TE TPA CHLOROh-nJANE CHLOROBUTANE TETRACHLOROETHYLENE CHLOROFORM TOLUENE DICRLOROBENZENE l,1,1-TIiICHLOROET'HANE 1,1,2-TRICHLOROETFiANE 1,2-DICHLOROPROPANE �_. TRICHLOROET'HYLENE ETHYL ACETATE VIN7C'I, ACETATE ETHYL ALCOHOL ETHYL BENZENE ETHYL ETHER ---------------- �.. XYLM (ORTHO) ETFiMNE CHLORIDE XYLENE PARA von gLEfEtr'GOLTtON " `. EXAMINATION REPORT inn;or Lab. Division Use OL-81 REV. 12-�4 LA t2R�1.Type or print one set and send to the address below. Y T N N COMPLETE 2.Repdxts will be furnished anly,to local director of t health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN COLLECTION r REPORT: -° rirfE? �i+' r r� t?/ irff' l G;'0. COLLECTED BY(Name) R, COLLECTOR'SNO I DATE COLLECTED1 TIME COLLECTED SAMPLING POINT M. Name and Address of person to receive Laboratory Report Well Semi-Public Private Identification: LD None Filtered Chlorinated Softened 13c;: �,ifEtseF•,.. �, Treatment: ❑ ❑ ❑ a'• .�'t �J :c:. f �£� y1 Other (Specify} ................................................. L ❑ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) <'& in� Fold Reason For Conformation to Laws Suspected of Causing .Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) ❑ ..Complaints Color Odor Taste Seda nt Fong .Ot❑her(Specify) Of: Use Of Constant Emergency 7- SourceE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply ❑ ❑ Of Drilled W Driven Well Well Dug Well Spring Other(specify) Water: 17 DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WOR Description Of WELL K IN SYSTEM Water Source: Ft. In. Possible Source Septi Tank Farm Industry Other (Specify) Of Pollution: Special Tests Required Additional Description If Needed:: Signature DATE SENT And Title: a" LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY NITRITE Sodium as No Maganese as Mn Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F Constituents as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as C00O3 Sulfate as SO4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- ❑Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed.' ❑The concentration of cert chemical of physical constituents exceeds acceptable limits. These are as follows: Other: 1 p POTABLE WATER COLLECTION/ EXAMINATION REPORT OL-81 REV. 12-74 } l• Type or print one i 2•Reports wi//Lie e set o d send to the address This Section for TO: health bolo Lab. Division Use Conn. State Dept. or state o .,y to /oca/director of j+ Y,y T, N P of Health, Labarotor 9encieS. • Nq. !1 I COLLE y Div., P.O, Box 1689 Ho hI, COMPL CTIO/y ME OF R ERTY DATE RECEIVED , CO�EC I ED By l-�!�(whore sample was taken) ADDRESSrd, 4 DAT`R PO RTED (Nam,€,) j U�, COL LECTOR'S NO 'rY TOWN ' ""c, Jfi/�K DATEC LLECTED r� Name and Address- ( /J TIME COLLECTED / Person i to receive {�' `�' .. SAM LING IN Labors tory Report !',:• .`"` .M. � ,.�.. Well y � Identifion: Semnublic icat J f i V _ i��c f • r' L`J%vff3�St,� LT None Filtered Treatment: ❑ E] Chlorinated Softene< Other (Specify) ...................... . .. PROPERTY ................. OWNE ,....R'S NAME NAME AND ADDRESS(!f different tro OF LAB THAT MADE LAST m name and address above) EXAM DATE OF L ST EX Reason Fore C®nformation to (t L Examination: Laws a (SPectty) Suspected of Cousin Complaints Color v Disease Oar (speclty or Of: O Or Taste Dousing Details) Kive details here)Sediment Fold 11 Fo ng Other(S a Here Use Of Con�_stant EJ P city) supply: Eme_rgency DATE OF LAST USE CONDITIONS WateSourr: Of Drilled �y„yt. Well THAT MAY AFFECT (�J ' ' Driven WATER QUALITY(Specity) Du�II Sprin Deseri ❑9 Oar(Specity) Pfion Of WELL DEPTH Water Source: WELL DI P AMETER CONDITION NDITION OF CURB AND TOP ossible Source Septic In. SEAL Of pollution: P❑°nk Form IndustryDATE OF LAST Other (Specify) PLUMBING WORK IN SYSTEM Special Tests Required: Additional Descri tion P if Needed; Signature And Title: 9 DATE SENT jtr w..a.s'•6 '.►..4i F`r..YJt .dB f%06.. L:i d"+.!'',E,F"CA t{Cat N6.F i- a4C till A.aj-i ah,,,o 5tcr;-rt,.l�i LA110R�A'4'ORY DIViylt� • 10 Clinton Street P.U. BOX 1689, Hartford, CoL. i 101 LABORATORY NUM$ER: HYDROCARBONS: ' Vapor Test Temp. 4,, °C 7j C S7 `� Column Temp. °C i Column Results expressed as Micrograms per Liter: P.;``,'h Component lConcentrati®n; Coaai onent Concentrast: METHYL ACETATE Methane I Butane ; METHYL ALCOHOL Propane METHYL CELLOSOLVE �..,i METHYL iso-BUTYL KETONE ACETONE' i METHYL ETHYL KETONE I t AMYL ACETATE METHYL METHACRYLATE AMYL, ALCOHOL METR=NE CHLORIDE iso-AMYL ALCOHOL -._ NONANE BENZENE iso-OCTANE BUTYL ACETATE PENTANE BUTYL ALCOHOL PETROLEUM ETHER iso-BUTYL ACETATE PROPYL ACETATE iso-BUTYL ALCOHOL iso-PROPYL ACETATE swBUTYL ALCOHOL iso-PROPYL ALCOHOL CARBON TETRACHLORIDE iso-PROPYL ETHER CHLOROBENZENE l,l,2,2,-TETRACHLOR0ETHANE CHLOROBUTANE 7EETRACHLOROETHYL.W CHLOROFORM TOLUENE DICHLOROBENZENE 1,1,1-TKTCHLOROETHANE 1,2-DICHLOROPROPANE 1,1,2-TRICHLOROETHANE .,....; TRICHLOROETHYLENE ETHYL ACETATE ETHYL ALCOHOL V 1NYL ACETATE ` -----,•----.--�..__ XY.T.,ENE (META) ETHYL BENZENE ETHYL ETHER XYLENE (ORTHO) � �ETf1YLENE CHLORIDE ��� XYLENE PARA SOWN Sfq - O * F T-own, V J Sc C t L/ T)G/ d 1.1 C� ti 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CONN. 06074 �Iosoa•co� AREA CODE 203/644-2511 November 5, 1979 Mr. Robert Davin 29 Farmstead Drive South Windsor, Connecticut Dear Mr. Davin: Recently, a sample of your water was taken and analyzed by the State Health Department Laboratory for hydrocarbons and organohalides (components of solvents, degressers, etc.). Although some components have been found in your water supply, their levels are well below those found to cause or suspected to cause any harmful effects. After discussing the results of your analysis with State Health Department personnel and Dr. Sidney Curtis, Director of Health for the Town of South Windsor, it has been determined that your water will be resampled in the spring of '1980 to determine any change in the levels of these components. If you have any questions, please feel free to contact me at Town Hall, 644-2511, Extension 42. You may also feel free to contact your personal physician if you so desire. Very truly yours, TOWN OF SOUTH WINDSOR Robert Dept la, R.S. Town Sanitarian RD:bra Enclosure .... --- nra1 a..\ .1 IV"/ 1/ [LABOREATORY EXAMINATION REPORT " Section for Lob. Division Use OL-St REV. 12-74 pr O. TOWN NO. PHYSICAL COMPLETE 1.Type or print one34 jt 1n0&d to t t�oddress below. P 72.Reports will be furnished only to local director ofhealth or state agencies. TE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 _If" "D R t COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS 4 1TO E" REPORT: �'j�( G %<! T"�Cd'�� 'T�`Cr �tl,✓f4•cA�cSr• j• COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TltdcCOLLE_CTED SAMPLING POINT ,,ll a Nome and Address of person to receive Laboratory Report Well Semi-Public Private Identification: ❑ t °�'/✓ff`. 19— None Filtered Chlorinoted Softened Treatment: (�[ ❑ S . j.v;►:.t�JCr�' (c .a�z Cr F.�'�c/ Other (Specify).. (( ......... ............................ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fbtd Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) Complaints Color Oa Taste Sed�nt Foaming Other(Specify) Of: Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: El Source Of . Drilled Well Driven Well Dug Well Spring Other(Specify) Water: LL_Jt ❑ ❑ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORKINSYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Oar (Specify) Of Pollution: El Special Tests , Required: Additional Description if Needed: Signature -� DATE SENT And Title: LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR f _J NITRITE Sodium as No Magonese as Mn t _ 1�. C /.f✓ Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F rl�t FG t_6 e+tn Constituents AMMONIA � mcj 10'C'04t�t k.'e_ tyO as Alkalinity as C00O3Carbonate Detergent as ABS �I Nitrogen (N) f�t;r atrnc�vd>7s O,Z-t-O ALBUMINOID Total Hardness as CoCO3 Sulfate os SO4 Hydrogen-(an Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results' of the analysis of this sample- .Beet the requirements for a-potable water;however, the chemical or physical constituents Iisted below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The colifoan density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed. The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: Other: ov PAYABLE WATE COLLECTION/ .» a f7,. EXAMINATION REPORT /��.. 33 �j C/. This Section for Lab. Division Use OL-81 REV. 12;74 1. Type or print one send to the address below. LABORATORY NO. TOWN NO. PHYSICAL COMPLY-,-�_. 2.Reports will be furnished only to local director of health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN .l�T j _ /REPORT: i^QCle�6 /G S / 4l ca 1 COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TIME COLLECTED SAMPLING POINT g o7g Y 2:�v/>.M. T Name and Address of person to receive Laboratory Report Well Semi�' Public Private ,,( Identification: I�i�I �GQ,/u�CL. i None •Itered Chlorinated Softened Treatment: ❑ ❑ ❑ �iK 0—e<ti.l9 Ot❑her (Specify) . .............. _...... �Gn)St NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) ,S'CL4 Fold Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: ❑ (specify) El(GiveDetails) ❑ Complaints Color Odor Taste Sediment Foaming Or(Specify) Of: Use Of Constant Emergency JDATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ Source Of Drilled Well Driven Well Dug Well Spr�i�ng Other(specify) Water: Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source SeptiTank Farm Industry Other (Specify) Of Pollution: Special Tests Required: C7N�c&AI-bIt-u-1.1 } Additional Description If Needed: Signature And Title: T✓r�t. DATE SENT / �®—//^ LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR NITRITE Sodium as Na Magonese as Mn a,,+o l,a,(: Nitro en NITRATE Alkalinity 9 as C00O3 Bicarbonate Fluoride as F Constituents t � 0 as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID . Total Hardness as CaCO3 Sulfate as SO4 Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The-coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: JOHN`z i M. (IP r..�7-Rf k�' .� �, LABC}f�la.�aE Y DIVISION 7-0�� ale Sou� ?dzn� 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CONN. 06074 I�dsoR.CoN� AREA CODE 203/644-2511 November 5, 1979 Mr. & Mrs. Lester Braddock 102 Brook Street South Windsor, Connecticut Dear Mr. & Mrs. Braddock: Recently, a sample of your water was taken and analyzed by the State Health Department Laboratory for hydrocarbons and organohalides (components Of solvents, degressers, etc.). Although some components have been found in your water supply, their levels are well below those found to cause or suspected to cause any harmful effects. After discussing the results of your analysis with State 1tealth Department personnel and Dr. Sidney Curtis, Director ofHealth for the .Town of South Windsor, it has been determined that your water will be resampled in the spring of 1980 to determine any change in the levels of these components. If you have any questions, please feel free to contact me at Town Hall, 644-2511, Extension 42. You may also feel free to contact your personal physician if you so desire. Very truly yours, TOWN OF SOUTH WTNDSOR Robert Dept la, R.S. Town Sanitarian RD:bw Enclosure r V r MLJI...t_ ttJAI ct-. �_VL_r_L_%,t rvty ,�/� ]gyp /� This Section for Lab. ivision Use EXAMINATION REPORT /✓ "` �iq j Y �� E J LABORATORY NO. TO'NN NO. FD COMPLETE OL-81 REV. 12-74 1.Type orprint one serf—P send to the address below.2.Reports will be furnished only to local director of / ahealth or state agencies. DATE RECEIVED ORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN COLLECT 7 C . REPORT: ;rctG�c�cc f(�1,.. �i���, �'� r .S • �,4rj Zc� z~ 7 /{ —f— COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TIME COLLECTED SAMPLING POINT M. Name and Address of person to receive Laboratory Report Well Semi-Public Private Identification: ` Treatment: None 'ltered Chlorinated Softened `�d/ �f�c ;��'Cjt(1Coc, Ff C, ❑ ❑ ❑ Other (Specify) .5'. Ltl j`z�r:j tc,� c?r>�zst 1=E<t•�y� ❑ LNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) j'(L Fold _Here Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sediment Foaming Other(Specify) Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply Source Of Drilled Well Driven Well Dug Well Sprung Other (Specify) Water: ❑ ❑ ❑ ❑ ❑ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution ❑ ❑ ❑ Special Tests Required: Additional Description If Needed: Signature DATE SENT t And Title: =t F�1st7���(� ;!4/:g-.. /C- -ff-?e% LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR Ctr�4�c>1��C.teS c-t.� NITRITE Sodium as No Maganese as Mn t J NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F Nitrogen Constituents CJ'10' C},� )Pr,�. "��`G as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Nitrogen (N) 1 1 .7 <;—r CjW o its eA ALBUMINOID Total Hardness as C00O3 Sulfate as SO4 --gs ��r«+�- -- �1 Of 4_. �L dfzlc�t�ba�t rft�. Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. F} ❑ CONCLUSIONS:The results of the analysis of this sample- 1•Ct µg�.� Meet the requirements for a potable water. Q ❑ Meet the requirements for a potable water; however, the chemical or physical constituents listed below appear abnormally high for a ground supply.-"late water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable-.eater because: ❑"laic•coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking- until the source of this bacterial contamination can be located and removed. ❑1�se concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other POTABLE WATER COLLECTION/ / i` EXAMINATION REPORT ..� ;"' 4 -.ri his 6n far Lab. Division Use ! LABORATORY NO. WN�O. PHYSICAL COMPLETE OL-at ems•:. t�a4 1. Type or print one set and send to the address below. _ '" !may � 2.Reports will be furnished only to local director of z-h4 I -. health or state agencies. DATE RECEIVE i Pk�TE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 " COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: r L fc;e Sf Si Lt�ihdSo/^ COLLECTED BY(Name) COLLECTOR'SNO FATE COLLECTED TIME COLLECTED SAMPLING POINT /� 8o y,23-$o tq M. Name and Address 6f person to receive Laboratory Report Well Semi❑Public Private Identification: 1E?" R /J f✓ice None Filtered Chlorinated Softened L Treatment: ❑ S• Gvl�t rb '' h G c % Ot er (SPecifyj.................................................................. �,sv�, LNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM S /i/ ,O /0 — '>9 PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Here ,eason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) xamination: ❑ (Specify) ❑(Give Details) ❑ :omplaints Color Odor Taste Sediment Foaming Other (Specify) )f: ❑ ❑ ❑ ❑ ❑ ❑ Ise Of Constant Emergency DATE OF LAST USE 1 I.CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) iupply: ❑ ❑ ource Of Drilled Well Driven WellDug Well Spr�g Other(Specify) !ater: WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM escription Of 'ater Source: Ft. In. ossible Source Septic Tank Farm Industry Other (Specify) if Pollution: ❑ ❑ EJ special Tests required: .dditional Description If Needed: ignature 71/- TE SENT ,nd Title: ® 7-3- �0 LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. PPARENT COLOR TRUE COLOR ODOR Tye NITRITE Sodium as No Moganese as Mn .ta Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F -on stituents 0sAMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS ditro (N) ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 H.,aw-e hlorides as CI Iron as Fe J MEMBRANE FILTER TEST p Coliform Colonies/100ML. U C}O CONCLUSIONS: The results of the analysis of this sample- Meet the requirements form potable water. Meet the requirements fora potable water; however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: r 0 1 VANWER, MAY 2 R 1®Ian POTABLE WATER COLLECTION/ � ' J3103 This Section for Lab. Division Use EXAMINATION REPORT ( It:-/.... 3;j LABORATORY NWT�O�WJN NO. PHYSICAL COMPLETE OL-81 REV. 12-74 7. Type or print one set an sendto the address below. n�2.Reports will be furnished only to local director of CPhealth or state agencies. DATE RECEIr� � gAr%PORTED TO: Conn. Stdte Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 a NAI/�1 9 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: C r / C r /- rfr/N.. .�-ice _r f,L.'i COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED I TIME COLLECTED SAMPLING POINT Name and Addr ss of person to receive Laboratory Report Well Semi-Public Private = J Identification: � None Filtered Chlorinated Softened 15' S"�� ��� Treatment: ❑ ❑ S r- W 1"CI - Gre C c� c46G?iV Ot❑her (Specify)................................................................... LNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) 0'e— Fold Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sediment nt Fong Other(Specify) Of: Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: Source Of Drilled Wel Driven Well DugWell Sprin Other(Specify) Water: Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: 11 El El El Special Tests _f-' Required: �nri CAW L,��) i.�} Additional Description If Needed: Signature ' DATE SENT And Title: .0- - LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR +� es O � NITRITE Sodium as No Magonese as Mn :d -CIO er o n Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F Constituents as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as C00O3 Sulfate as SO4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. El Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- - ❑ Meet the requirements for a potable water; however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: tV. ! t" (# ) Jot v ! �la��� Ll._._ .... •jl J'. W t ht�sp4- or H - ---•- t7 >'t IG�•G7y Other (Specify)-................................................................. JNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) FoR Reason For Conformation to Laws Suspected of Cousin Disease Other (Specify or Hero 9 Y give details here) :xamination: ❑ (Specify) ❑(Give Details) ❑ "omplaints Color Odor Taste Sediment Foaming Other (Specify) )f: Ise Of Constant Emerge=Well ONDITIONSTHAT MAY AFFECT WATER QUALITY(Specify) iupply: ❑ ouree Of Drilled We Drivenpag Oar(Specify) later Description�Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEALDATE OF LAST PLUMBING WORK INSYSTEM rater Sourc Ft. In. l le Source Septra Tank Farm if Po Industry Other (Specify) f Pollution: pecial Tests / equired: 9t p f„7 AI yca.*-Co'ftt bo-lj- dditional Description If Needed: ignature DATE SENT nd Title: �• p. t/t' C3 /C,-//- ?ter -ABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. 'PARENT COLOR TRUE COLOR ODOR TURBIDITY NITRITE Sodium as No Magonese as Mn Nitro en NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F 9 an5tituents as AMMONIA Alkalinity as C00O3 Carbonate - Detergent as ABS itrogen (N) ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 Hydrogen-ion Concentration (pH) ilorides as Cl Iron as Fe I rMEMBRANE FILTER TEST Coliform Colonies/100ML. CONCLUSIONS: The results of the analysis of this sample- Meet the requirements fora potable water. Meet the requirements for a potable water; however, the chemical or physical constituents listed-below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. 1 Do not meet the requirements for a potable water because EJ The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: 14t�A L COL,E t EXAMINATION REPORT This Section for Lab. DiviSSSstttioon Use OL-81 REV. 12-74 1. Type or print one set and;end to the address belo LQ ORATORY NO, TO N.