HomeMy WebLinkAboutWell New 269 Abbe Road ? 2-(Dq Poad
STATE OF CONNECTICUT WELL COMPLE)IbN REPORT DO NOT FILL IN
WATER COMMISSION r
317 STATE OFFICE BUILDING This report must be completed and submitted to STATE WELL NO.
HARTFORD 15, CONN. State Water Commission no later than 30 days OTHER NO.
after completion of well. -
WELL
OWNER
WELL Name :)treetCAfldress City or Town
DRILLER F
Name Stree ddress City or t�
PROPOSED USE OR USES(check):
omestic �Irrigation ❑Stock [Municipal [] Industrial ❑Test Well
CASING DETAILS PUMPING TEST WATER LEVEL SCREEN DETAILS
(measure from land surface)
LENGTH: FEET DURATION: J HOURS STATIC:--- - -- FEET MAKE: —
;3 SLOT
DIAMETER: INCHES PUMPING RATE: fi G.P.M. WHEN PUMPING: ® FEET LENGTH: FT. SIZE
KIND: DIAMETER: IN.
WELL L00
DEPTH FROM Give details of formations penetrated, such as: peat, silt,sand,gravel,clay, hardpan,shale,stone,rock. Include size of gravel
GROUND SURFACE (diameter)and sand (fine, medium,coarse),color of material, structure (loose, packed,cemented,soft, hard)
U FT.to FT. '
FT.to /J FT.
FT,to FT.
FT.to FT.
FT.to FT.
FT.to FT.
FT,to FT.
FT.to FT.
FT.to FT.
FT.to FT.
m
FT.to FT,
JillFT.to FT. C7 rJJ
FT.to FT. C) f 3f
FT.to FT.
FT.to FT. /
PATE WELL WAS COMPLETED: -C/% 57-4( DATE OF REPORT1 orb
WELL DRILLER
(Signature)
CERTIFICATE NO:
LOCATION OF WELL: TOWN OF
SKETCH SHOWING LOCATION OF PREMISES IN TOWN:
11� -
- 7-7
DIAGRAM SHOWING LOCATION OF WELL ON PREMISES:
!/LI
P ROUTE DIRECTIONS FOR REACHING WELL SITE FROM HARTFORD:
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