HomeMy WebLinkAboutWell New 380 Abbe Road WELL DRILLING BOARD STATE O CONNEt�UT PERMIT NUMBER
waaa 1169 WELL DRILLING PERMIT
STATE OFFICE BUILDING,H/46ORD,CONNECTICUT 06115 0
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LOCATION OF WELL (Town) (Sdraat) (Lod Number) DATE
SOUTH WINDSOR ABBY ROAD I 1/16/74
OWNER OF WELL
❑ INDIVIDUAL' ® BuibER ❑ OTHER(sp�:fy) JA ' LAM
OWNER'S ADDRESS
44 HENRY ST.'. , MANCHESTERS CONIt.
PROPOSE BUSINESS TEST Est'No.of
- DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ WELL People being
USE OF served.
WELL PUBLIC❑ AIR OTM
SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify) S
SKETCH OF WELL LOCATION
Locate-well with respect to at least two roads,showing distance from Intersection and front of lot
Location of lot to at least two roads Well location on lot and to house(I present)
Indicate North
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Approximate number of feet from well to 80
nearest source of possible contamination:
The-undersigned is aware that upon completion of the well,a'Well Completion Report`containing construction details and Information required under Section
25-131 of the 1969 Supplement to the General Statutes must be sent to the owner,the Board and the Water Resources Commission on fhe form provided by the
Board This permit is not valid until all Information is filled in and it has been counter-signed by the Director of Health or his agent
APP ( ure) I APPLICANT'S ADDRESS REGISTRATION NO.
LA __ ST:, VERNON, CONN. 100
g B own S Ofl�car or dyend DATA
APPROVED ❑� MECiED I O� yi 70-
REMARM
RETURN.THIS COPY TO CONNECTICUt WELL DRILLING BOARD
WELL MNMPLETEON REPORT STATE OF CONNECTICUT
WDB-5 12-69 REV. 9-71- WELL DRILLING BOARD Do NOT fill in
State Office Building STATE WELL NO..-
HARTFORD, CONNECTICUT 06115 (J (� Z
OTHER NO.
OWNER NAME ADDRESS
LOCATION (No.&Street) (Town) (Lot Number)
OF WELL ABBY HOAD 301 WIND OR
FJLDOMESTIC ❑ ESTABLISHMENT ❑ FARM BUSINESS
PROPOSE? El TEST WELL
USE OF
WELL ❑ PUBLIC SUPPLY ❑ INDUSTRIAL El CONDITIONING ❑AIR (Spe ify)
DRILLING Fxfl AIR PERCUSSION COMPRESSED CABLE
ROTARY ❑ ElPERCUSSION ❑ ((SSpe�y
ECUIP���I"cNT )
CASING LENGTH (feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
DETAILS 83I6 I ,* I ❑ THREADED � WELDED I a1 YES ❑NO ❑YES ONO
YIELD I HOURS YIELD(G.P.M.)
TEST ❑ BAILED ❑ PUMPED COMPRESSED AIR
MEASURE FROM LAND SURFACE—STATIC (Specify feet)I DURING YIELD TEST(feet)
WATER I Depth of Completed Well
LEVEL 40 200 in feet below Land surface: 250
MAKE f LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE I DIAMETER(inches) I IF GRAVEL I Diameter of well including I GRAVEL SIZE(inches)(FROM(feet) ITO(feet)
PACKED: gravel pack(inches):
DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances,to at least
FEET to PEET
two permanent landmarks.
0 4 Topsoil
Gravel
30 73 Hardpan 0-
3 2'30 Bedrock.
If yield was tested at different depths during drilling, list below
FEET GALLONS PER MINUTE
DATE WELL COMPLETED i PERMIT NO. I REGISTRATION NO. DATE OF REPORT VJ ignafur
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DEP7. OF ENVIRONMENTAL ENTAL OTEC T ION ^ WATER RESOURCES