+ COMPtE 2.Reports will be furnished only to local director of V� � health or state agencies. ) D E E D ! TO: Conn. State Dept. of Jiealth, Laboratory Div., P.O. Box=1689 Hartford, 'T 06 1 M ,>� t TE E ORTED COLLECTION At F R ERTY(Where sample was taken) ADDR SS r� REP RT: rowN COLLECTED BY(Namej COLLECTOR'SNO DATE COLLECTED IMEQOLL ED SAMPLING POINT f�t�r/�K/fib' Name and Address of person to receive Laboratory Report Weil Sema blic Private ✓\ ;}�j��� j�` —ry Identification: IL�TJ l•� / 1 None Filtered Chlorinated Softene d3�(a SUI�/L/i4 �Lt' Treatment:............4.......I... El El C'• � I �•C'?� Other (Specify) ................................................... NAME OF LAB THAT MADE LAST EXAM DATE OF LAST XA PROPERTY OWNER'S NAME AND ADDRESS(it different from name and address above) Fol Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Hei Examination: ❑ (Specify) ❑(Give Details) Complaints C�r Odor Taste Sediment Foaming Other(Specify) Of: ❑ Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WAT Supply ER QUALITY(Specify) Source Of Drilled WWII Driven Well Dug Well Spring Other(Specify) Water: JL_�Jj/ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source:. Ft. In Possible Source Septic Tank Form Industry Other (Specify) Of Pollution: Special Tests Required: c / C'->J ��-✓i r...l�(;,i,-.. I;C.••S Additional Description If Needed: — Signature And Title; �� }} Z/ f�j 1} DATE SENT esuits are in Mg/L. �urv0vc�.a+c.u� 51A E DEPARI&W TOF HhALTH Ph<,tu, 5fiG•2G0 LABORATORY 1)14'I�,l�i � � 10 Clinton $tr,et P.O. lint 1089, lBnrt.s,ud, !: tan. 66101 LABORATORY NUMBER: ADROCARBONS: Vapor Test Temp. v °C .,c y Column Temp. eC ' Column Results expressed as Micrograms per Liter: 'f-e k Cotn onent lConcentrationi Com onent lConcentral METHYL ACETATE Methane Butane METHYL ALCOHOL Propane METHYL CELLOSOLVE i METHYL iso-BUTYL KETONE ACETONE METHYL ETHYL KETONE AMYL ACETATE METHYL METBACRYLATE AMYL ALCOHOL METHYLENE CHLORIDE iso-AMYL ALCOHOL NONANE BENZENE iso-OCTANE BUTYL ACETATE PENTANE BUTYL ALCOHOL PETROI,EUM ETHER iso-BUTYL ACETATE PROPYL ACETAU3, iso-BUTYL ALCOHOL iso-PROPYL ACETATE s--BUTYL ALCOHOL iso-PROPYL ALCOHOL CARBON TETRACHLORIDE iso-PROPYL ETHER CHLOROBENZENE 1,1,2,21-TETRACHLOROETHANE CHLOROBUTATE TETRACHLOROETHn J E CHLOROFORM TOLUENEE DICHLOROBENZENE 1,1,1-TRICHLOROETHANE 1,2-DICHLOROPROPANE 1,1,2-TRICHLOROETHANE ETHYL ACETATE TRICHLOROETHYLENE ETHYL ALCOHOL VINYL ACETATE ETHYL BENZENE XYf ENE (M1?TA ETHYL ETHER ]{Yd.ENE (ORTIIO) ETHILENE CHLORIDE XYLENE PARA c < 7— 7 EXAMINATION REPORT This Section for Lab. Division Use f LABORATORY NO. T 1 PHY COMPLE OL-81 REV. 12-74 1. Type or print one set and tend to the address belowa ,} � 2.Reports will be furnished only to local director of health or state agencies. DA1rE E VIED f.;• t TE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, T 0611 49 COLLECTLON ME OF PROPERTY (When, s ample was taken) ADDR SS TOWN REPORT: COLL;C.TED BY(Name) COLLECTOR'SNO I DATECOLLECTED IMEOOLLECTED SAMPIING OINT M. Name and Address of person to receive Laboratory Report Well Semi❑Public Private Identification: fE]-- >� f None . Filtered Chlorinated Softens Treatment: (�} ❑ ® Q F ..........Sp ecif...e c if........................ Oth er ( .......................................... LNAME OF LAB THAT MADE LAST EXAM DATE OF LA T XF PROPERTY OWNER'S NAME AND ADDRESS(11 different from name and address above) Bt Conformation to Laws Suspected of Causing Disease Other (Specify or give details here He Reason For p g Y g' ) Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sediment nt Fong Other(Specify) Of: Use Of Constant Emergency JDATEOF LAST USE CONDITIONS THAT MAY AFFECT' WATER QUALITY(Specify) Supply Source Of Drilled Wy11 Driveenn Well DugWell Sprtg Other(Specify) Water: Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK INSYSTE Water Source: I Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: El 0 El El Special Tests Required: Additional Description If Needed: Signature DATE SENT And Title: ? _ j) ✓e lv.//-��i results are in Ma/L. ......•.��.•...�.. .�.r.e� tvcr-�lclrr�er 1 UI' HLALTH Phono 3Rti•2b;tlt 1*110RA.'lOR Y wV1 ,I644'� ► 4 10 Clinton Str,.et P.O. ling IG13a, Ilan."ord, (stun. 0%101 LABORATORY NUMBER: -4 -'- HYDR&ARBONS: Vapor Test Temp. °C ` 7 Colurnn Temp. °C ' Column Results expressed as Micrograms per Liter: Com onent !Concentration! Component lConcentral t METHYL ACETATE Methane i------- L Butane i METHYL ALCOHOL Propane METHYL CELLOSOLVE METHYL iso-BUTYL KETONE ACETONE METHYL ETHYL KETONE AMYL ACETATE I METHYL METHACRYLJATE AMYL ALCOHOL i METHYLENE CHLORIDE iso-AMYL ALCOHOL NONANE BENZENE Viso-OCTAVE ------------- BUTYL ACETATE PENTANE BUTYL ALCOHOL PETROLEUM ETHER iso-BUTYL ACETATE PROPYL ACETATE - • t iso-BUTYL ALCOHOL iso-PROPYL ACETATE s�BUTYL ALCOHOL iso-PROPYL ALCOHOL CARBON TETRACHLORIDE iso-PROPYL ETHER CHLOROBENZENE 1,1,2,2,-TETRACHLOROETHANE CHLOROBUTAANE TETRACHLOROETHYLENE CHLOROFORM TOLUENE DICHLOROBENZENE 1,1,1-TRICHLOROETHANE 1,2-DICHLOROPROPANE 1,1,2-TRICHLOROETHANE TRICHLOROETHYLENE ETHYL ACETATE ETHYL ALCOHOL VINYL ACETATE ETHYL BENZENE XYLEN� (MI��T'A ETHYL ETHER XYLENE (ORT110) .ETHYLENE CRT.-ORTDE XYLF.NE PARR _ LPXANE fill, 0*1N 8pq� _ C 7-awn, ove SotdA 1540 SULLIVAN AVENUE SOUTH WINDSOR, CONN. 06074 `IOSOR-CO AREA CODE 203/644-2511 November 5, 1979 Mr. & Mrs. Louis Carner 69 Farmstead Drive South Windsor, Connecticut Dear Mr. & Mrs. Carner: Recently, a sample of your water was taken and analyzed by the State Health Department Laboratory for hydrocarbons and organohalides (components of Solvents, degressers, etc.). Although some components have been found in your Crater supply, their levels are well below those found to cause or suspected to cause any harmful effects. After discussing the results of your analysis with State Health Department personnel and Dr. Sidney Curtis, Director of Health for the Town of South Windsor, it has been determined that your water will be resampled in the spring of 1980 to determine any change in the levels of these components. If you have any questions, please feel free to contact me at Town Hall, 644-2511, Extension 42. You may also feel free to contact your personal physician if you so desire. Very truly yours, TOWN OF SOUTH WINDSOR Robert Dept la, R.S. Town Sanitarian RD:bw Enclosure LABORATORY NO. TOWN NO. PHYSICAL COMPLETE OL-81 REV. 12-74 }.Type or print one set arisen to the address below. 2.Reports will be furnished only to local director of A4 C health or state agencies. DATE RECEIwpU� �ffj.SFPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 3� COLLECTION NAME OF PROPERTY(W here sample was taken) ADDRESS TOWN REPORT: C .�L f— C) i f-ju. '--:� tt�j.ficfs'c.�: COLLECTED BY(Name) COLLECTOR'SNO I DATE COLLECTED TIME COLLECTED. SAMPLING POINT Name and Addrerss of person to receive Laboratory Report - Well Semi-Public Private Identification: D tL�1 None Filtered Chlorinated Softened `✓ �j<Y4 S`�,L�U. , IJ u Treatment: ❑ .............. ............_.............................._... t:= Other(Speerfy) ...................... JNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS fit different from name and address above) S�Z .e Fold Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here (Specify) (Give Details) Examination: ❑ ❑ ❑ Complaints Color Odor Taste Sediment Foaming Other(Specify) Of: D F1 El El El Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: Source Of Drilled Well, Driven Dug Well Spring Other(Specify) Water: IUY Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank farm Industry Other (Specify) Of Pollution: El El ❑ ❑` Special Tests Additional Description If Needed:' _- Signature , DATE SENT And Title. s LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR E t�(ir�rur •CfE-S 0 ao NITRITE Sodium as No Maganese as Mn tt Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F ..t Constituents ,!zZQZ6.sL,,+.a�i, f%ft4�ip,,,�,t'..f •^" as AMMONIA Alkdlinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) '� ALBUMINOID Total Hardness as C00O3 Sulfate as SOq Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water;however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence Of the coliform group, while not necessarily meaning that disease producing organisms a.e present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe far drinking until the source of this bacterial contamination can be located and removed. ❑Tne concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: Other: 'OTABLE WATER COLLECTION/ ' EXAMINATION RF.PORT l� ct forlob. Divisioh Use OL-81 REVz;-r � L NO. PHYSICAL COMPL TE , 1.Type or print one set and send t the address below. 2.Reports will be furnished only to local director of $ health or state agencies. DATER C 1! s � l ::DA ;REPORTER TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 .T COLLECTIONNAME OF PROPERTY(Where sample was tak=16 RESS TOWN REPORT: cjr.'iAwf'- q Fr! mr S' L41yi Sir :OLLECTED BY(Name) COLLECTOR'SNO OATECOI LECTED TiMECOLLECTED SAMPLING POINT flame Ind Addre s of person to receive Laboratory Report Well Semi-Public Priva� te i Identification: t__!�l•r" None Filtered Chlorinated 5o teoe Treatment: ❑ ❑ ❑ n �/ _ ...._...............................................................:.. f s, w/�?O�So I^� �"bhP). OE G7 7 Other (Specify) L�. J NAME OF LAB THAT MADE LAST EXAM DATE OF LAST AM 07 'ROPERTY OWNER'S NAME AND ADDRESS(It different from name and address above) Fold :eosin For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Were xomination: ❑ (Specify) ❑(Give Details) ❑ :omplainrs Color Odor Taste Sediment Foaming Other(Specify) _ )se Of Constant Emer ency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY pact y) " apply: ❑ : ourcr• Of Drill11 Driven WellDug Well Spr'I❑ng-- Qr pacify) later: )escription Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM later Source: I s Ft. In. Sei�tM+C� 'ossibie Source Septic Tank Farm Industry Other (Specify) )f Pollution: ❑ ❑ ❑ ❑ pecial Tests _r;squired: O�°FaMa�nu�t Ctrs 4- �iyt�ro cmrhatis additional Description If Needed. Ignature DATE SENT ,nd Title: LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division). plot Chemical results are in Mg/L. PPARENT COLOR TRUE COLOR ODOR i NITRITE Sodium as No -- Magonese as Mn /j Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F ,onstituents as AMMONIA - Alkalinity as C00O3 Carbonate Detergent as ,nitrogen (N) ALBUMINOID Total Hardness as CoCO3 Sulfate as SOq 1_ hlorides as Cl Iron as Fe `J k.-HPEMBRANE FiLTEi �$ p Coliform Colonies/1 " r .CONCLUSIONS:The results of the analysis of this sample- i e77 Meet the requirements fora potable water. 7 Meet the requirements fora potable water; however, the chemical or physical constituents listed below appe$r abnotmally high for a ground supply. The water should.be suspect if local conditions indicate that the source of these constituents is a potentiaily;bful one. Do not meet the requirements for a potable water because: # ❑The Coliform density exceeds acceptable limits. The presence of the Coliform group, while not necessarily meaning the - sease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should'be consldered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑other: fit.'r ?� 1 MAY . Q moo POTABLE WATER COLLECTION/ .tom L EXAMINATION REPORT 3 This Section for Lab. Division Use OL-81 REV. 12-74 1. Type 1 print on et n'1sOend to address below. LABORA(T�ORY NO. T PHYSICAL COMPLETE 2.Reports will be furnished only to local director of QCT L 8 15 170 health or state agencies. DATE RECEIVED DA E REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF7 ROPERTY(Where sample was taken) ADDRESS TOWN REPORT: C} COLLECTED BY(Name) COLLECTOR'SNO DATECOLLECTED TIMECOLLECTED SAMPLING POINT j)k_J(� Ih---/Il•7�7 Jl t7.M. pv '��4/� ¢L(✓c'r� Name and Address of person to receive Laboratory Report Well Semi-Public Private Q 1 Identification: I ffs None Filtered Chlorinated Softened j.3�yt7 .fi/,�/ir6Fnn. �✓ae Treatment: ❑ ❑ ❑ ❑ ... Other (Specify) ❑ - NAME OF LAB THAT MADE LAST EXAM' DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) ,::�6x-k-ke- Fold Reason For'- Conformation to Laws .Suspected of Causing Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Cr T Sediment ify) Of: aE] E] o (Speca Use Of Constant Emergency DATE Of LAST IIEJ CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: El 0 Source Of Drilled Well Driven E Well lug Well Spag Other(Specify) Water: II 'mil/ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. 7 Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: Special Tests Required: Additional Description If Needed. Signature ' DATE SENT And Title: � LABORATORY EXAM/NATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR n �S NITRITE Sodium as NO Maganese as Mn t t'�JJ Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F Constituents f / G1�1C!'sICrO /triQJ j Q as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Nitrogen (N) ll �✓ C�Mr15 Q'OZ1 ALBUMiNOID Total Hardness as CaCO3 Sulfate as SO4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: F]The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: ' 1 (A"CION ORt t >.» Y ` , Thls'S�eetion for Lob. Division else. = OL-81 REV. 12-74 1.Type or print one set and send to the address below. CAB ORATORY NO. T N NO. PHYSICAL COMPLETE 2.Reports will be furnished only to local director of health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF. ROPERTY(Where sample was taken) ADDRESS TOWN REPORT: i '� ,. .,•:. r.ts clI i COLLECTED BY(Name) COLLECTOR'SNO I DATE- ECTFL) TIME COLLECTED SAMPLING POINT Name and Address of person to receive Laboratory Report Well Semi-Public Private r Identification: one Filtered Chlorinated Softened Treatment: ❑ ❑ ❑ ❑ .............. ....._........... c f <: y Other (Specify) NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) 7 f r`KC Fold Conformation to Laws Suspected of Causing Disease Other (Specify or Here Reason For P g give details here) Examination: ❑ (Specify) (Give Details) Complaints Color Odor Taste Sediment Fo ng O�r(Specify) Of: Use.Of Constant Emergency JDATE OF LAST USE I CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: Source Of Drilled Well Driven Well Dug Well Spag Other(Specify). Water: �t—.JT1 Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible source Septic Tank Farm Industry Other (Specify) Of Pollution Special Tests Required: drrtr- ti fr a Additional Description If Needed. Signature DATE SENT And Title: LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR NITRITE Sodium as No Maganese as Mn , Nitrogen NITRATE Alkalinity'as CaCO3 Bicarbonate Fluoride as F Constituents as AMMONIA Alkalinity as CGC03 Carbonate Detergent as ABS Nitrogen (N) // 4 ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water;however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because; ❑The Coliform density exceeds acceptable limits. The presence of the Coliform group, while not necessarily meaning that disease producing organisms are present,does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows ❑Other: s nearrn or state agencies DATE RECEIVED TED - TO: Conn. State µDepf:)of Health, Laboratory Div., P.O. Box 1689 Hartford; CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: 4" 6!E r4e-/ k� �l/w s r O� S COLLECT D BY(Name) COLLECTOR'SNO DATE COLLECTED TIMECOLLECTED SAMPLING POINT Name and Address of person to receive Laboratory Report Well Semi-Public _Private p' 1� y Identification: /i t f3 T ! None Itered Chlorinated Softened .�v��lPlltw. �v� Treatment: �❑ ❑ ❑ .................................................0 LA-1I fnC1,.3-0, / e tan Yl 06G7Y Other (Specify) • NAME OF LAB THAT MADE LAST EXAM ATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(lf different from name and address above) Fold Conformation to Laws Sus ected of Causing Disease Other (Specify of Here Reason For' P g ❑ give details here) Examination: (Specify) ❑(Give Details) Complaints Color Odor Taste Sediment Foaming Other(Specify) Of: El El El Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER,QIUALITY(Specify) Supply: 1-1 Source Of Drilled Well Driven Well Dug Well Spring Other(Specify) Water: ❑ ❑ ❑ ❑ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution El Special Tests Required: tj r 6'S3 f tfii c"U/ b�1J Additional Description if Needed: Signature TD6 SENT And Title: ep LABORATORY EXAMINATION REPORT (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY f-i i e;, NITRITE Sodium as Na Maganese as Mn Nitrogen NITRATE Alkalinity as C aCO3 Bicarbonate Fluoride as F Constituents as AMMONIA Nitrogen (N) Alkalinity as CaCO3 Carbonate Detergent as ABS ALBUMINOID Total Hardness as CoCO3 Sulfate as SO4 Hydrogen-ion Concentration(pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water; however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. . ❑ Do not meet the requirements for a potable-water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source-of this bacterial contamination can be located and;removed. ❑The concentration(of certain chemical or physical constituents exceeds acceptable limits. These are as follows: 1.2 11 f �_;: Other: _f `�. i, - , t _"1< �� SAMARA L.. C®M l ..v s ev�ai EXAMINATION REPORT This Section for Lob. Division Use OL-89 REV. 12.74 ODE—R—ECEIVE 1. Typc or print one set and fiend to the address beloY NO TOC��N PHY C�L GOMPLET2.Reports will be furnished only to local directorof � ` , «health or state agencies. TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 061 1 rWiRt �RTED_� COLLECTION NAME OF PRO ERTY(Where sample was taken) ADDRESS REPORT: /� TOWN COLLECTED Y(Name) !l`I I COL LECTOR'S NO DATE COLLECTED TIMECALLECTED j . LING OINT J t. ° f Name and Address of person to receive Laboratory Report Well Semi-Public Private Identification: fU7l., Treatment: None--Filtered Chlorinated Softened �•, YC` ,fv`/oi' c( -- /tt�C- ❑ ® ❑ L ..........Sp ecf...e c i fy)........... ............................ ..............am. l Vt�st.•i- a C't'o�rt `•�°C=,'�,' Other ( LNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXA10 PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Pole Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details hero) Here Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor T®e Sediment Foaming Other(Specify) O f: (I.JI ❑ ❑ Use Of Constant Lncy DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: Source Of Drilled Well Driven Well Dug Well Sp�g p�r{Specify) Water: Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP�SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: ❑ Special Tests Required: r ' i Additional Description if Needed: Signature DATE SENT Nm6fj in Mg/L. Phone 50 -'25su LAIiORA'1'UIIY 1)IVIPION ►o Clinton Street s tS P.O. Box 1689, Hartford, Cbnn..f6io1 LABORATORY NUMES: � �?� / l ,, HYDROCARBONS: Vapor Test Temp. 4 °C t� column Temp. °C i Column ~ Results expressed as Micrograms per Liter: a i Component SConcentratio-rii 4 Component IConc� entrat METHYL ACETATE Methane E Butane i i METHYL ALCOHOL Propane METHYL CELLOSOLVE METHYL iso-BUTYL KETONE ACETONE ' METHYL ETHYL KETONE i AMYL ACETATE METHYL METHACRY?ATE AMYL ALCOHOL E+ IENE CHLORIDE iso-AMYL ALCOHOL NONANE BENZENE iso-OCTAVE BUTYL ACETATE PENTANE i BUTYL ALCOHOL PETROLEUM ETHER iso-BUTYL ACETATE PROPYL ACETATE iso-BUTYL ALCOHOL iso-PROPYL ACETATE . s,-BUTYL ALCOHOL iso-PROPYL ALCOHOL CARBON TETRACHLORIDE iso-PROPYL ETHER CHLOROBENZEIQE 1,1,212,-TETRACHLOROE17ANE CHLOROBUTANE 'I`ETRACHLOROETHYLENE CHLOROFORM TOLUENE, DICHLOROBENZENE 111,1-TRICHLOROFTHANE 1,1,2-TRICHLOROETAANE 1,2-DICHLOROPROPANE TRICHLOROETHYLENE ETHYL ACETATE — VINYL ACETATE ETHYL ALCOHOL ETHYLBENZENE --- xYIENE (tTA ETHYL ETHER XYLENE (URTHO) XYLENF. (PARR) ETHYT2NE CHLORIDE ----*------ -...