Loading...
HomeMy WebLinkAboutWell New 42 Barber Hill Road (2) < CPR-8 Rev.7195 PERMIT NUMBER STATE OF CONNECTICUT 211698 DEPARTMENT OF CONSUMER PROTECTION REAL ESTATE&PROFESSIONAL TRADES DIVISION WELL DRILLING PERMIT 165 Capitol Avenue,Hartford,Connecticut 06106 LOCATION OF WELL (Town) (Sheet) (Lot Number) DATE S.WINDSOR 42 BARBER HILL RD. 2/25/02 OWNER OF WELL 11 INDIVIDUAL BUILDER El OTHER(Specify) OWNER'S ADDRESS PAGANELLI COEST. — P.O. BOX 652, S.WINDSOR Est.No.of PROPOSED ® DOMESTIC BUSINESS FARM TEST People being USE OF ESTABLISHMENT WELL served. WELL PUBLIC D SUPPLY INDUSTRIAL AIRCONDITIONING OTH 4 SKETCH OF WELL LOCATION Locate well with respect to at least two roads,s owing distance from intersection and front of lot location of lot to at least two roads Well location on to and to house(if present) CAR Indicate North v�. �� Approximate number of feet from well to nearest source of possible contamination: ABANDONMENT 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 Department of Consumer Protection and the Water Resources Commission on the form provided by the agency. 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 ►e) APPLICANTS ADDRESS REGISTRATION NO. P.O. BOX 406, WILLINGTON, CT. 42 JAF BY(Town h ee Ofter or Agent) DATE PROVED a REJECTED REMARKS RETURN THIS COPY TO DEPARTMENT OF CONSUMER PROTECTION CPR-9 Rev.7/95 Do NOT fill in STATE OF CONNECTICUT STATE WELL NO. . DEPARTMENT OF CONSUMER PROTECTION REAL.ESTATE F(PROFESSIONAL TRADES DMSION OTHER NO. WELL DRILLING COMPLETION REPORT 165 Capitol Avenue,Hartford,Connecticut 06106 OWNER NAME ADDRESS PAGANELLI CONST. P.O. BOX 652, SUFFIELD LOCATION (NO.a Street) (Town) (Lot Number) OF WELL 42 BARBER HILL RD. S.WINDSOR DOMESTIC BUSINESS FARM TEST PROPOSED ESTABLISHMENT WELL USE OF WELL PUBLIC INDUSTRIAL a AIR © 'OTHER ABANDONMENTSUPPLY CONDITIONING DRILLING EQUIPMENT ROTARY a AIR PERCUSSION PERCUSSION COMPRESSED CABLE OTHER CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED? DETAILS THREADED ❑ WELDED ❑ YES ❑ NO., ❑ YES ❑ NO YIELD TEST a BAILED El PUMPED COMPRESSED AIR HOURS YIELD(GPM) - WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet) 1.DURING YIELD TEST(feet) Depth of C 8 O Well in feel LEVEL MAKE LENGTH OPEN TO AQUIFER(fed) SCREEN DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well GRAVEL SIZE(inches) FROM(feet) TO(fed) - PACKED: inducting gravel pads (inches) DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances,to at least two FEET TO FEET perrmnent landmarks 0 80 CEMENTED R 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 WELL GRILLER(Signature) 2127102 1211698 42 5/20/02 AGENCY