HomeMy WebLinkAboutWell New 426 Abbe Road Q
WELL aRIwNG gBOA" STATEr PERMIT NUMBER
0i:-,coN1�C71CUT 4 5 V 5 7-
WDli.d 11-69 WELL DRILLING WPERMIT
STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115
LOCATION OF WELL (Tao") (street) (Lot Number) I DATE
SOUTH WINDSOR 426•ABBY ROAD 9/15/78
OWNER OF WELL
Q INDIVIDUAL ❑ BUILDER. ❑ OTHER(specrlyl GLEN SCHUKEI
iowNER•s ADDRESS
81 SCOT DR. , -S. WINDSOR, CONN.
PROPOSE) DOMESTIC ❑ BUSEST INES , ❑ FARM ❑ UIELL People being
USE OF served.
WELL ❑ l OTHER
SUPPLY
Iqy ❑ INDUSTRIAL ❑ CLIC IONDITIONING ❑ (Specify)' 4 .
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 Of present)
I of
, �
Indicate North
/7'd
EX I -
Approximate number of feet from well to Sc�J7].f'icz Sewers
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 the 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.
PPLI T ignatu ) APPLICANT'S ADDRESS REGISTRATION NO.
4&� /0 TAKE ST. , VERNON, CONN. � 100
BY(Town H604 olyker or e"t) DATE
IrAPPROVED ❑ REJECTED I /f` 0 g�
REMARKS
SCANNED
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT STATE OF CONNECTICUT
Do NOT tilt in
WDB-5 12-69 REV.9-71 WELL DRILLING BOARD . STATE WELL NO.
State Office Building
HARTFORD,CONNECTICUT 06115
OTHER NO.
OWNER NAME a.i E HU I ) ADDRESS
'T �I.tR. o C;�I�v�3�3��s G 3v�i�?.
LOCATION (No.&Street) (_Town) (Lot Number)
OF WELL 426 AB BY ROAD SOUTH )EDDS'S.OP.
BUSINESS
PROPOSED
DOMESTIC ❑ ESTABLISHMENT ElFARM ❑ TEST WELL
USE L PUBLIC AIR OTHER
WELL SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify)
DRILLING ROTARY ❑ AIR P PERCUSSION ❑ PERCUSSION ❑ (COMPRESSED CABLE Specify)THER
y)
LENGTH (feet) DIAMETER(inches)I WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
CASING DETAILS {3 I 9s45 I THREADED ❑ WELDED YES ❑NO ❑YES NO
HOURS YIELD (G.P.M.)
YIELD TEST 1-1BAILED ElPUMPED 6�1 COMPRESSED AIR 1 4 �2
WATER
MEASURE FROM LAND SURFACE-STATIC (Specify feet)I DUR114G YIELD TEST(feet) I Depth of Completed Well
LEVEL 20 175 in feet below Land surface: 2
MAKE I LENGTH OPEN TO AQUIFER(feet)
SCREEN _
DETAILS SLOT SIZE DIAMETER(inches) GRAVEL SIZE(inches) FROM(feet) TO(feet)
IF GRAVEL Diameter of well including
(PACKED: ` gravel pack (inches): ,
DEPTH FROM LAND SURFACE Sketch exact location of well with distances, to at least
FEET to FEETFORMATION DESCRIPTION two permanent landmarks.
15 Sand & G`�a ?
L
0 drOOL
e
R
t
If yield was tested at different depths during drilling, list belowI
FEET GALLONS PER MINUTE
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT °Lt-DRlLLE ignatu ') -
DEPT. OF ENVIRONMENTAL PROTECT€ON-VVi -ER RESOUPCES