- — OL1 'REV. ti=74 4 I.Type or print'trne set` and send(to the-addres7beiow.. ; PH SICAL COMPLETE 2.Reports will'be furnished only to local directo 'health or state,agencies. TE RECEIVED :,t T TED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 0 7 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN f REPORT: l f fir, j Ly COLLECTED BY�ICOLLECTOR'SNO DATE COLLECTED TIME COLLECT D SAMPLING POINT tr1.M. f41 Name and Address of person to receive Laboratory Report f r 6 / Well Semi-Public Private t�j ¢ r" f.' 1 14.- �I Identification: Treatment None .lt❑ered Chlorinated Softened O .. t . .. ❑ �: �� ther (Spem ....................fy) -•.............................. Y NAME OF LAB THAT MADE LAST EXAM ATE OF LAST EXAM. PROPERTY OWNER'S NAME AND ADDRESS(It different from name and address above) ;., Fold .. Reason For- Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: FI (Specify) (Give Details) ❑ Complaints Color Odor Taste Sediment Foaming. Other(Specify) Of: ❑ ❑ Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATEf3 -:1UALITY(Specify) L Supply Source Of Drilled Well Driven Well DugWell. Sprag Other(Specify) Water: El Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL Water Source: Ft. DATE OF LAST PLUMBING WORK IN SYSTEM In. Possible Source _ Septic Tankz- F� Industry Other (Specffy) Of Pollution: Ei Special Tests #t Required: Additional Description If Needed: Signature And Title:. i ' DATE SENT LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY V NITRITE Sodium as No Magonese as Mn 'Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as f Constituents as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as CoCO3 Sulfate as SOq Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. . ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- ❑Meet the requirements for a potable water;however,the chemical orphysical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms - are present,does indicate that such contamination might reach die supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration oA certain chemicajor physical constituents exceeds acceptable limits These are as follows: Other: s j ARBARA L COLE DIRE EXAMINATION REPORT ••�„ This Section for Lab. Division Use OL-81 REV. 12-74 T Y NO. TO MQ. PHY ICpL COMPLET 1. Type or print one set and send to the address below /mod 2.Reports will be furnished only to local director of i health or state agencies. ) D E RECEIVE t jR pRTED}� TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 061 1 �Y{ (Where sNfnple was taken ADDR sS COLLECTION F R R TC)WN REPORT: COLLECTED BY(Nanur) COL LECTOR'S NDATECOLLECTED TIMEC:OLLECTED S M LING POINT Name and Address of person to receive Laboratory Report Well Semi-Public Private Identification: f ' None Filtered Chlorinated Softenea I'Fyc' .fvll/v et ft t,r' Treatment: E ® ❑ ...... ................................................................................... .S" L4 1 Ih�3t•i- Other !specify) i LNAME OF LAB THAT MADE LAST EXAM DATE OF L X 6 PROPERTY OWNER'S NAME AND ADDRESS(I(different from name and address above) SC6......k" - Foll Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here.) Ner+ Examination: (Specify) ❑(Give Details) Complaints Color Odor —Taste Sediment Fong Other(Specify) Of: Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: rU� Source Of ,Drilled Driven Well Dug Well Spdg Other(Specify) Water: u Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. in. Possible Source Septic Tank Form Industry Other (Specify) Of Pollution: Special Tests Required: Additional Description If Needed: Signature ---]DATE SENT /L. o .�••..»...e..v■ .0.ra4U vr.a rrnaarss://vi `ar r'ICHLln Phone 566-°2b.36 LABOItA'1'ORY DIV1S10 i 10 Clinton Street ,,,��jj P.U. 114>x 1689, fliartford, 4nn.e&101 LABORATORY NWBER: 3 "5 l I � - y HYDROCARBONS: Vapor Test Temp. °C Column • Temp. - °C i Column Results expressed as Micrograms per Liter: a r . Com onent (Concentration' Cam onent Concentrat METHYL ACETATE Methane Butane { METHYL ALCOHOL Propane I METYffL CELLOSOLVE METHYL iso-BUTYL KETONE ACETONE ' METHYL ETHYL KETONE t AMYL ACETATE METHYL METHACRYLATE AMYL ALCOHOL METHYLENE CHLORIDE iso-AMYL ALCOHOL NONANE BENZENE ISO-OCTAVE BUTYL ACETATE PENTANE BUTYL ALCOHOL PETROLEUM ETHER I iso-BUTYL ACETATE PROYYL ACETATE iso-BUTYL ALCOHOL iso-PROPYL ACETATE, s-•BUTYL ALCOHOL iso-PROPYL ALCOHOL CARBON TETRACHLORIDE iso-PROPYL ETHER CHLOROBENZETTE l,1,2,2,-TETRACHLOROETHANE CHLOROBUTANE TETRACHLOROETHYLENE CHLOROFORM TOLUENE DICHLOROBENZF.NE I,1,1-TRI'CHLOROETHANE 1,1,2-TRICHLOROETHANE 1,2-DICHLOROPROPANE TRICHLOROETHYLENE ETHYL ACETATE - ----- _ --- VINYL ACETATE ETHYL ALCOHOL XYI,ENE (PTA ETHYL _BENZENE ETHYL ETHER _ XYI.ENE (ORTHO) ETHYLENE CHLORIDE XYLENE PARR _ ""- ���L�� co C 44 wG 1540 SULLIVAN AVENUE • SOUTH WINDSOR. CONN. 06074 I�oSOe•cO�'� AREA CODE 203/644-2511 November 5, 1979 Mr. Charles Barker 18 Farmstead Drive South Windsor, Connecticut Dear Mr. Barker: Recently, a sample of your water was taken and analyzed by the State Health Department Laboratory for hydrocarbons and organohalides (components of solvents, degressers, etc.). Although some components have been found in your water supply, their levels are well below those found to cause or suspected to cause any harmful effects. After discussing the results of your analysis with State Health Department personnel and Dr. Sidney Curtis, Director of Health for the Town of South Windsor, it .has been determined that your water will be resampled in the spring of 1980 to determine any change in the levels of these components. If you have any questions, please feel free to contact me at Town Hall, 644-2511, Extension 42. You may also feel free to contact your personal physician if you so desire. Very truly yours, TOWN OF SOUTH WINDSOR Robert Depfula, R.S. Town Sanitarian RD:bw Enclosure. f V 1 HL7 L.G JAIL.R t.v L.LL L_%.i IVIII /;: � �� This Section for Lab. Division Use EXAMINATION REPORT ! ((/'� 'o LABORATORY NO, T tin PHYSICAL COMPLETE OL-81 REV. 12-74 ),Type or print one set ant() to Q address below: ti 5 2.Reports will be furnished only to local director of e III �� IJ�it health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS _ / TOWN REPORT; `j - �,.i,`tstl�CI • GCr�G�f1�Jt�t' COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TIME COLLECTED SAMPLING POINT /!� .M. C%�='�,���?�•• -t��.c-c•r:.'?'L. Name and Address of person to receive Laboratory Report Well Semi-PPu6lic Private Identification: None Filtered Chlorinated Softened Treatment: ❑ El El El Other(Specify) ,�• t-L' i +.1r.I,5 c�— , C.'c.L.r1. C E.i_;'if. ❑ JNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(It different from name and address above) It-Ivtt Fold Here Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Examination: (Specify) ❑(Give Details) Complaints Color Odor Taste Sediment. -Foaming - Other(Specify) Of: ❑ ❑ LJ ❑ ❑ ❑ Use Of Consssttant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply Source Of Drilled Well Driven Well Dug Well Sprag Other(specify) Water: FL7 LJ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATEOF LAST PLUMBING WORK INSYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: ❑ ❑ El Special Tests Required: �•,y nGt - r:,/ ( `t� 3_ Additional Description If Needed: Signature i DATE SENT And Title: A, j)•i ? f_� .� jj� .t1 .. j�"'f!_ LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR NITRITE Sodium as No Maganese as Mn 3 NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F Nitrogen I �) f Constituents f ( z �G>xa f0 cJ`4" as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Nitrogen (N) ��✓ C;f►"Z►ccut€jt»S Q' } ALBUMINOID Total Hardness as CoCO3 Sulfate as SO4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ElCONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water. ❑ Meet the requirements for a potable water; however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ D-.) not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. Tlie water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed. ElThe concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: 'OTABLE WATER COLLECTION/. fAT e on or Lab. Division Use X-AMINATIO7 REPORTR o�)up PHYSICAL COM L tOL-81v=rz-7a 1. Type or print one set and send to he address below.2.Reports will be furnished only to local director o{ eheaNh or state ageneles. ED is f ti ATE REPORT z TO: Conn. State Dept. of Health, Laboratory Div., P.O.'Box 1689 Hartford, CT 06101 -712 COLLECTION N ME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: er, >�prnrl� C� .OLLECTED BY(Name) COLLECTOR'SNO DATECOLLECTED TIMECOLLECTED AM LING POINT 63.0 -4d c lame and Addre s of person to receive Laboratory Report Well S'emi-PubliZ Private Identification: None Filtered Chlorinated Softened IS i�p Jv//i Yam, jwe Treatment. ❑ ❑ ❑ s- a—,I NC1�SOP � C'frvfn o60�� Other (Specify) ..............:..................... L NAME OF LAB THAT MADE LAST EXAM DATE F LAST EXAM 'ROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Conformation to Laws Suspected of Causing Disease Other (Specify or give details here Reason For 9 y � ) 'Examination: ❑ (Specify) ❑(Give Details) ❑ :omplaints Color Odor Taste Sediment Foaming Other(Specify) )se Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: Iu�i ouree Of Drilled Well DrivenWell Dug Well Spring Other(Specify) ---- 'ater: ❑ ❑ )escription Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBIN .W RKINS ST 'ater Source: Ft. In. k ossible Source Septic Tank Farm Industry Other (Specify) )f Pollution: ❑ ❑ ❑ ❑ pecial Te^ts ! 1 ,equ?red: or la,,, xdoitlonal Description If Needed. signature DATE SENT r' ind Title: ® /J (f/— 23— 10 LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. .PPARENT COLOR TRUE COLOR ODOR W.de o. NITRITE Sodium as No Maganese as Mn ee Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F :onstituents as' AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Vitrogen (N) ALBUMINOID Total Hardness as CoCO3 Sulfate as SOq o n ArtD '• hlorides as CI Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. CONCLUSIONS: The results of the analysis of this sample- Meet the requirements fora potable water. Meet the requirements for a potable water; however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meanie that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located-,and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: 141 ....r t •tr MAY tom_ POTABLE WATER COLLECTION/ / 33095 ffa EXAMINATION REPORT T S c ion for Lab. Division Use OL-81 REV. 12-74 1. T LABO Cype t�r r�T'lSne se se o the address below. RATN TO AL OMPLETE 2.Reports will be furnished only to local director of health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS .it Est TOWN REPORT: earnei �a-tA -"d _S irtA�s�'o- COLLECTED BY(Nam.) COLLECTOR'SNO DATECOLLECTED TIME COLLECTED SAMPLING POINT 4� .�1 t�_w, , ��— M: rJv .fir V�G '�s e Name and Address of person to receive Laboratory Report Well Semi-Public Privat Identification: ❑ Ze IP� j S None Filtered Chlorinated Softened`l, Treatment: ❑ ❑ ❑ Other (Specify) L _j NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) ✓-^-"�- Fold Reason For' Conformation to Laws Suspected of Cawing Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sediment Foam Of: Other(Specify) Of: Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ ❑ Source Of Drilled Wgll Driven Well DugEll Spag Olr(specify). Water: Description Of WELL DEPTH WELL DIAMETER I CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: Special Tests Required f7�h emf G ka 11 df-.S Additional Description If Needed. Signature And Title: LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR n L ` e NITRITE Sodium as No Maganese as Mn • n Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F t 1 1 Jr-'.C ,10yo e"�'�1QnG It:/ C Constituents as AMMONIA Alkalinity as CoCO3 Carbonate Detergent as ABS Nitrogen (N) �'rrerA ALBUMINOID Total Hardness as C00O3 Sulfate as SO4 � �"nn Chlorides as Cl Iron as Fe I�a,,,G PMEMBRANE FILTER TEST Xs Coliform Colonies/100ML. ❑ Meet the requirements for able water. CONCLUSIONS:The results of the analysis of this sample- pota ❑ Meet the requirements for a potable water;however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ElThe coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ElThe concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ©Other• ,>1 3 on ��r lr,ab. Divi i n'Use OL-81 REV. 12-74 � . a�;ti. L BORATO OW N 1. Type all�f one set and send to the address below. AL COMPLETE 2.Reports will be furnished onlyto local director ctor of health or state agencies. DATE RECEIVED TO: Conn. State Dept. of Health, Laboratory Div., P.O.'Box 1689 Hartford, CT 06101 DATE REPORTED COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS REPORT: t JTOWN _ .'` tie- COLLECTED BY(Name) COL LECTOR'S NO DATE COLLECTED TIME COLLECTED SAMPLING POINT Name and A dress of person to receive Laboratory Report We Sem blic Private Identification: tification: I�= Treatment: NOne Filt❑ered Chlorinated Softened ❑ Via,= !.-sr-J t F;,-, (SP er (Sp ec{f,, 7 Oth ...................... JNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For' Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) Complaints Color O�r Ta❑ste Sediment Foaming Other(Specify) Of: ❑ ❑ ❑ Use Of Constant Emergency DATE OF LAST�USECON�MITIION�.STHAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ ❑ Source Of Drilled WgJI Driv�Wel1 Dug�ll Spring Other(Specify) Water: ❑ ❑ Description Of WELL DEPTH WELL DIAMETER CONDITION.OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank Form Industry Other (Specify) Of Pollution: ❑ Special Tests Required Cl Additional Description If Needed: Signature And Title; � u/ . f DATE SENT /L - LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR NITRITE Sodium as NO Mogonese as Mn NITRATE I f .l I iris. >• 1 Nitrogen Alkalinity as C00O3 Bicarbonate Fluoride as F Constituents as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as C00O3 Sulfate as SOq Chlorides as Cl `. l,:r itr, Iron as Fe MEMBRANE FILTER TEST e ,1 Coliform Colonies/100ML. - ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- - ❑Meet the requirements for a potable water; however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking ❑until the source of this bacterial contamination can be located and removed. The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: i:nts aection to) Lqb <UZKision Use OL-87 REV:. 72-74 '` ]•�Ype or print one set and send to the address below. LAO ATO Y TOWN NO. PH SICAL COMPLE E 2.Reports will be furnished onlyto,local,director of health or state agencies. 4 DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1`689 Hartford, CT 06101 — NAME OF PRO ERTY.(Where sample was taken) ADDRESS TOWN COLLECTION a #jf REPORT: 3 _ (�r nwi G t+v:74'nt l ' f�4r u41�Vic, `.Lir i'k/5 V� COLLECTED BY(Name)' COLLECTOR'SNO DATE COLLECTED TIME COLLECTED SAMPLING POINT I G- d- >t/ '— M. Name and d ess of person to receive Laboratory Report v _Src e • ub f . Identification Semi-Public Private Identification: None Filtered Chlorinated Softened 0.5'Yz� ,.�✓/lfi/ 'A.�•i p�i..�E' Treatment: �SC✓' t �G vtvl Other (Sp ecify) -.....-•-------•-.._•...-•---•-••--• -.....•.. NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For Conformation to Laws Suspected of CausingDisease Other (Specify or Here ❑ y give details here) Examination: ❑ (Specify) ❑(Give Details) Complaints Color Odor Taste Sediment Foaming Other (Specify) Of: ❑ ❑ ❑ _Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ ❑ Source Of DrilledW ll Drive❑n ell Dug Well Spr�g Other JSpecify) Water: Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. P SEIn. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution Required: �f/"vy3 �3YCl/Gta/ G'�wdf. Additional Description If eeded Signature nn DATE SENT And Title: LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division)_ Note: Chemical results .are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY NITRITE Sodium as No Magonese as Mn Nitrogen NITRATE Alkalinity as CaCO—Bicarbonate Fluoride as F Constituents as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) 7LBUMiN01D Total Hardness as CaCO3 Sulfate as SOq Hydrogen-ion Concentration (pH) -hlorides as CI Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water. ❑ Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a po�entially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group,,while not.necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same^.extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. 0 The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: [ •Other: • r f••va.c ttA t LK LULLEC TION EXAMINATION REPORT i OL-et REv. 12.74 This Section for Lab. Division Use I.Type or print one set and Rend to the address below L Q Y-NO. 2.Reports will be furnished only to loco) director of 1T1Rf� TOWN N'.. PHYSICAL COMPLE' health or state agencies. Ali/ / .�) T0: Conn. State,0ept. of,Health, Laboratory Div., P.O. Box1689 Harthtd, 9T 06 1 DA E RECEIVED D TE RE pRTEOr... :REPORT: LLEC=, -� ern ssmp a wag ra do AODR .f / "//' TCOLLECT (IVame) c rn.•y` .u/'f COLLECT R'S N LEC ED TIME COL Ep �� +^r�L NG - }y Nome anAd. rasa of person to receive Laboratory Report �� fir. M. --- _ r'/ // Well SemL:-IPublro Private IdentiFication: None✓3 Filtered Chic fed Treatment: ❑ Softener Other (Specify).......................... ........................................ NAME OF LAB THAT MADE LAST EXAM DATE OF LA Xqh PROPERTY OWNER'S NAME AND ADDRESS(If different from Warne and address shove) Reason For Con or --I to Laws Suspected of Cousin Disease Folc Examination: ❑ (Specify) g Ot�h_er (Specify or give details here) Here ❑(Give Details) Complaints Color Odor Taste 11 Sediment Foaming Other(Specify) Of: IL—J1 ❑ ❑ ❑ Use Coo nt Em rge ency DATE OF LAST USE CONDITIONS THAT Supplyly MAY AFFECT WATER QUALITY(Specify) Sup Source Of Drilled Weii Water: � Driven Well Dug Well SP Other(specify) ❑ El escription Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL Water Source: Ft. DATE OF LAST PLUMBING WORK IN SYSTEM In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: ❑ Special Tests Required: Additional Description If eeded: Signature ills• „r..b'�,G"',,._�`/. DATE SENT ore in M../i CONNECTICUT STATE DEPARTMENT OF HEALTH Phone 566-2536 LABORATORY .UiVIS1ON 10 Clinton Street P.O. Dox 1689, 1laartlurd, Conn. 06101 LABORATORY NLBER: 2 HYDROCAMftS: Vapor Test Temp. ?C °C-, J 7 Column Temp. °C Column Results expressed as Micrograms per Liter: t Com onentConcentration{' Component lConcentratiol METHYL ACETATE ►e''Methane VTutane METHYL ALCOHOL Propane METHYL CELLOSOLVE I METHYL iso-BUTYL KETONE V ACETOWE METHYL ETHYL KETONE AMYL ACETATE METHYL METHACRYLATE AMYL ALCOHOL METHYLENE CHLORIDE i.so-AMYL ALCOHOL NONANE i/ BENZENE iso-OCTANE BUTYL ACETATE PENTANE i BUM, ALCOHOL ETHER PROPYL ACETATE iso-BUi'YL ACETATE iso-BUTYL ALCOHOL - iso-PROPYL ACETATE s,.BVITL ALCOHOL iso-PROPYL ALCOHOL CARBON TETRACHLORIDE iso-PROPYL ETHER CH LOROBENZENE 1,1,2,2,-TETRACHLOROETHANE CHLOROB11TAT,dE TETRACHLOROETHYLENE CHLOROFORM TOLUENIE DICHI,OROBENZENF 1,1,1-TRICHLOROETHANE -- o.....v.