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Home My WebLink AboutWell Abandond 129 Beelzebub Road CONSUMER PROTECTION _ WELL DRILLING BOARD STATE OF CANECTICUT PERMIT NUMBER CPR-B REV.11-82 DEPARTMENT OF CONSUMER PROTECTION 144500 WELL DRILLING PERMIT 165 CAPITOL AVE.,HARTFORD,CONNECTICUT 06106 LOCATION OF WEIR (Sweep (Lot Number) DAR -1/9/90 S M!ftOR 129 BEELZEBUB RD. OWNER OF WELL ❑X INIINVIDUAL ❑ WILDER ❑-OTHER(Specify) ALAN PETEr2SON OWWR'5 ADDRESS 129 BEELZEBUB RD. , S. WINDSOR, CT. BUSINESS TEST Est.No.of PROPOSED ® DOMUTIC ❑ ESTABLISHMENT ❑ FARM ❑ WELL People being USE OF Abandon served. WELL ❑ PUBLIC PL ❑ INDU:TRIAL ❑ CONDITIONING OVER) 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 on lot and to house (it present) 0 Indieole North JAI t w , v, -.Z --r_ �b . �tl�•j RD Appioximote number of feel from well to nearest source of,possible contamination: The undersigned is aware that upon-completion of. the well, o "Well-Complelton Repori--containing construction'detods and-iriformotion required under •Section- 25 1J1 of the 1969 Supplement to-the Generol,Stalutes must be sent to the owner• .the.Board and the:Waler Resources Cominissiim on /he-form•provided'by-the• ' Board.This permit is not valid until all informotton is filled in and it has been countersigned by the Director of Health or his agent. 1 (SiSirarrre APPLICANVS-ADDRESS REGISTRATION-NO- P.O. BOX.1111 S.WILLINGTON, CT. -100 BY(rorvis f with Officer-.AS r) DATE t� A►lRolr� ❑REJECTED 'ov REMARKS -. ABANDON WELL. RETURN THIS COPY TO CONNECTICUT WELL DRILLNG BOARD W1 f,t_1-COMPLETION REPORT STATE OF CONNECTICUT — CPR-9 REV.11-82 DEPARTMENT OF CONSUMER PROTECTION D_o NOT fill in WELL DRILLING BOARD STATE WELL NO. 165 CAPITOL AVE. abandon well HARTFORD, CONNECTICUT 06106 OTHER NO. NAME 1 TT p n S.OWNER ALA!Y P�j'1. '�s7O 1�:� .L:r�.� I�i.�i1�V1J .LL.U• LOCATION (No. & Street) ' 1NDS� C ` (Town) (Lot Number) OF WELL 129 BE ZErBUB RD• U a��I-��r�C)� BUSINESS PROPOSED DOMESTIC ESTABLISHMENT FARM TEST WELL USE Of WELL PUBLIC AIR OTHER Abandon. Well SUPPLY INDUSTRIAL CONDITIONING (Specify) - DRILLING EQUIPMENT ROTARY AIR RCU D CABLE if SSION PERCUSSION ❑(Specify) CASING LENGTH(feet) DIAMETER (inches) WEIGHT PER FOOT IV H Wq$CA$ING GRO TED? DETAILS �YES = Kf0 THREADED ❑ WELDED 'YE3_, NO YL TEST 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 LENGT�OPEN O AQUIFER (feet) SCREEN DETAILS SLOT SIZE DIAMETER (inches) GRAVEL SIZE(inches) FROM(feet) TO(feet TIF GRAVEL Diameter of well includingACKED: grovel pock (inches): DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least FEET TO FEET two permanent landmarks. a 0) j vr 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 W RILLER (Signature)- DEPT. OF ENVIORNMENTAL PROTECTION-WATER RESOURCES WELL DRILLING BOARD STATE OF CONNECTICUT PERMIT NUMBER M1D8'4 " WELL DRILLING PERMIT' 19 51 STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 0611-5" / LOCATION OF WELL(Town) (Street) 6F (Lot Number) DAft (? J OWNIN INDIVIDUAL ❑BUILDER ❑ OTHEit(Specify) OWNER'S ADDRESS PROPOSED �j� BUSINESS TEST Est.No.of U DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ WELL People being USE OF served. WELL ❑ PUBLIC SUPPLY INDUSTRIAL ❑ CIR OTHER ONDITIONING ❑ (Specify) SKETCH OF WELL LOCATION -Locate well with respect to at least two roods,showing distance from intersection and front of lot Location of lot to at least two roads Well location on lot and to house(if present) Indicate North i Approximate number of feet from well.to nearest source of possible contamination. �0 Q��F-,<. gr/Ap—D X-=_k1Q9S AZ44144&/ C'` 7S' .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 t6 the General Statutes must be sent to the owner,the Board and the Water Resources Commission on the form provided by the Board.This per it is not valid until all i r ation i illed in and it.has been counter-si ed by the Di or of Health r.his agent. AP NT(Sig re) APPLICANT DRESS RE ST TION NO. BY(T o1Ih Officer o Agent) DATE APPROVE) ElREJECTEDVIC REMARKS cii�k�ic°� t'L E BOARD RETURN THISCOPY TO CONN CitCUT M/Ell.DRILLING B R ELL 41 v. N J \XA. I � LA E 2.9 Ac err- . . � 1 PRoPosczo 1 24 vk E N J tv �04 con►r�� y.R� �� I'1 S.o0 9b� _.Rw_ T E BLA e� ft0 as r � a 7 coca p�.t=tT y o F BEi;�'ZI�E�c�® Rc7�t�, _Soc�TK WI►.1Psvf2 , Cv�1�..1. MAY 31� 1973 F t L- P