HomeMy WebLinkAboutWell New 210 Avery Street CPR-9 Rev.7/95
STATE OF CONNECTICUT Do NOT fill in
DEPARTMENT OF CONSUMER PROTECTION STATE WELLNO.
REAL ESTATE&PROFESSIONAL TRADES DIVISION
WELL DRILLING COMPLETION REPORT OTHER NO.
165 Capitol Avenue,Hartford,Connecticut 061 o6
OWNER NAME
.7CSEF � O AD++��DRR+j�ESSry�rr ��vv�t�[�q}}��}�y 77����jj (ry�//�'�� �7r airy ( �i (� /.
133 CLIFF WOOD DR. 9 a7V s 611��r311�s 1Y1 i1����}
LOCATION (No.3 Street) (Town) (Lot Number)
OF WELL 210 AVERY STREET SO. WIND80R
DOMESTIC BUSINESS Lj ESTABL HMENT 0 FARM WELL
PROPOSEDLj USE OF WELL
PUBLIC El a SUPPLY INDUSTRIAL AIR OTHER
CONDITIONING (S city)
DRILL TG
ROTARY COMPRESSED CABLE OTHER-
EQUIPa ® AIR PERCUSSION PERCUSSION (Specify)
CASI ..............
TH(feet) DIAMETER(inches) WEIGHT PERFOOT
DETAT= THREADED WELDED DRIVE SHOE WAS CASING GROUTED?
YIELD �BAILED PUMPED COMPRESSED AIR HOURS IR YES ❑ N0 YES ❑ NO
YIELD(GPM)
4
WATRE FROM LAND SURFACE-STATIC(Specify feet) DURING YIELD TEST(feet)
LEVEL 30
545 Depth of Completed Well in feet
MAKE 545
SCREEN LENGTH OPEN TO AQUIFER(feet)
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well GRAVEL SIZE(inches) FROM(feet) TO feet PACKED: including gravel pack ( )
(inches)
DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION
Sketch exact location of well with distances,to at least two
FEET TO FEET permanent landmarks
O 9 SAND GRAVEL
9 545 RED SMUE
I
� I
f-�
If yield was tested at different depths during drilling,list below
FEET GALLONS PER MINUTE
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. =ATEOF=P'r:;2 O . OR
DEPT.OF ENVIRONMENTAL PROTECTION-WATER RESOURCES
CPR-9 Rev.7/95 . Do NOT fill in
STATE OF CONNECTICUT STATE WELL NO.
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE&PROFESSIONAL TRADES DIVISION OTHER NO.
WELL DRILLING COMPLETION REPORT
165 Capitol Avenue,Hartford,Connecticut 06106
OWNER NAME ADDRESS
JOSEPH CITING 11-33 CLIFFWOOD DR. , SO. WINDSOR CT 06074
LOCATION (Afo•s Sb-Wt) (roam) (tot Arumber)
OF WELL 210 AVERY STREET SO. 'WINDSOR
DOMESTIC BUSINESS FARM -TEST
PROPOSED ESTABLISHMENT WELL
" USE OF WELL Q SPUBLIC 1:1 UPPLY INDUSTRIALEl OTHER
CONDITIONING (Apecilyl
DRILLING ROTARY COMPRESSED CABLE OTHER
EQUIPMENT ® AIR PERCUSSION 1:1 PERCUSSION (Specify)
CASING LENGTH(feet) XAMETER @Wws) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
DETAILS 20 6 17# im THREADED[:] WELDED Q YES ❑ NO. Q YES ❑ NO
YIELD TEST BAILED PUMPED PUMPED a COMPRESSED AIR HOURS �-s� YIELD(GPM)
4 1 3
WATER MEASURE FROM LAND SURFACE-STATIC(Spedfy feel) DURING YIELD TEST(feet) Depth of Completed Wep in feel
LEVEL 30 545 545
MAKE LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(indws) IF GRAVEL - Diameter of yell GRAVEL SIZE(hdm) FROM(feet) TO(feet)
PACKED: indudkv gravel pads
(dxtm)
DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances,to at least two
FEET TO FEET permanent landmarks
0 9 SAND & GRAVEL
9 545 RED SHALE gaI
1
ova
—T
s
If yield was tested at different depths during drilling,list below
FEET GALLONS PER MINUTE
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT L RIL gna e)
7/22/03 220070 102 2/31/03
JOHN M.DrrFFORD
AGENCY