� ,- 1,1,2-TRICHL,OROETHANE 1,2-DICHLOROPROPANI°: TRICHLOROETHYLENE ETHYL ACETATE '--- VINYL ACETATE ETHYT. AI:COHOL r XYLENE (META) ETHYL BENZENE i XYLENE (ORTHO) ETHYL. ETHER ETHYLENE CHLORIDE � " _ X� GJ PARA '' . CANE j„ . �IG1 IGTIN £ .ix s, [DATE Y'"f!X7 Srti' ?CfG.?lJTilfeiOYr�tl5ea . _. OL 81 �V. 12-74 1•Type or print one sef and send to the address below. �{O �'tg Y TOWN ' , s;. PHYSICAL COMP ETE f ; } 2.Reports will be furnished only to local director of health or state agencies. RECEIVED DATE REPORED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 /l COLLECT►ON AM PROPERTY;(Where sample was taken) ADDRESS w. TOWN REPORT: COLLECTED BY(Name) COLLE9TOR'SNO DATE COLLECTED TIMECOLLECTED SAMPLING POINT Name and Addfess of person to receive Laboratory Report Well Semi-Public (-Private } Identification: IL tJ�+�' r ", le, � None Filtered Chlorinated Softened Treatment:- ❑ ❑ ..... .........ec ........... .,t {-#✓l.:�.:,yr �,..a r`e,- C. �:<.,e"3 Other (Sp eci fy) ._..........» NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For- .Conformation to Laws. Suspected of Causing Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sediment Foaming Ot❑her (Specify) Of: Use Of Constant Emergency IDATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: 11 Source Of Drilled Well Driven Well DugWell Sp Other Other(Specify) Water: IFZ - Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Othr (Specify) Of Pollution Special Tests Required: ,, s y Additional Description IfNeeded:y Signature FDATE SENT And Title: . : " ,t.J LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY NITRITE Sodium as No Magonese as Mn Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F Constituents as AMMONIA Alkalinity as CGC03 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as CoCO3 Sulfate as SOq Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. Meet the requirements fora potable water. CONCLUSIONS:The results of the analysis of this sample ❑ Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentiallyEl hazmft{1' te?"� Do not meet the requirements for a potable water because The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acce table limits. These are as foll s Other:/ i \ BANUMA L • •+ MDLC TWA i Ltd CULLL.L I JUNK EXAMINATION REPORT OL-81 REV. 12_74 r�is Section for Lob. Division UseYµ 1.Type or print one set and stand to the address below L 2.Reports will be furnished only to loco/ director of ATQRy�O, TOwN NO. PHYSICAL COMPILE TO: Conn, State Dept. of Health, Laborhealatory Lary Divh or e, P OCtBox'1SS9 Ha 1 1 D E RECEIVED ►tiofd, 9T Dd f DATE REPORTED, COLLECTION (w ere sample was to on ADDR REPORT: 7 e COLLECTED BY TOWN(N COLLECT R' � r -Y `` J EC D TIME CO L� C ^j,'V K<I S r t`. •� !.1 c M NG 1 �,.. (dame an Ad rasa of person to reeeiv�L aboratory Report ._:�c 1/ s M. i // { Well Semr Public Pr�• vote Identification: �_ �', � f✓/�/Lc�. a �j'� t Treatment: Non Filtered Chlorinated Softene ?Y Other (Specifyj............................... El NAME OF LAB THAT MADE LAST EXAM DATE OF LAST E A PROPERTY OWNER'S NAME AND ADDRESS(it different from name and address above) Reason For Conformation to Lows Suspected of Ca us ing D isa ese Other (Specify or give details here) Examination: � (Specify) Foi EJ (Give Details) ElHet Complaints Color Odor Taste Sediment Foa�_ming Other(S Of: pecify) Use Of Co nt Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) supply: u-=I Source Of Drilled ell Driven Well Dug Well Spring Other(Specify) Water: ❑ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL Water Source: Ft In DATE OF LAST PLUMBING WORK IN SYSTEM Possible Source Septic Farm Industr Of Pollution: ❑ y Other (Specify) Special Tests Required: Additional Description If eeded; Signature e• � SENT /u"lr�'-lEJ CONNECTICUT STATE DEPARTMENT OF HEALTH � Rhone 566-2536 LABORATORY DIVISION - ao Clinton street Y.O. BOX 1690, Ilartford, Conn. 06101 LABORATORY NWER: _3 HYDROCARBONS: Vapor Test Temp. 6 °C J Column i Temp. °C Column Results expressed as Micrograms per Liter: ' Component !Concentrations Com onent Concentration METHYL ACETATE V/ Me thane V-Butane 4-1 o , METHYL ALCOHOL Propane METHYL CELLOSOLVE METHYL iso-BUPYL NONE ACETOWEE i r METHYL ETHYL KETONE AMYL ACETATE METHYL METHACRYLATE AMYL ALCOHOL METHYLENE CHLORIDE iso-AMYL ALCOHOL NORM BENZENE iso-OCTANE BUFYL ACETATE PENTANE BUM, ALCOIiOL PETROLEUM ETHER ACETATE iso-BU['YI. PROPYL ACETATE I • i iso-BUTYL ALCOHOL iso-PROPYL ACETATE i s,-:BUTYL ALCOHOL iso-PROPYL ALCOHOL I CARBON TETRACT ORIDE —- iso-PROPYL ETHER CHLOROBENZENE I11,2,2,-TETRACHLOROETFANE CHLOROBUTANE TETRACHIAROETHMNE CHLOROFORM TOLUENTE DICHLOROBENZENE 1,1,1-TRICHLOROETHANE 1,2-DICHLOROPROPANE 1,1,2-TRICHLOROETHANE TRICHLOROETHYLENE ETHYL ACETATE -- VINYL ACETATE ETHYL ALCOHOL , ETHYL BENZENE XYLENE (META ETHYL ETHER XYLENE (ORTHO) ETHYLEI4; CHLORIDE j\ XY(IJ:NE PARA ,J sXANE /✓ `✓I. C% '.. j . M •. _ - SOW N S fq - - - - - A H T19�-W n �SouK VO. - C, 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CONN-06074 lN�SOR•co� AREA CODE 203/644-2511 November 5, 1979 Mr. Carlos do Nascimento 81 Farmstead Drive South Windsor, Connecticut Dear Mr. do Nascimento; Recently, a sample of your water was taken and analyzed by the State Health Department Laboratory for hydrocarbons and organohalides (components of solvents, degressers, etc.). our water supply, Although some components have been found in y pp 5 , their levels are well below those found to cause or suspected to cause any harmful effects. After discussing the results of your analysis with State Health Department personnel and Dr. Sidney Curtis, Director of Health for the Town of South Windsor, it has been determined that your water will be resampled in the spring of 1980 to determine any change in the levels of these components. If you have any questions, please feel free to contact me at Town Hall, 644-2511, Extension 42. You may also feel free .to contact your personal physician if you so desire. - Very truly yours, TOWN OF SOUTH WINDSOR ( ' - Robert Deptula, R.S. Town Sanitarian RD:bw Enclosure ru I AD LC YtA I CK LVLLCl.11VN/ I ril_ti`-,' V13�!`7v f r '-- EXAMINATION REPORT T .1 s c ion for Lob. Division Use OL-81 REV. 12-74 ,J tom' PaPP LABO.RAT N TO � Y AL COMPLETE 1.Type r nTt3ne se se o the address below. ,,} ,. 2.Reports will be furnished only to loco)director of `�J health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN COLLECTION - f � REPORT: f'G�!?t - l-c-ri h C.6�t�.- COLLECTED BY(Name) COLLECTOR'SNO JDATECOLLECTED TIMECOLLECTED SAMPLING POINT x�7.r r.' ,j�..-- M. t•V ,�,c}fr. �a�.E.. Name and Address of person to receive Laboratory Report Well Semi-Public Private Identification ❑ L�7`r [0 '' > L, Cam_ j� ' , ' None Fired Chlorinated Softened Treatment: .................. ......... ......... Other (SPectfy) _.... .................. JNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For' Conformation to Lows Suspected of Causing Disease Other (specify or give details here) Here Examination: ❑ (specify) ❑(Give Details) ❑ Complaints- Color Odor Taste Sediment Foa❑ming Other(specify) Of: Use Of Constant Emergency JDATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ ❑ Source Of Drilled >11 Driven Well Dug Well Spr�g Other(specify) Water: Description O{ WELL DEPTH �J`WELEL DIAMETER CONDITION OF CURB AND TOP SEAL ��F LAST PLUMBING WORK IN SYSTEM Water Source: In. Possible Source Septic Tank Form Industry Other (Specify) ❑Of Pollution: L Special Tests tt- Required: Additional Description If Needed: Signature { DATE SENT And Title: /_ lL�l•-�lh� LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are.in Mg/L. APPARENT COLOR TRUE COLOR ODOR t r- vn n S G vi S NITRITE Sodium as Na Magonese as Mn NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F •l Nitrogen Constituents as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) - - - .. I•�. t�Yt'�Ct1hl^Xrt•1 #t}t(t�> ALBUMINOID Total Hardness as CbCO3 Sulfate as SO4 Chlorides as Cl Iron as Few �✓ � � f� t MEMBRANE FILTER TEST Coliform Colonies/100ML. 1 CONCLUSIONS:The result's of the analysis of this sample- ❑ Meet the requirements for n potable water. ❑Meet the requirements for a potable water; however, the chemical or physical constituents listed below appear abnormally High for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ 113 not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the cojiform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent.. The water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑0:hc•r: POTABLE WATER COLLECTION/ 'S�p EXAMINATION REPORT - 1ro, ise tion for Lab. Division Use . e'•W!OL-81 REV. 12-Tr—�, 1,Type or print one set and send tores ', PHYSICAL COM 2.Reports will be furnished only to local director of _ -health or state agencies. DATE REC e i i A EPORTEQ TO: Conn. State Dept, of<Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 NAME OF PROPERTY(Where sample was taken) ADDRESS COLLECTION p TOWN REPORT: do /,/uscima«t COLLECTED BY(Name) COLLECTOR'SNO AT COLLECTED TIME OLLECTED SAM LI G IN :q. Y F.tIOn- y 23 TS o .q M. ,cf e e Name and Address of person 4o receive Laboratory Report Well Sem�blic Private I Identification: ❑ If (/P�7f✓�(R None Filtered Chlorinated Softbnod f'SyD s✓//iv2., �t,,� Treatment: ❑ a s wT►id s a� Other Specify) .................................................... s E"o�,n 0607V - ❑ LNAME OF LAB THAT MADE LAST EXAM DATE OF L S � /0-) PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) 0 9 l+o)d .Reason For Conformation to Laws Suspected of Causing Disease Other !Specify or give details here) Nete Examination: ❑ (Specify) ❑(Give Details) ❑ . complaints Color Odor Taste Sediment Foaming Other(specify) ❑ ❑ El Ise Of Constant Emergency [DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) ;upply: ❑ lU� .ounce Of Drilled Well Driven Well Dugall Spr❑'Ing Oar(Specify) later: )escription Of WELL DEPTH WELL DIAMETE C R ONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN$YS M later Source: Ft. In. 'ossible Source Septic❑Tank Farm Industry Other (Specify) )f Pollution: special Tests Required: O'r-fa—cAA(Alides ,{. {�yO�r6Car�jcwf kddltlonal Description If Needed i gnature 'and Title: DATE SENT Z3- gam' LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) "More: Chemical results are in Mg/L. PPARENT COLOR TRUE COLOR ODOR NITRITE Sodium as No Magonese as Mn Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F ,onstituents as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Nlitrogen (N) ALBUMINOID Total Hardness as C00O3 Sulfate as SO4 hlorides as Cl Iron as Fe MEMBRANE FILTER TEST O on Celiform Colohlas/100ML. CONCLUSIONS:The results of-the analysis of this somple- Meet the requirements form potable water. Meet the requirements fora potable water;however, the dhemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these conjBtituents is a lsotentiaClp hapsdul one. Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not fiecessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considere(1 as unsafe for drinking L�until the source.of this bacterial contamination can be located and removed. I The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: 04 - 'A n�. r MAY Z'i 19 POTABLE WATER COLLECTION/ 33101_ # EXAMINATION REPORT �� 33102 C) This Section for Lab. Division Use OL-81 REV. 12=74 1. Type or print one set and send to the address below.fDATE ATORY NO, T PHYSICAL COMPLETE 2.Reports will be furnished only to local director of GET health or state agencies. ECEIVE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTYElWheresampleEWastaken) ADDRESS TOWN REPORT: vtc�S�iCOLLECTED BY(Name) COR'SNE COLLECTED TIME COLLECT SAMPLING POINT �a C� / Icy S' �.M. `� Name and Address of person to receive Laboratory Report Well Semi-Public Private FIdentification: �` +1]�P7fcJrCc- Treatment: None Filtered Chlorinated Softened ❑ ❑ Other (Specify) I VV f�-1- S'v." � try wv� G��� y ❑ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) `S CC i-e— Fold Reason For Conformation to Laws Suspected of Causin Disease Other (Specify or Here q ❑ give details here) Examination: ❑ (Specify) ❑(Give Details) Complaints Car Odor Taste Sediment Foaming Other(Specify) Of: Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ Source Of Drilled Well Driven Well Dug Well Spaing Other(specify) Water: ❑ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank For Industry Other (specify) Of Pollution: EJ ❑ Special Tests Required: o�'Pf.f��'lZrt1( Additional Description If Needed Signature ' / DATE SENT And Title: '0 C__# 7 LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Ckemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR NITRITE Sodium as Na e)rcnN10 Magonese as Mn Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F Constituents as AMMONIA Alkalinity as CaG03 Carbonate Detergent as ABS n5 a." Nitrogen (N) ALBUMINOID Total Hardness as C00O3 Sulfate as 504 Hydrogen-ion Concentration (pH) Chlorides as Cl ___]Iron Os e MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample-Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group,while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. EJThe concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: CTOR 79 `OTABLE WATER COLLECTION/ d$ I-t , rXAMINATION REPORT This Section far Lab. Division UseJL-81 REV. 12-74 I,Type or print one sef and sen the address by/pw LAB R W A, PHYSICAL COM t,2. Reports will be furnished onlyocal director ofS,t4. aq ✓_y health or state agencies. R C DATA RT '- TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford CT 06101 `I COLLECTION A OF R ERT (Where sample was taken) ADDRESS WN 7 REPORT: ;� 6t�vi>kld.SAs- ;OLLECTED BY(Name) COL LECTOR'S NT AT COLLEC ED TIM- COLLECTED M P L I Rd PotNT--- /jP Jame and Address of person to receive Laboratory Report Well Semi-Public Pri ai.J /s�rD 1v�/i Identification: i(.:..l � L None i tered Chlorinated Soften® S. wi✓I:�3a/� Cb�idf G�b�y Treatmen . �,*J bther tsp®city) ....:..................................... ...,.,t L_ NAME OF LAB THAT MADE LAST EXAM DATE OF L 749 'ROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) d�►�B Fbld.,' eason For Conformation to Laws Suspected of Causing Disease ❑Other (Specify or give details here) xamination: (Specify) a(Give Details) ` :omploints Color Odor Taste Sediment Foaming Other (Specify) r )f: ❑ ❑ ❑ ' Ise Of Constant merpency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY Specl y) iupply: ❑ Iu� ource Drilled W Driven Well ug�ll Spr�g Other (Specify) later: - IL•�y `escription Of WELL DEPTH W=1ndustryify) DIAMETEROF CURB AND TOP SEAL DATE OF LAST RLUMBINGWORK NSYSTEM dater Source: Ft. ossible Source Septic Tank Fart 4f Pollution: .pecial Tests ° required: O/�QMOYiGdil/ C7l1DS �- !�5/6JI'OC'U/`�Jt,7Vyr - idditional 6escnption If Needed ignature DATE SENT !nd Title: t 23 LABORATORY EXAMINATION REPORT: '(To be filled out by Laboratory Division) Not Cheaa I f040-Its.,are in MgIL. PPARENT COLOR TRUE COLOR ODOR 3 � NITRITE Sodium as Na Maganese,as Mn rrrt it lal NITRATE Alkalinity as CaCO3 Bicarbonate Fivaride as F Nitrogen-onstituents �lYywL tla."7 as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ASS `.f; 'Pd� � Q Yitrogen (N) !�.� or ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 1�,..{«�.,,_:Q hlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ; CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for;ra potable water. Meet the requirements fora potable water;however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The -7 water should be suspect if local conditions indicate that the source of these constituents is a potebtiaily harmful`one:'. J Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical cons ti tuentsil exceeds acceptable limits. These are as follows: ❑Other: , /wt�ell�pit/ � l t. �. LANIn HAY lg �. POTABLE WATER,COLLECTION/ / 33097 11C EXAMINATION REPORT This Section for Lab. Division Use OL-81 REV. 12-74 � � ��]��� f J LABORATORY NO. T W yq PHYSICAL COMPLETE 1. Type r r�he 3 to tT'rEaddress below. / 1�J,l 2.Reports will be furnished only to local director of health or state agencies. DATER I E REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECT ON NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: C� "vzc�SlE/ S �tei Ja b $.. (�c✓>Gfa�,)d� COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TIME COLLECTED SAMPLING POINT A* %-k C3 I/d,�'�-7 F // ram:7 e�_ M. Name and Address of person to receive Laboratory Report Well Semi-Public Private '� Identification: Ill—�7/ R' r/" r� Treatment: None Filtered Chlorinated Softened lJ-YG J.�l//�'''~'� �j rr� ❑ ❑ ❑ ❑ / (S_ecf.................. I / Grsd/'1 C ovi�1 U�C3�f! Other Peciy) ............... NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold rs Here Reason F Con-formation L or Conmaon to Laws Suspected of Causing Disease Other (Specify or give details here) Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sed nt Foaming Other(Specify) Of: ❑ ❑ Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ ❑ Source Of Drilled Well Driven Well Dug Well Spring Other(Specify) Water: u✓ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: ❑ Special Tests Required: 0/' utid 14A- Cots Additional Description If Needed Signature DATE SENT And Title`: la-lam? LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR Y'1 � NITRITE Sodium as No Magonese as Mn Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F <1.e Constituents ` I _1_� O��as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS P_7YG1 h Nitrogen (N) ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. Ll ElMeet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- . Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present,does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other`. ncrc�KT ,. IN I C"A _)3 fK /rr41 di', COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TIMECOLLECTED SAMPLINGTPOINT M. ? of J(J Name and Address of person to receive Laboratory Report Well Semi-Public Private , Identification: D•/ None Filtered Chlorinated Softened Treatment: ❑ ❑ ❑ ❑ . ..... ... Ot�h�er (Specify) ......... J NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For- Conformation to Laws Suspected of CausingDisease Other (Specify or Here ❑ y give details here) Examination: ❑ (Specify) ❑(Give Details) Complaints Color Odor Taste Sediment Foaming Other(Specify) Of: 0 Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply SourceWater: Of Drilled Well Driven Well Dug�ll Sp Other(Specify) Water: t�j ❑ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In Possible Source Septi-Tank Form Industry-- Other (Specify) Of Pollution: Special Tests / Required: Additional Description If Needed $i.gnature DATE SENT. And Title: LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. %PPARENT COLOR TRUE COLOR ODOR TURBIDITY NITRITE Sodium as No Magonese as Mn Nitrogen NITRATE Alkalinity as CGC03 Bicarbonate Fluoride as F 9 Constituents as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as COCO3 Sulfate as SO, Hydrogen-ion Concentration (pH) ;hlorides as CI Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply: The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: ❑The Coliform density exceeds acceptable limits. The presence of the Coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: LJ`Other: 1/ j - .�-E' ,cr— s%®LC WA C LK LLtiCLL; a diJlY/EXAMINATION REPORT OL-81 REV. 92-74 ]. Type or print one set This Section for Lob. Division Use 2.Re orts and!send to the address be/o4 A p will be furnished only to Jaca)director of �R� TO N NO PHYSIC health or stoPe o RL COMP T0: Conn. State Dept, of Health, Laboratory Div.,agencies. Bo. COLLECTfOa� ME ofP.O. Box 1689 Hartford, (� TE RECEIVEt]I ROPERTY(ti'bert san,pfe was taken) ADD rT 0 I /(�� DATE REPOR3€p REPORT: � J ass t9 c ►,�, `` / COLLECT �\ I• ,. . ED BY(Name) COL LECTO TOWN Y, (li.e yC. !J R'S NO DATE COLLECTED L (✓ �l TIME COLLECTED .�~' <r/, ';!�-x�� SAM LING OIN7 Name and Address of p erson to receive Laboratory _j Report M' f .7 Wei l 7 > Semi-public Private Identification;. I(—�L/ y/t'L C: None Filtered t}L� Treatment: ❑ Chlorinated Softer .. Other (Specify'] ......