HomeMy WebLinkAboutWell Correspondence 64 Beelzebub Road Xr4
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Dear Homeowner:
The Town of South Windsor Health Department's goal is to keep you informed about the
status of water quality throughout the town whether you are served by and individual well
or by a public water source.
In an attempt to better serve you, we have reviewed our files to ensure we have the
most recent and accurate information possible. Our review has revealed that we do not
have any information regarding how your residence receives its water.
We are hopeful that you will take a moment to help us keep our records current. Please
indicate the type of water service by circling the appropriate entry below and return this
letter no later than in February 27, 2009, in the self addressed stamped envelope
provided.
If you receive your water from a private well, please let us know the location as it relates
to your home by providing two measurements from the foundation to the well in the
space provided and let us know if the well is used for domestic, lawn and garden, or
agricultural use. See example below.
Thank you in advance for your cooperation.
Any questions can be addressed to the South Windsor Environmental Health Officer,
Robert De Vito at 860-644-2511, extension 248.
Water service:
Circle the appropriate service:
WELL MDC
1
=WAR
WELL USE: DOMESTIC LAWN & GARDEN AGRICULTURAL
Well Location :
BACK DRAWING:
40 FT RECEIVED
A FRONT B
30 F 14 FT FEB 0 3 7nna
SOUTH NGI
WELL E c f
ENGINEERING EPTPT ,.,f
STREET y 8er/ Cb" �" `
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CONSUMER PROTECTION
WELL DRILLING BOARD SKiE OF CONNECTICUT PERMIT NUMBER
CPR-6 REV.11-62 DEPARTMENT OF CONSUMER PROTECTION 144649
WELL DRILLING PERMIT
165 CAPITOL AVE.,HARTFORD,CONNECTICUT 06106
LOCATION OF WELL(Town) (Street) (Lot Number) DATE
S.WINDSOR 64 BEELZEBUB RD. lIZ30190
OWNER OF WELL
13 INDIVIDUAL BUILDER OTHER OTHER(Specify) RUSSELL ELLIOT
OWNER'S ADDRESS
64 BEELZEBUB RD. , S. WI NDSOR, CT.
BUSINESS TEST Est.No.of
PROPOSED ® DOMESTIC ESTABLISHMENT FARM � WELL People being
USE of AIR OTHER Abandon served.
WEII w� ElINDUSTRIAL CONDITIONINO ® (Specif ) Well
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 of least two roads Well location an lot and to house (if present)
V
Indioote North
x
Approximate number of feet from well to
nearest source of possible contamination:
The undersigned is.aware 0at•-upon completion of the well, a "Well Completion Report" containing construction details and. information'required under Section
25131 of she 1969.Supplemen! to the General Statutes must be sent to-the*owner,.the Board and the Water Resources Commission on the form-provided by the
Boord..This permit is not valid until all information is filled in.and it has been.counter-signed by the Director of Health or his ogent
APPI (Sit rtr APPLICANT•5 ADDRESS :.. REGISTRATION NO.
P.O. BOX -1112 S.WIL LINGTON CT. • .. _ 100 .
BY(Town NealM Officer ar:Agent) DATE. "
��APPROIIW �REJKTED - 'z... "..•-QD' .
REIVNIRKS
ABANDON WILL. J j zy f / 2 y/
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION. REPORT STATE OF CONNECTICUT
CPR-9 REV.11-EY DEPARTMENT OF CONSUMER PROTECTION Do NOT fill in
WELL DRILLING BOARD STATE WELL NO.
165 CAPITOL AVE.
HARTFORD,CONNECTICUT 06106 OTHER NO.
----------------------------
NAME 7 p _ ADDRESS # DOWNER a`i tt is Lt `�.r ae 3 T{ BEr.:zZp 7 i3 i F1. e W. +^�+L1xti .
LOCATION t� (No. &Street) (Town) (Lot Number)
OF WELL c, 4 BEELZ EBTUB +LD• S.1ATI-BT D S OR
BUSINESS
DOMESTIC El EST FARM ABLISH
PROPOSED ESTABLISHMENT E] TEST WELL
USE OF
WELL PUBLIC AIR OTHER SUPPLY INDUSTRIAL CONDITIONING 1:2(Specify) Abandon
Well'
EQUIPMENT � ROTARY ❑ AIR COMPRESSEDOTHER
PERCUSSION � PERCUSSION FI(Specify)
CASING LENGTH(feet) DIAMETER (inches) WEIGHT PER FOOT I WAS CASfNG GRQUTED?
DETAILS THREADED WELDED YES 01 NO1:1 YES El NO
YR
TEST ST BAILED PUMPED COMPRESSED AIR HOURS YIELD (G.P.M.)
WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet)
LEVEL Depth of Completed Well
in feet below Land surface:
MAKE
LENGTH OPEN TO AQUIFER (feet)
' fCREEN
DETAILS SLOT SIZE DIAMETER(inches) GRAVEL SIZE (inches) FROM (feet) TO(feet IF GRAVEL Diameter of well including
PACKED: gravel pock(inches):
DEPTH FROM LAND SURFACE
FEET TO FEET FORMATION DESCRIPTION Sketch exact location of well with distances, to of least
two permanent landmarks.
t3 State s E:, 'lT.j t 4 OnS.
Uj
If yield was tested of different depths during drilling, list below _
FEET GALLONS PER MINUTE
DATE WELL COMPLETED PERMIT NO. REGISTRATION-NO. DATE OF REPORT WE R.(Signature) 45
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DEPT.OF ENVIRONMENTAL PROTECTION-WATER RESOURCES