HomeMy WebLinkAboutWell New 727 Avery Street STATE OF CONNECTICUT —7 A—vf --
WATER COMMISSION �y
WELL
317 STATE OFFICE BUILDING COMPLETION REPORT
HARTFORD 15 This report must be completed and submitted to DO NOT FILL IN
CONK, STATE WELL NO
State Water Commission no later than 30 days
WELL after completion of well, OTHER NO. ....,,,
t f. :
UWNLR eWELL
Name
DRILLER
I
Street Ad -A 1 iy Jsr�
...
v i City or Town
/ Name L ? c r
Street Address 7�
o
PROPOSED USE OR USES (check):
City r Town
�j Domestic
[J Irrigation Cj Stock
❑Municipa► Cl Industrial
CASING DETAILS El Test Well
LENGTH:
PUMPING TEST
WATER LEVEL
._ SCREEN DETAILS
{ � FEET DURATION: (measure from lana surface)
HOURS STATIC:
DIAMETER: " FEET MAKE:
INCHES PUMPING RATE: -------
--EX-f G.P.M. WHEN PUMPING: SLOT
KIND: `/� --- —_— FEET
--- ------- LENGTH: FT. SIZE
— -- —_
WELL LOG DIAMETER: IN.
��"-'--- ---- _ _
DEPTH FROM
Give details of formations penetrated
• such as: peat, slit, sand
medium, coarse , gravel,clay, hardpan,shale,stone,rock. Include size of gravel
GROUND SURFACE (diameter)and sand (fine, —
), color of material, structure (loose, packed,cemented, soft, Nord)
6' FT.to;,� FT. 12 -
FT.to FT.
FT,to !fir
FT.
FT.to FT.
FT.to FT.
FT,to FT.
FT.to i
FT.
i
i
FT,to FT.
FT.to FT
FT,to FT. _
FT.to FT. _
FT.to FT. -----_—_ _
FT.to FT — -- —_--- ----
FT.to FT
FT.to FT '
WELL WAS COMPLETED: G —
DATE OF REPORT "' G C
WELL DRILLER `
,
f (Signature)
CERTIFICATE NO.