•••.. El PROPERTY OWNER•g � NAME OF LAB THAT MADE 1 NAME AND ADDRESS LAST EXAM DATE OF L ST E (if different from Warne and address above) — —--�� Reason For Conformation to Laws Examination; Suspected of Causing Disease ❑ (Specify) Oo r (Specify or give detaits here) Complaints Color Odor ❑(Niue vetaits) Of: ❑ Toe Sediment Foomin ❑ ❑ g Otthheer(Specity) Use Of Constant Emergency DgTEOFLASTUSE CONDITIONS THAT MAY gFFECT WATER Supply; ❑ ER QUALITY(Specify) Source Of Drilled Well Driv�e�n Well Du Water; 9[D SPog Other Water Source: (Specify) Description Of WELL DEPTH WELL DIAMETER ONDITION OF CURB Ft. In C AND TOP SEAL DATE OF LAST PLUM Possible Source SepticTank Farm SING WORK IN SYSTEM El Induustry Other (Specify) Of Pollution: Q Special Tests Required: Additional Description If Needed: f Signature And Title: 7 DATE SENT L.iJd'oif'8f.i.f fi»�i i :�r "t f� �Ja:J"?•liti 1lWbY:: 't,t i.,lC` §ia:rt f" Phone 560-2536 LABORA1'011%,Y WV1S; (N: Il} Clinton Street s A 1',0e Box 16bo, tinrtfold, Coin. 01 LABORATORY NUMBER: '3 j ) cI J HYDROCARBONS: Vapor Test Te4_ °C Lc j� Column i `Pemn. °C Column Results expressed as Micrograms per Liter: A�� ( J Component !Concentration Component lConcentratii ' METHYL ACETATE Methane Butane i METHYL ALCOHOL Propane METHYL CELLOSOLVE i METHYL iso-BUTYL KETONE ACETONE 1 f METHYL ETHYL KETONE - AMYL ACETATE METHYL METBACRYIATE i - AMYL ALCOHOL WVHYLERE CHLORIDE iso-AMYL, ALCOHOL NONANE BENZENE iso-OCTANE BUTYL ACETA'I'F PENTANE Bt= ALCOHOL PETROLEUM ETHER � iso-BLTYL ACETATE PROx'YT. ACETATE iso-BWYL ALCOHOL iso-PROPYL ACETATE swBUITL ALCOHOL —r---- iso-PROP'YL ALCOHOL CARBON TETRACHLORIDE iso-PROPYL ETHER CHLOROBENZENE 1,1,2p2,-TETRACHLOROETHANE CHLOROBUI'ANE TETRACHLOROETHYLENE CHLOROFORM, TOLUENE DICHLOROBEP;ZENE 1,1,1-TRICHLOROETHANE 1 1,2-DI CAI,OFtOPROPANE ,1,2-TRICHLOROETHANE TRICHLOROETHYLENE ETHYL ACETATE VINYL ACETATE ETHYL ALCOHOL .� ETHYL BENZENE XYLnNE (META ETHYL ETHER ----- XYLENE (ORTHO) ETMENE CHLORIDE XYLENF. PARR OL-61 REV! 12 7 1 Type or print one"set trnd s:d4,io'yhe F7'dres 2.Reports will be furnished only to local director of 7Tjj, health or state agencies. DATE RECEIVT0: Conn. State-Dept. of Health, Laboratory Div., P.O. Box i689 Hartford, CT 06101COLLECTIONREPORT COLLE TED BY(Name),ii a ; ' ? / COL�ECTOR'SNO DATE COLLECTED TIME COLLECTED SAMr^^LING POINT M. Name and Address of person to receive Laboratory Report .n Well Semi-Public Private_, Identification: tj..Ai/fc None Filtered Chlorinated Softened f S y't> =v/f/ ttitot Treatment: ❑ ❑ ----•..........-........ ❑ ❑ Other (Specify) .................. ❑ NAME OF LAB THAT MADE LAST EXAM=0FEAST PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Conformation To Laws SuspecTed of Causing Disease Other lSpecify or give details here) Pole Reason For Here Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints C�r Od��or Taste Sediment Fong OEr(Specify) Of: ❑ ❑ Use Of. Con nt Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply c Source Of Drilled Well Driven Well Dug Well Spring Other(Specify) Water: 11_1 ❑ .Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL Water Source: DATE OF LAST PLUMBING WORK IN SYSTEM Ft. In. Possible Source SepticTank Farm Industry Other (Specify) Of Pollution: ❑ Special Tests Required: Additional Description If Needed F i , Signature And Title: 1S-� ja DATE SENT LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) _Note: Chemical results are in Mg/L. "9 APPARENT COLOR TRUE COLOR ODOR TURBIDITY Y� NITRITE Sodium as No Magonese as Mn Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F Constituents .as AMMONIA Alkalinity as Nitr gen (N) CGC03 Carbonate Detergent as ABS ALBUMINOID Total Hardness as C00O3 Sulfate as SO 4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST coliform Colonies/100ML. Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- :❑ ❑Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally hi h for ground water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. gPP1Y The ❑ Do not meet the requirements for a potable water because ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking ❑until the source.of this bacterial contamination can be located and removed. The concentration of certai����Stltuents hilh exceeds acceptable limits. These are as follows L;kOther: z i --I I EXAMINATION REPORT /VTE This Section for Lab. Division^Use OL-81 REV. 12.74 ), Type or print one set and�send to the address belol4. QR� TO N NO. PHYSIC L COMPLE' s t o� +, 2.Reports will be furnished only to local director of health or state agencies. ECEIVED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford T 0 01 DATE REPOR �g NAME OF PROPERTY(e'here sxrnple was taken) ADD ESS / i.S i r t'1 t COLLECTION Y TowN REPORT: Cl? .�','fi.•%' 1 COLLECT D BY(Name ^ / <<� •%r�r`''� 1 CQL-LECTOR'S NO TECOLL£CTED TIMECOLL CTED SAM LING OINT M. blame and Address of person to receive Laboratory Report Well Semi'1��Public Private /t Identification: None Filtered Chlorinated Sokene f�` �` �: //l+d t•:-, ���� Treotinent: 1 G,.- .0.; Other(Specify).. l�sGs• ( r• sloe ) ............................................................... NAME OF LAB THAT MADE LAST EXAM DATE OF LAST X I PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fbl Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Her Examination: ❑ (Specify) ❑(Give Details) Complaints Color Odor I o�oste Sediment Foaming Other(Specify) Of: ❑ (� � Use Of Constant Eme�ncy DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: Source Of Drilled Well Driven Well Dug�WWeell Spring Other(Specify) Water: � U Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Passible Source Septie�Tank Form Industry Other (Specify) Of Pal lution: IL�J L,) Special Tests Required: I`ia..� Additional Description If Needed: / Signature _ And Title: �) DATE SENT .0 a 11.I. W%►# r-%1%a Nvt"I'I'a tsa 911.1'%&Ill Phone 5RG-253(; I ABOI2ATOIL DVY'i.,• CJId 10 Clanton Street ! l i3 y 11.0. Box 1689, Ilartfuld, Coin. ®1 i LABORATORY NUCER: HYDROCARBONS: Vapor Test Te � °C C" jd Coliunn : 41 !Temp. °C ! Column Results expressed as Micrograms per Liter: Ali b ,e._ 2).e �'er_ Component ICo�ncentrationi Component lConcentrati ° METHYL ACETATE Methane Butane METHYL .ALCOHOL Propane i METHYL CELLOSOLVE i gg� METHYL iso-BUTYL KETONE ACETONE f -- - ------ - METHYL ETHYL KETONE AMM ACETATE METHYL METH'ACRY'LATE i AMYL ALCOHOL r METHYLENE CHLORIDE iso-AMYL ALCOHOL NONANE BENZENE d iso-OCTANE I BUTYL ACETATE PENTANE PETROLEUM ETHER BVTYL ALCOHOL PRO.r YT, ACETATE iso-BUTYL ACE'.PATE,' iso-BUI!YI, ALCOHOL iso-PxOPYL ACETATE saBUTYL ALCOHOL iso-PROPYL ALCOHOL CARBON TETRACHLORIDE iso-PROPYL ETHER CHLOROBENZv'NE 1,1,212,-TETRACHLOROETHANE CHLOROBUrANE TETRACHLOROETHYLENE CHLOROFORM TOLUENE DICHLOROBENZENE 1,1,1-TRICHLOROETHANE 1,1,2-TRICHLOROETHANE 1,2-DICHLOROPROPANE �..-_..® TRICHLOROETHYLENE ETHYL ACETATE VINYL ACETATE ETHYL ALCOHOL, XYLENE (META ETHYL BENZENE XYLENE (ORTIiO) ETHYL ETHER �� XYLENE PARR ETHYLENE CHLORIDE y Oil �� t�WN Sfq Oy F' ��! L �SouM, ?&adsot w a 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CONN. 06074 0x•C0 AREA CODE 203/644-2511 November 5, 1979 Mr. Frank Klosowski 89 Overlook Drive South Windsor, Connecticut Dear Mr. Klosowski: Recently, a sample of your water was taken and analyzed by the State Health Department Laboratory for hydrocarbons and organohalides (components of solvents, degreasers, etc.). Although some Components have been found in your water supply, their levels are well below those found to cause or suspected to cause any harmful effects. After discussing the results of your analysis with State Health Department personnel and Dr. Sidney Curtis, Director of Health for the Town of South Windsor, it has been determined that your water. will be resampled in the spring of 1980 to determine any change in the levels of these components. If you have any questions, please feel free to contact me at Town Hall, E44-2511, Extension 42. You may also feel free to contact your personal physician if you so desire. Very truly yours, TURN OF SOUTH WINDSOR Robert Deptu. a, R.S. Town Sanitarian RD:b,-7 Enclosure niil GR t.VLLCLI IVIV/ pL,.� �-�'�✓�►l I !-7 - -- EXAMINATION REPORT This Section for Lab. Division Use OL-81 REV. 12-74I!.° f' LABORATORY NO. 7QW1 ► PMYSICAt jC0jPLET1.Type�r t»rrp#wwae 3tZ 98to thhhtAA�oddress below. //!! 2.Reports will be furnished only to local director of health or state agencies. DATER IV, [ E REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 PROPER (where sample was taken) ADDRESS COLLECT/ON AME OF PROP TOWN REPORT: 6' J / 5 crt•v�/(/ Vol o t-f-'"A'!.f< COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TIa1-COLLECTED SAMPLING POINT 4L M. u� Name and Address of person to receive Laboratory Report Well Semi-Public private Identification: ❑ C"'F t` .. ��`�f-/,/ None Filtered Chlorinated Softened Treatment: ❑ (`1 (`� ❑ a-,-,1 GE_o 2f! Other (Specify) .................... El NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(It different from name and address above) .Fold Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) flare Examination: ❑ (Specify) ❑(Give Details) Complaints Color Odor Taste Sediment Fong Other(Specify) Of: El ❑ ❑ El El Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify] Supply: ❑ ❑ Source Of Drilled ell DrivEan�Well Dug Well Spr�g Other(Specify) Water: ljs_/II 1L�1 Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK LNSYSTEM Water Source: Ft. In. Possible Source Septic Tank Form Industry Other (Specify) Of Pal lution: l(_II Special Tests Required: Additional Description If Needed: Signature fj f DATE SENT And Title: 1f �` LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR "r t r?CY r,f7 ,Cj rf� NITRITE Sodium as No Magonese as Mn Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F to 01Constituents as AMMONIA Alkalinity as C00O3Carbonate Detergent or ABSIO�e •�i Nitrogen (N) ALBUMINOID Total Hardness as C00O3 Sulfate as SOq L4 _, r•- .cct�ia� C7hrQ�fiyO�� l��tS: Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. �•'0-0 .t ❑ Meet the requirements for a potable water. CONCLUSIONS: The results of the analysis of this sample- ❑Meet the requirements for a potable water; however, the chemical or physical constituents listed below appear-abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source Of these constituents is a potentially harmful one. ❑ DO not rr,eet the requirements fora potable water because: ❑The coliform density exceeds acceptable limits. The presence of the cOjifOrm group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the suppl}•to the same extent. The water should be considered as,unsafe for drinking until the source of this bacterial contamination can be located and ren:o:ed. ❑Thr cc�,:cent ration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Othc.. IOTABLE WATER COLLECTION/ `��/ V s OTAB EXAMINATION REPORT `' This Section a .L� Division Use I ' 7=t^ 2 7 LABORATORY NO. TO N PHYSICAL COMPLETE OL-81 REV. 12-74 1. Type or print one set and send to the address below. r,r —� 2. Reports will be furnished only to local director of health or state agencies. r D R EIVED ,7, DATE REPORTED TO: Conn: State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06i01 ' ' .* A- COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS N REPORT: C1 g d sar COLLECTED BY(Name) COLLLECTOR'SNO DATE COLLECTED TIME COLLECTED SAMPLING POINT Q• V,4 S7T�Gv y 2'S" p T M. / dame and Address of person to receive Laboratory Report ' d+ Well' Semi-Publif Private Identification: None Filtered Chlorinated Softened Treatment Other (Specify) ................................................. S. W1�+olso� Cahn , Df7G7y ❑ LNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM SN 9 PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Here Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sediment Foaming Other(Specify) If: Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ ❑ source Of Drilled Well Driven Well Dug Well Spring Other (Specify) Vater: = ❑ 1:1 ❑ ❑ WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM )escription Of later Source: Ft. In. 'ossible Source Septic Tank Farm Industry Other (Specify) )f Pollution: ❑ ❑ ❑ ❑ special Tests t _p required: p✓`�G1/�^O�L��IC�e's `{— Y1)/C7YOC4eV bQt�S additional Description If Needed: signature DATE SENT iIn Title: , �- Z3-Ciro LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. PPARENT COLOR TRUE COLOR ODOR P NITRITE Sodium as No Maganese as Mn C j 5 Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F :onstituents as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS litrogen (N) ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 ) hlorides as Cl Iron as Fe r yi -r ', MEMBRANE FILTER TEST O UYJ coliform Colonies/100ML. 7 C014CLUSIONS: The results of the analysis of this sample- Meet the requirements fora potable water. Meet the requirements fora potable water; however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The --77 water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. 1 Do not meet the requirements for a potable water because; ❑'Ilse coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: �' ,i, ,.per f f,t_ i T t MAY POTABLE WATER COLLECTION/ I ..33113 H L EXAMINATION REPORT This Section for Lab. Division Use OL-81 REV. 12-74 vw 3�JA� LABORATOOiRY NO., TOWN N PHYSICAL COMPLETE 1. Type or print one a to address below. OCT t L �� 4� 2.Reports will be furnished only to local director of health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O.Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS -/ TOWN REPORT: ��G'G!.SCL ilrs�fs7 ea S'Ct�itr �5 r" COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TIME COLLECTED SAMPLING POINT . D ,',t/._ z0 !o-11-7 �� M. L'4 J/Cl✓e jCe,,cEcr Name and Address of person to receive Laboratory Report WelI Semi-Public /IPublic Private 1 f Identification: II �i_— 71/C�+ None Filtered Chlorinated Softened ��Y :f.✓��lwp,,. Treatment: ❑ ❑ ❑ ❑ S, I'C.>t Gt�S`t+�- �' v1 b 6''b;>y Other (Specify) ......•• _...... LNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For'- Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sediment nt Foaming Other(specify) Of: Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ Source Of Drilled Well Driven Well Dug Well Spring Other(Specify) Water: ❑ ❑ ❑ ❑ Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In.1 Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: ❑ Special Tests Required: LG-ta�1Ct 11��5' Additional Description If Needed: Signature DATE SENT And Title: r LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR NITRITE Sodium as Na Magonese as Mn Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F � Constituents )&'nz as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) j Tt�ro�C�,(Ora �t 1- 7 ALBUMINOID Total Hardness as CoCO3 Sulfate as SO4 Chlorides as Cl Iron as Fe r rv", MEMBRANE FILTER TES hek,/ �Y� 4- Coliform Colonies/100ML. ! &? ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high fora ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially hatmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: p0'PABLNATER COLLECtION/ e�. 1r3' EXAMINATION REPORT } FDATERECEivED his Section for Lab. Division Use OL-t31 REV. 12-74 r ti j $ RY NO. TOWN A .* HYSICAL COMPLETE1.Type or print one 3*t�iind�ei�i to tfie address below. 2.Reports will be furnished only to local director of health or state agencies. DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.Q: Box 1689 Hartford, CT 06101 NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN COLLECTION IS REPORT: c t `z`i > COLLECTED BY(Name) COLLECTOR'SNO I DATE COLLECTED TIME COLLECTED SAMPLING POINT s'F - .•�Sa. M. Name and Address of person to receive Laboratory Report Well Semi-Public Private Identification: ❑ None Filtered Chlorinated Softened /_3 `E o .?.r}ts 1 Treatment: ❑ ❑ ❑ ❑ -S ` 1,;-e< H,t s„<c;,- ;j�a �� ..: �, f' t;;�r� -•. Other (Specrfy) ......... .............................. LJ ❑NAME OF LAB THAT MADE LAST EXAM BATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For' Conformation to Laws Suspected of Causing Disease- Other (Specify or give details here) Here Examination ❑ (Specify) ❑(Give Details) ❑ Complaints. Color Odor Taste Sediment Fong Other (Specify) Of: Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) o Supply: ❑ El Source Of Drilled Well Driven Well Dug Well Spr�g Other(Specify) Water: �1 --1.,r' Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: ❑ ❑ ❑ ❑ - Special Tests Required: Additional Description If Needed: Signature DATE SENT And Title: `+ a.{ s �a �E �.¢�r, •: LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR Or NITRITE Sodium as No Moganese as Mn Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F Constituents as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) d ALBUMINOID Total Hardness as C00O3 Sulfate as 504 Chlorides as Cl Iron as Fed f•>'r�• ,>-� .'p.r,� MEMBRANE FILTER TEST I? .• ri,Ii f•/Voi l ., coliform Colonies/100ML. CONCLUSIONS:The results of the analysis of this sample- ` . ❑ Meet the requirements for a potable water. ❑ Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical`or physical constituents exceeds acceptable limits. These are as follows ❑Other: OL-81 "REV. 4 1.Type or print one set and send to the address below.EDATEREC Y(t�j TOWN NO. PHYSICAL COMPLETE .[.. d 2.Reports will be furnished only to local director of health or state agencies. VED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NA OF PRP OERTY(Where sample was taken) ADDRESS f TOWN REPORT: JGv.�r� zt A�~�eis COLLECTEDBY(Name) COLfL�E^-77CT�O/R'SNO DATE COLLECTED TIME COLLECTED SAMPLINGP-, / Name and Address of person to receive Laboratory Report Well Semi-❑Public Private I Identification: h � 1 �'� 7 None Filtered Chlorinoted Softened Treatment: ❑ ❑ F-1 El -er (Sp eci f•--..ec ... ••..... Oth ...................................•. El NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For' Conformation to Laws Suspected of CausingDisease Other (Specif or Here y give details here) Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sed�nt Foaming -Other(Specify) Of:. E]. 1-1 Use Of Constant Emergency JDATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply Source Of Drilled Well Driven Well Dug Well Spring Other(Specify) - Water. 'K�/ WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL Description Of DATE OF LAST PLUMBING WORK IN SYSTEM Water Source Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: Special Tests �/ Required: C# r C 3 3 h tYs (,e6rt•�ZiL7_r Additional Description If Needed: Signature _ DATE SENT And Title: j f ..M• a ie—I1- 7y LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division)_. Note: Chemical results are in Mg/L. \PPARENT COLOR TRUE COLOR ODOR TURBIDITY li/tJ Ir NITRITE Sodium as Na - Magonese as Mn Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F 9 Constituents as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as CaCO3 Sulfate as SOq Hydrogen-ion Concentration (pH) :hlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water;however,the chemical or physical constituents listed below appear abnormally high fora ground.supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. Do not meet the requirements for a potable water because: ❑The,coliform density exceeds acceptable limits. The presence of the coliform group,while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed: ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These areas follows: Other: AARSARA L �, VLL EXAMINATION REPORT CL OL-81 REV. 12-74 / This Section for Lai.1. Type or print one set and send to the address below] L ision Use TOWN NO. p 2.Reports will be furnished only to local director of /a HYSICAL. COMPLE health or state agencies. e OQ-)G /:.,`t? T0: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06 D E RECEIVED DATE REPORTED COLLECTION ME OF ROPERTY(Where sxrnple was taken) ADDR SS _ REPORT: ? ' TOWN COLLECTED BY(Name) �' rir3ai3'_fC11eiCi _J COLLECTOR'S NO DATE COLLECTED IME COLLECTED l•7 SAMPLING OINT Name and Address of person to receiverLobotory Report9 M. Well Semi-Public Private JC , ��.fL•`,. —"I Identification: ,e,,,•.1 Y /fj Treatment: N❑ Filtered Chloriinnoted Softene Other (Specify) El NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAp PROPERTY OWNER'S NAME AND ADDRESS(lf different from Warne and address above) Reason For Conformation to Laws Suspected of Cousin g Disease Other (Specif or Folt Examination: (Specify) ❑ Y give details here) - ❑(Give Details) Complaints Color Odor Taste Sediment Foaming Other(specify) 0 f: r--, ❑ El Use Of Co ant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply; IitJ�I Source Of Drilled We I Driven Well Dug Well Spring Water: Other(specify) El ❑ a Description WELL DEPTH W Water Sourer: ELL DIAMETER CONDITION OF CURB AND TOP SEAL Ft. DATE OF LAST PLUMBING WORK IN SYSTEM In. Possible Source Septic Tank Farm Industry Other (specify) Of Pollution: ❑ Special Tests Required: /r/_•�_� .3 ,f Additional Description If Needed: Signature nd Title• - �/� �� ��`�.o' )�t..yLCI. it 7 �'• DATE SENT /c ESEN Phone 566-2536 LABORAT()RY DIVI 1(4 N 10 Clanton Street at' P.U. 13ox 1689, 11gr#.ford, C� n. 101 LABORATORY NUMBER: 3 HnROC4RBONS: Vapor Test Temp. Column 0 Temp. °C i Column V,�"_1 �/c v-� �= �r •+ ..t. 5 oar - Results expressed as Micrograms per Liter.: Component Concentratio7ii Component lConcentrati METHYL ACETATE Methane Butane ( METHYL ALCOHOL y Propane METHYL CELLOSOLVE WTHYL iso-BUTYL KETONE ACETONE ' META, ETHYL KETONE � AMYL ACETATE � � METHYL MCTHACRYLAITE AMYL ALCOHOL j WLENE CHLORII)P iso-AMYL ALCOHOL NQNANE BENZEWII Ino-OCTANE BUTYL ACETATE PENTANE BUTYL ALCOHOL PETROLEUM ETHER PROPYL ACETATE iso-BUTYL, ACETATE iso-BUUI'YL ALCOHOL iso-PROPYL ACETATE s%BUTYL ALCOHOL iso-PROPYL ALCOHOL ! CARBON TETRACRLQRIDE iso-PROPYL ETHER CHLOROBENZENE 1,1,212,-TETRACHLOROETHANE CHLOROBUPANE TETRACHLORQETHYLENE CHLOROFORM TOLUENE DICHLOROI3ENZF,NE 1,1,1-TRICHLOROFTHANE 1.,1,2-TRICIiLOROETIIANE 1,2-DICHLOROPROPANE - TRICHLOROETIiY'LENE ETHYL ACETATE -----�- VLNYL ACETATE ETHYL ALCOHOL _-- _ -_.- XYLEI'JE (META) -- ETHYL BENZENE _ ETHYL ETHER - XYLEM; (ORTAO) ETIiYIENE CHLORIDE _ XYLENE PEA L'E TER'COLLECT("ON7 EXAMINATION REPORT This Section for tab. iwision Use OL-81 REV. 12-74 1.Type or print one set and send to the address below. LAB A O$2 N ' TOWN NO. PHYSICAL OMPLETE 2.Reports will be furnished only to local director of ! .j l health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: r t e • r:a - n rvI_5"?{CY tE C 3, 1 r COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TIME COLLECTED SAMPLING PLIANT e Name and Address of person to receive Laboratory Report Well Semi-Public Private Identification: ` � `i ` , � None Filtered Chlorinated Softened p yl> _rti {l d tr + : Treatment: ❑ ❑ ❑ ❑ > .................... ---...... .._.. ..........---- o -0ther (Specify) ""'"' "" NAME OF LAB THAT MADE LAST EXAM.DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address'above) Fold Reason For' Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) Complaints Color Odor Taste Sediment Foaming O�r (Specify) Of: - Use Of Constant Emergency JDATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ Source Of Drilled Well Driven Well Dug Well Spr�g Other r(specify)Water: �1.�"l Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Souree: Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: Special Tests Required: ` .r Additional Description If Needed: Signature DATE SENT And Title: Y ' ) LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY NITRITE- Sodium as No Magonese as Mn Nitrogen NITRATE Alkalinity as CoCO.3 Bicarbonatel Fluoride as F - Constituents as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as CoCO3 Sulfate as SO4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- ❑ Meet the,requirements for a potable water;however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the'coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concetAtTation of c rtain chemical or physical constituents exceeds acceptable limits. These are as follows: (y m Other: f�// V EXAMINAT nA i ION REPORT OL-81 REV. 92-74 I, Type or print one This Section for Lab, set and send to the address below L ision Use 2.Reports will be furnished TOWN NO. health or state on to local director of PHYSICAL COMPLI TO: Conn. State Dept. of Health, Laboratory Div., p agencies. ~ D E RECEIVED 0.JC-� �''a- M Box 1689 Hartford, CT 061 , DATE REPORTED COLLECTION ��Y Ili'h��re,snnrple was tnkert REPORT: ADDR TOWN COLLECTED BY (.7,� (Name) _riissy„s• V/ COLLECTOR"SNO DATECOLLECTEp �c{CSC` t.y IMECOLLECTEp Name and Address of person to re SAM LING DINT eeive�Labo tory Report -7 M. (, I Well Semi-Public P rivaivte Identification: O i Nome iltered Chlorinated Treatment: SOftene ....................................... --1 NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXA PROPERTY OWNER'S NAME AND ADDRESS(If ditfetent from name and address above) Reason For Conformation to Laws Suspected of Examination: (Specify) Causing Disease Other (Specify or Fol (Give Details) give details hero) Her,Complaints C ► Odor Taste Of: ❑ $ediment Fo�ng Qar(Specify) Use Of Constant ED ❑ Emeigency- DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER Supply; QUALITY(Specify) Source Of Drilled We I Driven Well Dug Well Spring Water: �9 Other(Specify) Description Of WELL DEPTH WELL DIAMETER ❑ Water Source: CONDITION OF CURB AND TOP SEAL Ft. In. DATE OF LAST PLUMBING WORK IN SYSTEM Possible Source SeptiTank Form Industry Of Pollution: ❑ Y Other (Specify) Special Tests Required: .4. �. / Additional Description If Needed; ! �iL`C t,y• ,�5. Signature DATE SENT N T—'----- M /I Phone 566-3536 LABORATORY DI VI�(1('lN• — - lU Clinton Street s P.O. Dox 1689, llArt.ford, 04n. ti 101 LABORATORY NUMBER: 3 HYAROCARBONS: Vapor Test Ted. 4 °C �: .5 J C Column Temp. r Column VC v ' Results expressed as Micrograms per Liter: I Component lConcentratiohi Component IConce.ntratl METHYL ACETATE Methane 1 Butane METHYL ALCOHOL i ` � Propane ATITHYL CELLOSOLVE METHYL iso-BLVYL KETONE ACETONE METHYL. ETHYL, KETONE AMYL ACETATE METHYL METEACRXLAIM' AMYL ALCOHOL I.IETHYLENE CHLORIDE iso-AMYL ALCOHOL � NONANE � BENZENE 9 so-OCTANE BUTYL ACETATE PENTANE PETROLEUM ETHER BUTYL ALCOHOL PROPYL ACETATE iso-BUTYL ACETATE iso-BUIIYI, ALCOHOL iso-PROPYL ACETATE owBUPYL ALCOHOL iso-PROPYL ALCOHOL i CARBON TETRACHLORIDE iso-PROPYL ETHER CHLOROBENZENE 1,1,2,2,-TETRACHLOROE°IfM CHLOROBUI'ANE TETRACHLOROE CHLOROIOmm TOLUENE DICHLOROBENZENE 1,1,1-TR ° 3.,1,2-TR77�—IF 1,2-DICHLOROPROPANETRICHL0RETHYL ACETATE VL'fYI. ACETATE ETHYL ALCOHOL ,•...... kYT..EldE (META ETHYL BENZENE XYLENE (ORTHO) ETHYL ETHER ETRYII:IVE CHLORIDE XYLENE (PARR} _ �'XANE j (� D -awn 0-/?S-(� s 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CONN. 06074 �psOR'.coN AREA CODE 203/644-2511 November 5, 1979 Mr. Raymond Sousa 26 Farmstead Drive South Windsor, Connecticut Dear Mr. Sousa: Recently, a sample of your water was taken and analyzed by the State Health Department Laboratory for hydrocarbons and organohalides (components of solvents, degressers, etc.). Although some components have been found in your water supply, their levels are well below those found to cause or suspected to cause any harmful effects. After discussing the results of your analysis.with State Health Department personnel and Dr. Sidney Curtis, Director of Health for the Town of South 1,11indsor, it has been determined that your. wa ter will be resampled in the spring of 1980 to determine any change in the levels of these components. If you have any questions, please feel free to contact me at Town Hall, 644-2511, Extension 42. You may also feel free to contact your personal physician if you so desire. Very truly yours, T014N OF SOUTH WINDSOR Robert Deptula, R.S. Town Sanitarian RD:bw Enclosure r This Section for Lob. Division Use EXAMINATION REPORT ;,* rp�j p� LABORATORY NO, TOWN N PHYSICAL COMPLETE OL-81 REV, 12-74 1.Type or print one dktt�ad � /to fheraddress below. OCT !! .,.- �' � 7 2.Reports will be furnished only to local director of U. i =� '��,)! health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div,, P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: �G4''if. (.- !tl���rs "cLCl/ .Ct-'it� ClSti. COLLECTED BY(Name) COLLECTOR'SNO DA7ECOLLECTED 71ldECOLLECTED SAMPLING POINT ho.eo 7 l 3 M. Nome and Address of person to receive Laboratory Report Well Semi-Public Private f Identification: L None Filtered Chlorinated Softened /.��`�c• /�J��[a t w. J'7�� Treatment: ❑ ❑ ❑ El _? Other (Specify) ........ t� J NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from narne and address above) Fold Conformation to Laws Suspected of Causing Disease Other (Specify or tlere Reason For P g y give details here) Examination: (Specify) ❑(Give Details) Complaints Color Odor T�a�ste Sedo nt Foaming Other(Specify) Of: Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ Source Of Drilled Well Driven Well Dug Well Sprag Other (Specify) ',ti�4-�'Water: Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL_____fDATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Form Industry Other (Specify) Of Pollution: l�_l �11 Special Tests Required: ! e Additional pescription If Needed:' Signature ". rt DATE SENT And Title. LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODORr�i9tfSi NITRITE Sodium as No Magonese as Mn J[ NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F Nitrogen rt! Constituents C (N) as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen JALBUMINOID Total Hardness as CoCO3 Sulfate as SOq � f t, „�,,• !1 Li t ��,F.Y� E7i't7rBfLt l,4ilJ:7 tlKILS Chlorides as CI Iron as Fe MEMBRANE FILTER TES Coliform Colonies/IOOML. CONCLUSIONS:The results of the analysis of this sample- ❑ Meet the requirements for a potable water. ❑Meet the requirements for a potable water;however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water Should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ IR,not meet the requirements for a potable water because: ❑`Ihe coliform density exceeds acceptable limits. The presence of the colifo:m group, while not necessarily meaning that disease producing organisms are present, does indicate that such conc,"ination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. 'these are as follows: Other: POTABLEVATER COLLECTION/ 5�111 L EXAMINATION REPORT ��/.� .nS h This Section for Lab. Division Use OL-81 REV. 12-74 v� � f: J LABORATORY TO N NO. PHYSICAL COMPLETE 1. Type or print one set an sen o the dress below. f ��� 2.Reports will be furnished only to local director of �CT � �+ 35 health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of,Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN / REPORT: 7 1 '�9 A I cs: (.i✓/Gt9'Jo., COLLECTED BY(Name) COL/LECTOR'SNO I DATE COLLECTED TIME COLLECTED SAMPLING POINT M.Name GJ�drBvc - and Addre s of person to receive Laboratory Report Wei Semi-Public Ieu Pub'lic Private j''� Identification: 1 �.\J?ef �L!` None Filtered Chlorinated Softened❑ lS � ffl�/�► Treatment: ❑ ❑ ❑ _I Other (Specify) ................ LNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S'NAME AND ADDRESS(If different from name and address above) Sa Fold Reason For" Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: (Specify) ❑(Give Details) Complaints Color Odor Taste Sediment of Fong Other(Specify) Of: Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply El r_1 Source Of Drilled Well Driven Well Dug Well Spring Other(specify) Water: Description Of WE LL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Other (Specify) Of Pollution: Special Tests Required: P1r'�lrr`�o `4Gc�(q/NS Additional Description If Needed: Signature �"/ DATE SENT And Title: tt LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR NITRITE Sodium as No Magonese cis Mn • t4 A t o r•o /r7 Nitrogen NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F Constituents Cis AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 Hydrogen-'on Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample ❑Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ElDo not meet the requirements for a potable water because The colifoim density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: Jdf,t L,ABC _ 1 IYOMM-WHER:COLLECTION/ f This Section for Lab. Division Use EXAMINATION REPORT f 0 ' '� I OL-81 REV. 12 41-8,1 LABORATARY TOWN NO PA"MICAL COMPLETER -74 7.Type or print one set address below. PON C - :1 - W 2.Reports will be furnished only� loco/ director of health or state agencitis. DATE RECEIVED I D State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford,I I CT 06101 ID 7AT E:RE REPORTED ROTMEP TO: Conn. RTED COLLECTION NAM F PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: ry COLLECTED BY(Name)- COL ECTOR'SNO DATECOLLECTED TIOM�EC—OLL—ECTED SAMPLING POIffT— M. Name and Address of person to receive LaboratoryReport Wel I Semi-Public 'rivate Identification: L-ij F k - Identification:0 Is-ye a-, W Treatment: None Filtered Chlorinated -Softened ❑ J- 0-5 Other..(Specify).- . .................................................................... LNAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If differentfrom name and address above) 5 0 0vt Fold Reason Foe Conformation to Lows Suspected of :ausing Disease Othe❑r (Specify or give aetails here) W—ere va : (Specify) Examination ❑(Give Details) Complaints Color Odor Taste Sediment Foaming—Other(Specify) Of: El Odor F� 0 0 Use Of Constant Emergency DATE DATE OF LAST USEI CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Source Of Drilled Well Driven 5—ther(Specify) Water: Fl�r 0 Well Dug Well Sp 0 Description ELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING W ORK IN SYSTEM Water Sour Ft. In. Possible Source Septic Tank Form Industry (Specify) Of Pollution: ❑ Other Special Tests Required: Additional Description If Needed: Signature DATE SENT And,Title: Z i J LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR T NITRITE Sodium as No Magonese as Mn 'z Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F n Constituents as AMMONIA Alkalinity as CaCO3 Carbonate --Detergent as ABS Nitrogen (N) ALBUMINOIF— Total Hardness as C00O3 Sulfate as SO4Hydrogen-i6n Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ElMeet the requirements for a potable Water. CONCLUSIONS:The results of the analysis of this sample- ❑ Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliforin density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. The concentration of certain chemical or physical Constituents exceeds acceptable limits. These are as follows: ❑Other: OL-8fiAIN V. 12 REPORT This`Secf(on for Lab. Divisign'Use OL-81 REV. 12-74 A RA_ Y NO. TOWN NO. PHYSICAL ICOMPLETE 1,Type or print oneset and send to the address below. � � � 2.Reports will be furnished only to local director of ' 1-2 health or state agencies. DATE RECEIV Ah PORTED ov TO: Conn. State Dept. Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 F COLLECTION NAME OF RO ERTY(Where sample was taken) ADDRESS TOWN REPORT; ` - i• f. COLLECTED BY(Name) COLLECTOR'SNO COLLECR DATECOLLECTE TIMEED SAMPLING POI�S!!mip.61ir �{Name and Addr ss of person to receive Laboratory ReportWell rivate J) identification: 11 ❑ 17� Na Filtered Chlor�ted Softened + y6 wa Treatment: Other (Specify) NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) ' Fold Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints C°❑I°r Odor T�e Sediment Foang O�r(Specify). Of: Use Of Constant Emergency JDATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ` Source Of Drilled Well Driven Well Dug Well Spg Ot�heF(Specify) Water. Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN-SYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry 0�r (Specify) Of Pollution: Special Tests Required: t . Additional Description If Needed Signature [DAE SENT And Title: � LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY 'Vl NITRITE Sodium as No Magonese as Mn '.Nitrogen NITRATE Alkalinity as C00O3 Bicarbonote Fluoride as F Constituents as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as C00O3 Sulfate as SO4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements for a potable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because ❑The Coliform density exceeds acceptable limits. The presence of the Coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: Other: f` 'irV�'., Q � C.► of POTABLE WATER COLLECTION/ EXAMINATION REPORT OL-ei REV. 12-74 This Section for Lob. Division Use I. Type or print one set and send to the address below. jRADRY NO, 1.Reports will be furnished only to local director of j TOWN O' PHYSI L COMPLETE health or stat T0: Conn. State Dept. of Health, Labor ory Dive., / ,� t 0. Box 16$9 Hartford CT 06101 DATE RECEIV T DOTE i E ORTED, COLLECTION M R Y REPORT; (Where sample was taken) ADDRESS 1 tljlll�ffj 7 TowN LEC ED BY(Name Csi�ri�GGJ fi COLLECTOR'S N TE COLLECTED TIME COLLECTED S `s' GCJ/s-1 Cy >d p `, ris LING OINT Name and A d as of Person to receive Laborato �0` 7� �z /� M. rY ReportWell en Semi Public Private Id Identification: jy' %' ��YIaL'"•` Treatment: ❑ -� ❑ Softened LL'f'NW(3G/! C'C:r a6l [.i yLl, ..-.. ..E Other (Specify)ona Filtered Chlorinated El NAME OF LAB THAT MADE LAST EXAM DATE OF LAST X PROPERTY OWNER'S NAME AND ADDRESS IN dtfferer+t frwn name and nddrass.above) M Reason For Conformation to Laws Suspected of Cousin Examination: ❑ (Specify) 9 Disease Other (Specify or give details hare) Fbld (Give Details) Here Complaints Car OQr Ta�s�t® Sediment .F amin Of: ❑ ❑ g Other(specify) Use Of Constant mee�g ency DATE OF LAST USE CONDITIONS THAT MAY AFF Supply; EJ I� ECT WATER QUALITY(Spectfy) Source Of Drilled WL-11 Driven Well Dug Well Spring Water: L=,rly ❑ P❑g Other(Specify) Description Of WELL DEPTH Water our er Source: WELL DIAMETER CONDITION OF AND TOP SEAL F CURB A Wat - ' Ft. DA Possible Source Septa �Tank Farm Industr In. TE OF LAST PLUMBING WORK IN SYS EM Of Pollution: ❑ y Other (Sp ectfy) Special Tests Required Additional Description Bf Needed: I Signature And Title: r �CL. t. DATE SENT ro 1r-7 �..4-4ev0416�--b10..ut J vo. JiLALiti Phone 566-2536 LABORATORY DIVISION to Clinton 9tr"i. P.O. Box 1680, Hartford, Conn. 06101 LABORATORY NUMBER: 3 2 HYDROCAlfBONS: Vapor Test Temp. 7 4 °C C 5� Column Temp. 'C Column ifiJ '` Results expressed as Micrograms per Liter: /Y 6�j 2¢ -��" '��' Con onent lConcentrationi Component Concentratia METHYL ACETATE Methane Butane METHYL ALCOHOL Propane METHYL CELLOSOLVE f4 METHYL iso-BIgM KETONE < ` , ACETONE METHYL ETHYL KETONE r AMYL ACETATE METHYL METEAA� AMYL ALCOHOL MET NE CHL9 nE iso-AMYL ALCOHOL ! NONANE 1 , BENZENE i iso-OCTANE BUBYL ACETATE j PENTANE BUTYL, ALCOHOL PETROLEUM ETHER iso-BUTYL ACETATE ! PROPYL ACETATE PH IL ALCURUL iso-BUTYL ALCOHOL iso-PROPYL ACETATE swBUTYL ALCOHOL iso-PROPYL ALCOHOL CARBON TETRACHLORIDE iso-PROPYL ETHER CHLOROBENZENE 1111212,-TETRACHLOROETBANE CHLOROBUTANE TETRACHLOROETHYIENE ! f CHLOROFORM TOLUENE DICHLOROBENZENE ! 1,1,1-TRICHLOROETHANE I , 1,1,2-TRICHLOROETHANE 1,2-DICHLOROPROPANE ` TRICHLOROETHYLENE ETHYL ACETATE ETHYL ALCOHOL VINYL ACETATE ' XYLENE (META ETHYL BENZENE (ORTHO) ETHYL ETHER XYLENE i ETFMFNE CHLORIDE XYLENE PARA �;XANE -77�3•,� - pwam �. , ECTED BY(Name) COLLECTOR'SNO DATECOLLECTED TIMECOLLECTED SAMPLING POINT' fib �fi /yG- M. and Addr ss of person to receive Laboratory Report Well ' Seri Identification: & None F ✓S�Yi� ��{/�� Treatment:_ ❑ Other (Specify)' NAME OF LAB THAT MADE --RTY OWNER'S NAME AND ADDRESS(If different from name and address above) Sji4-UC41L- _. n For' Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) nation h ❑ (Specify) ❑(Give Details) ❑ aints Color Odor Te Sediment Fong Other(Specify) f Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Spec Of Drilled Well . DrivaWell Dug We . .Spring: Othef';(specify) ❑ ❑ ption Of WELL DEPTH WELL DIAMETER[CONDITION OF CURB AND TOP SEAL DATEOF >ouree: Ft.qI In. le Source ''=-Septic Tank Farm Industry Other (Specify) lution: ❑ ❑ ❑ Tests / ed: i�j U3 1/1 5/Vf�li f'<r/ , Gs21 >nal Description If Needed: ire 1 / IRATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical n ENT COLOR TRUE COLOR ODOR TURB Wi<tllj NITRITE Sodium as No Maganese as Mn n Ig NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F e tuents s AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS :n (N) ALBUMINOID Total Hardness as CaCO3 Sulfate as SO4 Hydro es as Cl Iron as Fe 17 MEMBRANE FILTER TEST Coliform Colonies/100ML. t the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- t the requirements for a potable water; however, the chemical or physical constituents listed below appear.abnormally hi :r should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. lot meet the requirements for a potable water because: The coliform density exceeds acceptable limits. The presence of the coliform group,while not necessarily meaning tha are present, does indicate that such contamination might reach the supply to the same extent. The water should be con: until the source.of this bacterial contamination can be located and removed. The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: Other: ' f f: y, i C, �.= .r ,' _ , < �4) 'f` rvIAULlt WATER COLLECTION/ EXAMINATION REPORT This Section for Lob. Division use OL-t)1 REV..12-74 ],Type or print one set and send to the address below. : ®Y NO, T�N O. PHYSICAL COM LJ=T 2.Reports will be furnished only to local director o f 1 /�`ja.•Z health or state agencies. DATE RE 0 EIV T0: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 T f 4 D-u REPORTED lit 1 7REPO)''17 ECTION as taken) ADDRESS: �' / rowN / COLL CTED a(Na a COLLECCTOR'SN ATE COLLECTED TIMECOLLECTED AM LING DINT `✓ 4.7e Name and Add ss o person to receive Laboratory Report 1 Wall Semi Public Private Identification: None Filtered Chlorinated Soft nod I.S�U tf�yjjL�r� Treatment: El ............. Other Specify) .....................�� NAME OF LAB THAT MADE LAST EXAM DATE OF LAST Nf PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here l_Foi Here ; Examination: (Specify) ❑(Give Details) i Complaints Cur O�d�or Of: Taste Sediment Foaming Other(Specify) ❑ ❑ ❑ Use Of Car nt Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: Ilt--�li I Source of Drilled Well Driv�en W� ell Dug Well Spring Other(Specify) L•��J/ Water: ❑ ❑ ❑ {`. Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL Water Source: Ft DATE OF LAST PLUMBING WORK IN SYS EM In. Possible Source SePtiCI ank Farm Industry Other (Specify) Of Pollution: ❑ Special Tests Required: r j,G>J 11 Additional Description If Needed: Signature And Title: DATE SENT �..v.�I's I.%-v. d0r%IS- I.�LI'MY�IIV%CI`A VI nVIALIn Phone 566-2536 LABORATORY DIVISION 10 Clinton Streee, P-U. Dox 1689, Hartford, Conn. 06101 , LABORATORY NUMBER: HYDROCARBONS: Vapor Test Temp. °C S'6 Column • Temp. 'C Column Results expressed as Micrograms per Liter; .a ic• Component iConcentration) Component Concentritic METHYL ACETATE Methane Butane I METHYL ALCOHOL P Propane ! METHYL CELLOSOLVE METHYL iso-BUM KETONE ACETONE METHYL ETHYL KETONE 1 AMYL ACETATE I METHYL METHA9RVA7E AMYL ALCOHOL ; METHMNS CHL43RIDE '{s iso-AMYL ALCOHOL p NONANE - 77 BENZENE iso-OCTANE i BUTYL ACETATE j PENTANE j I BUM, ALCOHOL j PETROLEUM ETHER PROPYL ACETATE iso-BUTYL ACETATE iso-BUTYL ALCOHOL is o-PROPYL ACETATE swBUTYL ALCOHOL iso-PROPYL ALCOHOL CARBON TETRACTILORIDE � iso-PROPYL ETHER I I CHLOROBENZENE 1,1,2,2,-TETRACHLOROETHANE ' I � • CHLOROBUTANE j TETRACHLOROETHYLENE CHLOROFORM TOLUENE i 1 1 1-TRICHLOROETHANE ff DICHLOROBENZ ENE ' ' I i 1,1,2-TRICHLOROETBANE 1,2-DICHLOROPROPANE TRICHLOROETRYLENE ETHYL ACETATE VINYL ACETATE i ETHYL ALCOHOL XYLENE (META) ETHYL BENZENE XYLENE (ORTHO) ETHYL ETHER PARA FTAXIENE CHLORIDE XYLENE -77 C w r 7-0-aw 0_/e S-0irdA ?V a w� 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CONN. 06074 oR•co` AREA CODE 203/644-2511 November 5, 1979 Mr. Frank J. Gervascio 129 Overlook Drive South Windsor, Connecticut Dear Mr. Cervascio: Recently, a sample of your water was taken and analyzed by the State Health Department Laboratory for hydrocarbons and organohalides (components Of solvents, degressers, etc.). have been found in your water supply, their levels uare gh swell ome cbelow �nts those found to cause or suspected' to cause any harmful effects. After discussing the results . of your -analysis with State 'Health Department personnel and Dr. Sidney Curtis, Director of Health for the Town of South Windsor, it has been determined that your water will be resampled in the spring of 1980 to determine any change in the levels of these components. If you have any questions, please feel free to contact me at Town Hall, 644-2511, Extension 42. You may also feel free to contact your personal physician if you so desire. Very truly yours, TOWN OF SOUTH WINDSOR �:.�tt'Dep(lam Robert u a, R.S.- Town Sanitarian RD:bw Enclosure EXAMINATION REPORT __••v ���-- �� � This Section for Lab. Division Use � LABORATORY N,O. TOWN NO.,F PHYSICAL COMPLETE OL-81 REV. 12-74 1.Type or print one set ond'en to the2r�dress below. f1�T i L Q -5 A, ►"{} 2.Reports will be furnished only to local director of O 1 ( 8 health or state agencies. DATE RECEIVED DATE REPORTED TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 `COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: !, G- GG-<.�lac �- Cf✓rl.V iG .� COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TIMECOLLECTED SAMPLING POINT F , l?r''. f7'A . �� G% dj ��. J� 4; Name and Address of person to receive Laboratory Report Well Semi-Public Private Identification: ❑ t t sl'r' ' v�r None Filtered Chlorinated Softened 77Y Treatment: F, ❑ ❑ ❑ th ....er.. (....Specify)................. ........................................................ - O El L_ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S-NAME AND ADDRESS(If different from name and address above) S'C= Fold Reason For Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Erere Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Color Odor Taste Sediment Foaming Other(Specify) Of: ❑ ❑ ❑ ❑ ❑ ❑ Use Of Conssttant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: Source Of Drilled Well Driven 1'!el! Dug Well $pr_-ing Other(Specify) Water: Description Of Y''ELL UEP7H WELL DIAMETER CONDITION OF CURB AND TOP SEAL DA7EOFLAST PLUMBING WORK IN SYSTEM Plater Source: Ft. In. Possible Source Septic Tank -Form Industry Other (Specify) Of Pollution: ❑ ❑ ❑ Special Tests Required: Additional Description If Needed: Signature DATE SENT And Title: l( `-'>e' LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR t+I T RITE Sodium as No Maganese as Mn _ •j Nitro.en NITRATE Alkalinity as C00O3Bicarbonate Fluoride as F 9 i / ty Constituents },f 1F7t-11,C. ft1 It)-e.) . 1) e-,F.' If <1� as AMMONIA Alkalinity as CaCO3Carbonate Detergent as ABSt-- Nitrogen (N) r �f�E-h ���cjC.�t'tt(� Ax�;.t�.s �l� {►-; ALBUMINOID Total Hardness as CoCO3 Sulfate as SO4 Hydrogen-ion Concentration (pH) Chlorides asCl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. CONCLUSIONS: The results of the analysis of this sample- Meet the ;:i.ements for a potable water. ❑ Meet the:rc::i:c zcnts for a potable water;however, the chemical or physical constituents listed below appear abnonnadly high for a gro-und supply. The water sho;'.: be suspect if local conditionS indicate that the:source of these constituents is a potentially harmful one. ❑ Do not t - requirements for a potable water because ❑'the r density exceeds acceptable limits. The presence of the colifo:rn group, while nbt necessarily.meaninS• that disease producing orFanisins are r __.n., does indicate that such contamination might reach the supl,ly to the same extent. The water should be considered as unsafe for drinking until t.._ .SOU.ce of this bacterial contamination can be located and removed. ❑The c- -entrario,, of certain chemical or physical constituents exceeds acceptable•limits. 'these arc as follows: ❑Oth 26 u ---�(!t✓tom --��-�r`f-- _��vG��L�C - ----- � 2 STATE sT'E OF CONNECTICUT ` DEPARTMENT OF. HEALTH SERVICES � a OFFICE OF PUBLIC HEALTH June 22, 1979 TO: Water Utilities Using Sources in Excess of EPA Guidelines for Certain Volatile Organic Chemicals FROM: Richard S. Woodhull , Chief, Water Supplies Section . SUBJECT: Compliance with Guidelines The enclosed guidelines were received from the EPA by this department on June 18, 1979• These are suggested*no adverse response levels . We feel every water utility should strive to maintain all water sources as free as possible from these chemical contaminates. We are writing to you because our records show that your system is presently out of compliance with these guidelines. It is requested that you bring your system into compliance as promptly as possible, but not later than August 1 , 1979• Measures that should be considered would include removal, containment or neutrali- zation of the source of contamination, provision of an alternate source of water, blending with an uncontaminated source, inter-connection with another water utility, or treatment to remove the contaminant. If for any reason the guidelines cannot be met by August 1 , notice of all affected water consumers will be required. The Department of Health Services will review the notice content with you before it is delivered so as to be certain it constitutes sufficient and accurate information. The news media may be used for this purpose where appropriate. Please let us hear from you not later than July 15 as to, your plans and your progress in complying with this message. RSW:fab Phone: 566-3110 79 Elm Street — Hartford, Connecticut 06115 An Equal Opportunity Employer Water Supplies Section .June 20, 1979 Department of Health Services Plan for Dealing with Contamination of Drinking Water by Chemical Pollutants Whenever a public drinking water supply is found to be contaminated by a - chemical which constitutes 'a hazard to health, the following steps will b.e taken: ; . Treasures will be promptly instituted to locate the source of the: contaiminate and, if- possible, to remove it, neutralize it or coltain 2. The consumers of the water supply will be not i f ied 'of the nature and degree of the contamination and will be advised of the hazard to health. They will be informed of what actions are being taken by the utility to correct the problem and where or how safe drinking water can be obtained in .the interim_ 3, if the proble.. =with the source water cannot be quickly corrected, u_i lity shall , i feasible, connect to another source of Crater supply and remov3 th:e affected source from use. a satisfactory a—ter source cannot be promptly obtained, adequate ::a_er treatment to :e:-ove the contaminant shall be promptly instituted. .are;agent =aci l i es will require a substantial time period to design a-d construct, m,:b .ia emergency treatment units shall be used in the interim. 5_ In are extreme emergency, the utility shall arrange for tank trucks of water or the hc;:e delivery of bottled water from an approved source where piped connection from a suitable water source cannot be obtained. 71 RSW: fab June 1$, 1979 CPA Suggested No Adverse Response Levels (SINARLS) for Vol ati I Organic Chemicals Detected in Drinking Water Less Than Chemical 1 Day I Year 1 Month Life-Time 1 . trichloroathylene 225/49/1 25/49/1 2. 1, 4 d i oxane ---- 20,/t19/l - 3. toluene __ ! mg/i -- __- 4. methyl ethylketone. -- t mg/l --- 5. ethylene glycol 1 mg/l. 10O ig/l ---- -- 6. 1, 1 , 1 trichloroathaze 330/61,9/1 ---- --- 33/sg/I 7. acry Ion i tri I e -- 35`.fg/1 3/ig/l 3. alcohol . ---- t mg/i 9. poll ych')orinatecEhiph= vIs ---- 10. t__rach l orcethyl ere 14.0/;g/1 15/,:g/i Supplies In Use Which Exceed EPA's Limits For Organics. EPA Limits 2 - 1 ,1 ,1 trichloroethane — 59 trichloroethylene — 5• AA M9111 tetrachloroethylene — 15• Atg/1 Total of Affected Systems - 12 benzene 1 .0Aq/1 Total of Affected Sources - 16 EPA g/1 Limit. Town Utility Sou Substance concentration Ag/1 Date Type* rce Prospect Highland Heights Well #7 (drilled) 1 ,1 ,1 trichloroethane 100. 35• 9/21/78 raw raw trichloroethylene 25• 25• 9/21/78 comment - This source is being blended in the distribution. The most recent distribution sample was 0.0j4g/1 collected 11/7� Plainville tWater inville Johnson #3 1 ,1 ,1 trichloroethane 42, 35• ' 11/3/77 raw Co. comment Samples were collected 5/30/79 and we are expecting the results shortly. 1 ,1 ,1 trichloroethane 150. 535. 4/27/79 Create Southington Southington Well #5 trich]oroethylene 38. 25. 4/27/79 treate Water Dept. Well #6 1 ,1 ,1 trichloroethane 120. ' 35• 10/3/78 raw comment . — Well #5 will shortly be replaced if testing of the New Britain Patton Brook well proves satisfactory. Well #6 is not presently operating. Windham Cedarcrest Apts. Well #1 3/12/79 distri tetrachloroethylene 23. 15. comment The well will be resampled and a follow-up investigation will be conducted by the regional engineer. trichloroethylene 60, 25, 11/2/78. distri Canton Mazza Block Well #1 15, 11/2/78 distri tetrachloroethylene 30• 1 trichloroethane. 110. 35'• 3/15/78 treate Farmington Farmington Gravel packed #2 1 ,1 raw Industrial Park Gravel packed #3 1 ,1 ,1 trichloroethane 90. 35• 3/t5/78 ` tetrachloroethlene 20. 15. 3/15/78 raw 3/15/7� treat4 Gravel packed #4 tetrachloroethylene 140. 15. Page 2 1 } . EPA 1 9/1 Limit Town Utility Source Substance concentration Al9/1= Date Typo` Thomaston Thomaston Gravel Packed #1 tetrachloroethylene varies with 15. Oct. , '78 raw and Water Co. pumping cycle to present treated Gravel Packed 92 Unknown at this time. 50-200 May or may not fall below limit. Plainfield Union Water Works Drilled Well #1 trichloroethylene 280. 25. 4/10/79 raw tetrachloroethylene 45. 15. 4/10/79 raw benzene area 1 .6 1 .0 4/10/79 raw Plainfield Kaman Aerospace Well #1 trichloroethylene 270. 25. 10/11/78 raw tetrachloroethylene 16. 15. 10/11/78 raw Well 92 trichloroethylene 3100. 25. 10/11/78 raw tetrachloroethylene 44. 15. 10/11/78 raw Woodbury Woodbury Gravel Packed#2 1 ,1 ,1 trichloroethane 83• 35• 5/15/79 raw Danbury Lakeview MHP Drilled Well #1 1 ,1 ,1 trichloroethane 91 . 35. 5/16/79 Dist. no trea trichloroethylene 80. 25. 5/16/79 Norwalk Norwalk 1st Layne #2 trichloroethylene 53• . 25. 3/12/79 raw Taxing .Dist. (gravel packed) comment This source is blended with reservoir water before use. i *Type - raw untreated water @ source treated - treated water @ treatment station distribution representative sample in the system after treatment. ,@RO)rOYt SUC�$lar.vn rv:�m}r+ura�s .ruf7gaar.vrr ns�carua r r.+y+ I n i se ede pti r i m e"i) Message SAVE TI M E: Handwritten messages are acceptable; :3TC5-235'-REv. 7178 STATE OF CONNECTICUT Use carbon if you really need a copy. If typewritten, iknore fair,[ lines 'Stack No.6933-051-tit)' TITLE DATE NAME John Lv4is, H,Ia. M.P.H+ thief June: 21 1-- � 979 _ �� Ac?�Cv Aaaasss Bureau of Health promotion and Disease Prevent1.on ' TITLE - TELEDat�3t$ po , ace Richard S. Woodhull Chief 3itU At5DR�59 Water Supplies Section , sassecr Volatile Organics in prinking Water 6/18/79 Steve Hal ish', Ray -Jarema and i met: w i th the EPA arid the other New Encgland .states to. review the status of contamination of .the region's water supplies by volatile organic chemicals. The object was to j develop a uniform approach with respect to the states ' responses to this type .of problem. Attached is an updated list of`SNARLS which was presented to the states at this rneeting. . ..Note the[ these are guidelines only. the -,three that affect us now are trichloroethylene 2D,fty/1 , tPtrachloroethylene 1511qg/1 , and 1 , 1 , 1 t r i ch I oroethane 33A9/l - We have' 12 pub ic- water supplies using 16 water sources that exceed these limits_ . A sumrary , sheet of those water supplies is attached. l .feal that in those cases where water sources exceeding the guide- _ lines must be continued in use, we crust requira public notification of the problem, as we did in Southington. 3 have outlined the protocol --_----- we plan to follow in dealing with these problems in my suggested response to Toby �4of fet (attached) - --die w-i-1 1 a 1-1-ow-w a t e r- ut- -1 i ties-one month (un:ti l��kugais� �t t' to cart _ into compI iance with _the._nEw-guides-fines, b e f ore__pybi Liq no_ti_ce -.is .-required. RSW:fab SAVE TIME: If convenie-nt, handwrite reply to sender on this sarne sheet. STATE OF CONNECTICUT - i UEVAR`I'MEiv"I' OF Hti t1LT H SERVICES STATE �JEM.- T CE WITH OFFICE OF PUBLIC HEALTH i'tar JUG 2 0 i on Lism-d Dale ................... FPO Cede_ Honorable Toby Moffett, Chairman June 20,, 1979 Subcommiltee on Environment Energy & Natural Resources House of Representatives 1007 Longworth House Office Building Washington, D.C. 20515 Dear Congressman P,.bffettz i am responding to your letter of June 14, 1979 to- commissioner Lloyd concerning chemical pollution of drinking water supplies. Enclosed is a protocol we have prepared for dealing with problems of this nature_ Beyond this, we believe that special funding should be provided by either state or federal legislation to pay for emergency procedures and corrections that are found necessary. The present state fund for imple- ment.ation of the Safe Drinking Water. Act would be a source of loan money to investor-cxgned utilities, but a giant in-aid fund for towns is also needed that could be tapped speedily in an emergency. Either main bxtension or emergency treatment procedures will require very substantial sums of money in most such situations. The state Department of Environmental Protection should also have a fund which it can use to immediately cause clean up and correction of chemical spills and dumps, these costs to be .later billed to the party responsible. The Department of health Services is anxious- to cooperate in the drafting of such legislation and will work for its passage. In the meanwh11e, we feel that the possible courses of action are outlined by the enclosed protocol We would welcome your comments and suggestions on this_ Sincerely, John N. Lewls, M.D. , M.P.H. , Chief Bureau of Health r Promotion anti Disease Prevention JNL:F'11Svq . lab anc. Phone: 566-IF140' 79 E!,n Street flurtfard, vrtnectfc:ttt poll An I;c ual opportcntity En!ployes .' - � I,J t•1..;..._ ciST+!lCY OIfiC7L]# tpCiYtvicFrET"C IGOF.-MIaaAWAV"VX f.Grt.01s.Mitr.Co"MCCriCUT f?atsrct CrN+NtcFieect W10111 584:._750 yV R�NthC.tpN OYnGP:: pg yq {� (yy �}{�. 1 7 R,ONO+Y(?fiTN MI 7C GUST OAFC Ut,ituuirc► ti✓ .i � +i{, Y �y ,r`1t �• 17tS Et !'STRXE WASH::wO FtJN.D.L--. 20515 � � f��}9(Y ii 'fY iVl i' - E30fiZla.C4NHLCMCVC 11$0$2 TFL"HOSa:(Z02)L?5-"7ii �1i#��r6 �` ygpJ y�$^t} /,�{y FeuPerekts:(P))7AS-$577 dCSMMIrTEEONINTERSTATE -- - yµ.'��7y. Ot_3,•��Li..L3t�i.tati eq 81LUX060T001S-Mite* AN4 FOREIGN COMMERCE p� r�r� 1 G EFL E3kir�iW C0r4MX=NWT 0603Z . COMMITTEE ON t3 'jib I , •4fi+s 205L:B '£ei.Rv„uNe+(203)234-7FU5 GOVERNMENT OPERATIONS �Tw.a..•Faiz.1-${%Y38t.43Zi} :a June 14, 1:979 Mr. Douglas S. Lloyd Commissioner, Health Services . 79 Elm Street Hartford, CT 06115 Dear Doug: Recently, several towns and communities in Connecticut have dis- covered that their drinking water supplies have been contaminated by chemical waste from past and present industrial. practices. Under the Safe Drinking Water Act and the Toxic Substances Control Act, vent future contamination of surface efforts are now being made to pre and groundwater sources. Despite these efforts, however, we will be paying, the price for past mistakes for many years to come. For example, the industrial chemicals found in some Canton wells caused the town to shut down the wells and look for alternative water sources. The chemicals were dumped by a now defunct company in the early 70's. Recently, in Southington, two of the town's wells were shut down because of chemical contamination from a company that has Other industrial sources past and pre- been in operation since 1955. .seat, were also found to be causing ground water pollution. Mr. Douglas Costle recently stated, "As our national water needs increase, so does our reliance vn subsurface drinking water sources. People generally assume their water is safe to drink, and in most ses it is. However, once a community's groundwater supply is con- ca taminated, it can remain unserviceable for decades, or centuries. . In such a case, a safe alternative supply would have to be found which can be both difficult and expensive for the community." Some COMIM1' Connecticut may need short and long term assist- ance from the state in providipw citizens wit a ecivate an sate drin'kin water supplies until_their particular pollution pro ems are alleviated; As lair. Cost indicated, the contamination o su s 3- water supplies may require long term use of alternative sources of drinking water. THIS ✓TATIC>,IERY i'FfiN'1Fn ON PAPER MAD£ WITH f2ECYCt...ED F'IUIERS - - 2 Presently, under the Safe Drinking Water Act the State has primary authority to administer and enforce the Act. The State is required by law to develop and submit to the U. S. Environmental Protection t Agency -a plan for providing ewer enc water supplies to affected corrrnunities. Connecticut's plan, developed be fore 1966,, ana periodic— ally updated, provides for the supplying of water to a community only in the case of nuclear attack or natural disaster. While a mechanism is in place to provide water: to communities if any of these circum— stances should occur, citizens are unprotected in the face of disasters such as Canton has experienced. According to EPA, the states have a great deal of flexibility in developing their individual emergency water supply plans. Under the Act, emergency is not specifically defined. Under these circumstances, and due to our increasing awareness and understanding of hazardous wastes in the environment, it is essential that a mechanism be developed for rnvidinc, alternative water sources t� o c t�i-, i orun� tri� k nere rining water supplies have .been seriously affe�cted by chemical wastes.. T urge the State of Connecticut to take the lead in developing such a program and including it in the State's emergency water supply-plans, for c -ieiriical waste conra:riination of our drinking waters is an immediate and threatenin, hazard, as serious as any natural disaster. Sincerely, TobyZiOLfett, Chainlan Toby Subcommittee on Environment, Energy and Natural Resources. ww:rs fOr-PlIRTNIFIT OF HEALTH t i ` APPENDIX A Carcinogens and Suspect Carcinogens in Drinking Water (USA) 1. Benzo(a)pyrene 2. Carbon tetrachloride 3. Chloroform 4. Vinyl chloride 5. 1,4-Dioxane 6. Methyl iodide 7. DDE 8. DDT 9. Chlordane 10. Lindane 11. Dieldrin 12. Benzene 13. Vinylidene chloride 14. Heptachlor 15. 1,1,2-Trichloroethane 16. 1,1,2-Trichloroethylene 17. Bis(2-chloroethyl)ether 18. Simazine 19. Tetrachloroethylene 20. Heptachlor epoxide 21. Acrylonitrile 22. Aldrin 23. Butyl bromide 24• Ethylene Chloride 61 APPENDIX A (CONTINUED) Mutagens and Suspect Mutagens in Drinking Water (USA) 1. 1,1,1-Trichloroeth,ane 2. Bromomethane (methyl bromide) 3. Methyl chloride 4. Bromochloromethane 5. Methylene chloride 6. Bromoform 7. Bromodichloromethane 8. 2-Chloropropane 9. 1,2-Dichloropropans 10. 1-Chloropropene 11. 1,2-Dichloroethane 12. Bis(2-chloroisopropyl)ether 13. Chlorodibromomethane 14. 1,3-Dichloropropene 15. 2,6-Dinitrotoluene 16. Dichloroacetonitrile 17. Methylene bromide 18. Chlordane 19. Vinylidene chloride 20. n-Butylbromide 21. Bis(2-chloroethyl)ether 22. Acrylonitrile 23. Benzo(a)pyrene 24. Methyl iodide 62 Mutagens and Suspect Mutagens in Drinking Water (USA) 25. Vinyl chloride 26. 1,3-Butadiene 27. 1,2-Bia(chloroethoxy)ethane 28. Pyrene 29. 1,1,2-trichloroethylene 30. Tetrachloroethylene (Perchloroethylene) 63 APPENDIX A (CONTINUED) 1' List of Promoters in Drinking Water (USA) 1. Ortho-Cresol 2. 2,4-Dimethylphenol 3. Phenol 4. n-Dodecane S. Eicosane 6. 2,4-Dichlorophenol 7. n-Decane 8. Limonene 9. Octadecane 10. n-Tetradecane 11. n-Undecane 64 POTABLE WATER COLLECTION/ � ` T3099 / CEXAMINATION REPORT I V— 100 This Section for Lab. Division Use OL-81 REV. 12474 ),Type or print one set and send to the dress below. LABORATORY NO. TO PHYSICAL COMPLETE 2.Reports will be furnished only to local director of health or state agencies. DATE RECEIVE �/f�6ppRTED p_ TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 f� •,(J� COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: COLLECTED BY(Name) C LLECTOR'SNO DATE COLLECTED TIME COLLECTED SAMPLING POINT 6' a� 1 12- M. f�C G '%t- Name and Address(of person to receive La oratory Report Well Semi-Pu .PbJJc Private Identification: LL--r ❑ 0 ^'ff rJ/fit' None Filtered Chlorinated Softened Treatment El El El dl C'GS Gc At ., 06 07J'1 Other.(Specify) ............ ............................ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Conformation to Laws Suspected of Causing Disease Other (Specify or Here Reason For, P g ❑ y give details here) Examination: ❑ (Specify) ❑(Give Details) Complaints Color Or Taste Sediment Fong—Other(specify) Of: Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ❑ Source Of Drilled Well Driven Well Dug We Spr�g Other(Specify) I91* Water: ' Description O{ WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Farm Industry Other (Specify) Of Pollution: Special Tests Required: C? ef'-0 ACI Additional Description If Needed: Signature e DATE SENT And Title: I) vllca7 LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR NITRITE Sodium as No Magonese as Mn Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F Constituents DI 1 btdwow>4s�,or� '� S as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) are "o^eA4-'_ 1.O rBUMINOID Total Hardness as CaCO3 Sulfate as SO4 Chlorides as Cl Iron as Fe e - dF�Ac MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- Meet the requirements forpotable water;however, the chemical or physical constituents listed below appear abnormally high for a ground supply. The a water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: �( is �J( 1'jLC�OR -LA �..�i S ��ii f���1 �9iV]� Arm ` ulliS�eGrlort.i'fJ.lat9�, li71yi5foi:.Us@ : OL-81' REV. 12-74 +•• LABORATOR NO. TOW N'NO. PHYSICAL COMPLETE 1.Type or print one set and send to= e address below. 2.Reports will be furnished only to local director of health or state agencies. 7 DATE RECEIVE TO: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 TED COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT: COLLECTED BY(Name) COLLECTOR'SNO DATE COLLECTED TfMECOLLECTED SAMPLING POINT ' /00`.r fit` M. Name and Address of person to receive Laboratory Report Weil Semi-Pub 'c Private Identification: 0 None Filtered Chlorinated Softened gJC v _.jfi° b�+ + Treatment ❑ ❑ . �r'-#:vi'1 f,..� '1'`�� Other (Specrfy}.................................................................... 3 _❑ NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Conformation to Laws Suspected of Cousin Disease Other (Specify or Here Reason For' P g y give details here). Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Car Odor .Taate $edi❑ment Foaming Other(Specify) Of: Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply Source Of Drilled Well Driven Well Dug Well Spag Oar(Specify) ❑Water: Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic Tank Farm Industry Oar (Specify) Of Pollution: Special Tests i Required: or ✓EL"t`; t + eK:., Additional Description If Needed: Signature SENT And Title: �j / DATE oet LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR T. y1 ,. , ►ram , NITRITE Sodium as No Magdnese as Mn j -- - �!} { 4..:.�•-.fir t7 1.'3 S�,Y� Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F Constituents I ! i; ,j, ,,,,. > 1 �•:� > s as AMMONIA Alkalinity as CaCO3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as C00O3 Sulfate as SO4 Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- e ❑ Meet the requirements for a potable water;however,the chemical or physical constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The coliform density exceeds acceptable limits. The presence of the coliform group,while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These are as follows: ❑Other: OL-81 REV 12-Y.4 7.iType or print one set and send to the address belowffDATE N tOyWN NO. P.HYSI A: , OMPLETE 2.Reports will be furnished aril to local director of f fi #t ' i P y 4 t health or state agencies. RECEIVED DATE RE RTED TO: Conn. State Dept. of Health, Laboratory Div., P.O: Box 1689 Hartford, CT 06101 COLLECTION NAME OF PROPERTY(Where sample was taken) ADDRESS TOWN REPORT:,w F l I r 1 IYY/P) l`'c# 5S'L4—' COLLECTED BY(Name) CO'L LECTOR'S NO DATE COLLECTED TIME-COLLECTED SAMPLING POINT M. 1h Name and Addr ss of person to receive Laboratory Report Well Semi-Publi Private [} v j Identification None Filtered Chlorinated Softened . /�`�C.• ,Jrv�j/fi'�"1 �t.� Treatment: Other (Specify) L NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) t 6✓f7 Fold Reason For Conformation to Laws Suspected of CausingDisease Other (Specify or Here ❑ y gyve details here).. Examination: ❑ (Specify) El(Give Details) Complaints Color Odor Taste Sediment Foaming Other(Specify) Of: ❑ ❑ El Use Of Constant Emergency DATEOF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: - ❑ Source Of Drilled Well Driven Well DugWelI Spring Oar(Specify) Water: El Description Of WELL DEPTH WELL DIAMETER CONDITION-OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source SeptiaTank Farm Industry Otheo(Specify) Of Pollution El Special Tests Required: / f / •�. r Additional Description If Needed ` Signature DATE SENT ' And Title: • �G&a LABORATORY EXAMINATION REPORT: (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY Mc• -)e:, NITRITE Sodium as No Magonese as Mn Nit ro9 en NITRATE Alkalinity as CaCO3 Bicarbonate Fluoride as F Constituents as AMMONIA Alkalinity as C00O3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as C00O3 Sulfate as SO4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- ElMeet the requirements for a potable water; however, the chemical or physical constituents listed below appear abnormally high for aground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because: ❑The Coliform density exceeds acceptable limits. The presence of the Coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source:of this bacterial contamination can be located and removed. ❑The concentration of certain chemical or physical constituents exceeds acceptable limits. These_ are as follows: �. Other: c+L k*'4c"c -i%".'U Sir,. ►.�r' ►i:►avli� �l i Ui- iLAL i Phone btit>.2G3t{ LABORATORY DIVISION to Clinton Sera9t P.O. Box 1688, Hartford, Conn. 06101 LABORATORY NUMBER: HYDROCARBONS: Vapor Te st Temp. . -7 o °C 'a Column Tem / 0 'C L, r O Column if d #as Results expressed as Micrograms per Liter; Component IIII Concentration Component Cancentr�ltiy v , METHYL ACETATE Methane Butane METHYL ALCOHOL .G Propane - L$a a i METHYL CE'LLOSOLVE METHYL iso-BUM KETONE y ACETONEs - WTHYL ETHYL KETONE AMYL ACETATE METHYL METHACRYLATE art' ! i AMYL ALCOHOL I METHYLENE CHLORIDE iso-AMYL ALCOHOL NONANE jI BENZENE ! I iso-OCTANE i --- 7-.-- BUTYL ACETATE PENTANE BUTYL ALCOHOL PETROLEUM ETHER i PROPYL ACETATE iso-BUr'YL ACETATE iso-BUTYL ALCOHOL iso-PROPYL ACETATE I srBUTYL ALCOHOL iso-PROPYL ALCOHOL —CARBON TETRACHLORIDE igo-PROPYL ETHER II CRLOROBENZENE i 1,1,212,-TETRACHIAROETBAI!3E I CHLOROBUTANE TETRACHLOROETHYLENL 1/ CHLOROFORM 3 d, TOLUENE ; E i DICHLOROBENZENE 1,11,1-TRICffiAROETAANE 1,1,2-TRICHLOROETHANE 1,2-DICHT.OROPROPANE I . TRICHLOROETSYLENI' ETHYL ACETATE ETHYL ALCOHOL VINYL ACETATE ETHYL BENZE XYLENE (META NE ETHYT, ETHER XYLENE (ORTHO ETHYLENE CHLORIDE XYLENE _ PARA ,�. "1101ANE ��• 3C. n.-1 -7 r7 ' _ I Dpt�►TOR nwm[t ►# KtCM, )K l , _ r<_ �; �:� rrrrs,aeetitt�t fir"C"atj; rtslorG�Else ` 6L-81 REfif 2.44 1 N TOWN NO. 'COMPLETE' Ttype or prir%t one set and send to the address beloy�, PHYS CA"L= 2.Reports wW be furnished only io local director of health or state agencies. DATE RECEIVED DATE RE RTED" T0: Conn. State Dept. of Health, Laborata}y Div., P.O. Box-1689 Hartford, CT 06101 NAME OFiPR ERTY(Where sample was taken) ADDRESS t ; COLLECTION TOW REP ��te { ► +s r~ �i & �js: F_ r COLLECTED BY(Nara€); COLLECTOR'SNO DATE COLLECTED TIME COLLECTED SAMPLING POINT ti l Name and Address of person to receive Laboratory Report Well Semi-Publ' Private " 000 / Identification: ❑ �5_ � Vsff/� C��t � None Filtered Chlorinated Softened / Treatment n.. "` ❑ ❑ ❑ Other (Specify) --------- --------- NAME OF LAB THAT MADE LAST EXAM DATE OF LAST EXAM PROPERTY OWNER'S NAME AND ADDRESS(If different from name and address above) Fold Reason For' Conformation to Laws Suspected of Causing Disease Other (Specify or give details here) Here Examination: ❑ (Specify) ❑(Give Details) ❑ Complaints Car Oar Tae $eda nT Foaming Oar (Specify) Of: Use Of Constant Emergency DATE OF LAST USE CONDITIONS THAT AFFECT WATER QUALITY(Specify) SupplyEl I Sater: Of Drilled Well Driv0Well Du9a11 Spag Other(Specify) Water: 1L�J1 Description Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL DATE OF LAST PLUMBING WORK IN SYSTEM Water Source: Ft. In. Possible Source Septic❑Tank Farm Industry Ot❑h (specify) Of Pollution Special Tests f •.. Required: . Additional Description If Needed. Signature i [DATE SENT And Title: } ., LABORATORY EXAMINATION REPORT (To be filled out by Laboratory Division) Note: Chemical results are in Mg/L. APPARENT COLOR TRUE COLOR ODOR TURBIDITY NITRITE Sodium as Na Magonese as Mn Nitrogen NITRATE Alkalinity as C00O3 Bicarbonate Fluoride as F Constituents as AMMONIA Alkalinity as C;CO3 Carbonate Detergent as ABS Nitrogen (N) ALBUMINOID Total Hardness as C00O3 Sulfate as SO4 Hydrogen-ion Concentration (pH) Chlorides as Cl Iron as Fe ; MEMBRANE FILTER TEST Coliform Colonies/100ML. ❑ Meet the requirements for a potable water. CONCLUSIONS:The results of the analysis of this sample- ElMeet the requirements for a potable water;however, the chemical or physical,constituents listed below appear abnormally high for a ground supply. The water should be suspect if local conditions indicate that the source of these constituents is a potentially harmful one. ❑ Do not meet the requirements for a potable water because ❑The coliform density exceeds acceptable limits. The presence of the coliform group, while not necessarily meaning that disease producing organisms are present, does indicate that such contamination might reach the supply to the same extent. The water should be considered as unsafe for drinking until the source.of this bacterial contamination can be located and removed. ❑The concentration A certain chemical or physical constituents exceeds acceptable limits. hesepAr as follows: ther: -4ARSAM L. cum J%IJI-Q "AI CK LULLECTION/ EXAMINATION REPORT OL-81 REV. 12-74 This Section for Lob. Divisio e I. Type or print one set and send to the address belo Og4 ORY ry0. TOWN NO. PHY 1 COMPL T'E 2.Reports will be furnished only to local director of 1Ui health or state agencies. T0: Conn. State Dept. of Health, Laboratory Div., P.O. Box 1689 Hartford, CT 06101 DATE RECEIVED DA R RTEI�, COLLECTION M R T Whore same a was REPORT: to en) ADDRESS �+ ^�,�- t` TOWN 7 �` S``G c`-/ E+r COLLECTED BY(N m�e)� OLLECTOR'SNO DATE COLLECTED ECOLLECTED M LING DINT s, ��`✓f�S'a7✓` Nama and ^00fless of person to ..,wove Laboratory Report Well Semi-Publi Private r �� v jam; Identification: ;' ❑ 1 /� Nono i Itered Chlorinated So r road Treatment: ❑ Other(Sjieoidyj............................................. LLJ NAME OF LAB THAT MADE LAST EXAM DATE F PROPERTY OWNER'S NAME AND ADDRESS(!t different from name and address above) ' Reason For Conformation 4o Laws Suspected of Causing Disease Other (Specify or glue details here) 1 Examination: ❑ (Specify) Li Here ❑(Give Details) it Complaints Crr OI cr Taste Sediment Of: Fong Other(Specify) ❑ ❑ ❑ Use Of Conn nr Emergency DATE OF LAST USE CONDITIONS THAT MAY AFFECT WATER QUALITY(Specify) Supply: ' Source Of Drilled Well Driven Well Dug Well Spring Other(specify) Water: ILS=J ❑ ❑ ❑ ❑ Description,Of WELL DEPTH WELL DIAMETER CONDITION OF CURB AND TOP SEAL Woter Source.: Ft DATE OF LAST PLUMBING WORK IN SYSTEM In, Possible Seuree Sept: ank Farm Industry Other (Specify) Of Pollution: ❑ ❑ ❑ Special Tests Required: Ss ? ch'46 Additional Description If Needed: `. v-1 ri. Signature And Titie: Al-? �� y // DATE SENT a..fcL SESEN i cUNNtc11LUr 51Art WWARTMENT OF HEALCH Phono 666-2636 LABORATORY I)IVISION � 10 Clinton $trjey� P.O. Box 1689, Hartford, Conn. 06101 LABORATORY NUMBER: HYDROCARBONS: Vapor Test Temp. -7 O 'C b r,s,a Column Temp. / a 'C L- a 0 Column Results expressed as Micrograms per Liter: Component Concentration Com onent Concentreti METHYL ACETATE 1-' Methane J Butane METHYL ALCOHOL , Propane a ' METHYL CELLOSOLVE METHYL iso-BUTYL KETONE ; . ACETONE a 2 • a METHYL ETHYL` nTONE AMYL ACETATE METHYL METH gMATE AMYL ALCOHOL METHYLENE CHLORIDE Jso-AMYL ALCOHOL j NONANE j iso-OCTANE BENZENE I BUTYL ACETATE I PENTANE PETROLEUM ETHER BUTYL ALCOHOL f PROPYL ACETATE iso-BUTYL ACETATE iso-BUTYL ALCOHOL iso-PROPYL ACETATE i swBUTYL ALCOHOL I iso-PROPYL ALCOHOL CARBON TETRACHLORIDE iso-PROPYL ETHER CHLOROBENZENE ! 1,11212,-TETRACHLOROETHANE I CHLOROBiYDW, TETRACHLOROETHYLENE J� CHLOROFORM 3 d, TOLUENE 1 DI CHLOROBENZENE 'I'1-TRICHLOROETHANE rr 1,1,2-TRICHIAROETHANE 1,2-DICHLOROPROPANE i t.' I TRICHLOROETHYLENE ETHYL ACETATE VINYL ACETATE I r. ETHYL, ALCOHOL XYLENE (META) ETHYL. BENZENE XYLENE (ORTHO) ETHYL ETHER ETHYLENE CHLORIDE XYLENE_ PARA XANE /,�• t(, r�lf it �I•t�, 00t.4+OR — Mr. ___C - e, of-- _A r_ - of---A evc Va i sc _ C2 _—Le FarL,,xlcad L I o aflow 5� November 5, 1979 Recently, a sample of your water was taken and analyzed by the State Health Department Laboratory for hydrocarbons and organohalides (components of solvents, degressers, etc.). Although some components have been found in your water supply, their levels are well below those found to cause or suspected to cause any harmful effects. After discussing the results of your analysis with State Health Department personnel and Dr. Sidney Curtis, Director of Health for the Town of South Windsor, it has been determined that your water will be resampled in the spring of 1980 to determine any change in the levels of these components. If you have any questions, please feel free to contact me at Town Hall, 644-2511, Extension 42. You may also feel free to contact your personal physician if you so desire. Very truly yours, TOWN OF SOUTH WINDSOR Robert Deptula, R.S. Town Sanitarian RD:bw Enclosure Ii l � � a I Q$j 114k