HomeMy WebLinkAboutWell New 355 Beelzebub Road WELL DRILLING BOARD STATE OF CONNECTICUT PEST NUMBER
TDB .. „.69 WE
« LING PERMIT-.. 14539
STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115 /
LOCATION OF WELL(Town) (Street) (Lot Number) DATE
SOUTH WINDSOR 355 BEELZEBUB ROAD 1/25/73
OWNER OF WELL
a]INDIVIDUAL ❑BUILDER ❑ OTHER(Specify) PHILIP WELLS
OWNER'S ADDRESS
355 BEELZEBUB ROAD, S. WINDSOR, CORK.
PROPOSED BUSINESS TEST Est.No.of
® DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ WELL People being
USE OF served.
WELL ❑ SUPPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (BLIC AIR specify) 4
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 at least two roads . Well location on lot and to house(if present)
I
Indicate North
to,
t
'li
aSi- op,— °
3
C Ch ZE �UQ �OA.h
Approximate number of feet from well to
nearest source of possible contamination: ?5
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 Board and the Water Resources.Commission on the form provided by the Board.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..
APP (Sig re) APPLICANT'S ADDRESS REGISTRATION NO.
LAKE ST. , VERNON C010. 100
wn Floalth r or Agent) DATE -
OAPPROV� ❑ REJECTEDD-
REMARKS
4a-V4MK
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT STATE,OF CONNECTICUT --
WDBS •12.64 :REV.9-71 -WELL DRILLING BOARD Do NOT fill in
State Office Building STATE WELL NO.
HARTFORD,CONNECTICUT 06115
OTHER NO. .
NAME ADDRESS
OWNER
PHI= WELLS I 355 BEELZEBUB RD. , S. - WINDSOR, CONK..'
LOCATION., (No.6 Street) (Town) (Lot Number)
OF WELL35.5 BEELZEBUB' ROAD SOUTH WINDSOR
BUSINESS-
PROPOSHI. ® DOMESTIC : ❑ ESTABLISHMENT' El FARM : .❑ TEST WELL
USE OF
WELL . PUBLIC❑ 0 HER
SUPPLY INDUSTRIAL :❑ CONDITIONING: ❑ (Specify)
:DR OTHER
ILLING ® ROTARY . AIR- ERCCOMPREUSSION• 'PERCUSSION B •LE ❑ (Specify)
• EQUIPMENT' ,.
,CASING 'LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?.
DETAILS 41 I 6 I 1 .4 I THREADED ❑ WELDED I ®-YES ❑NO ❑YES ®NO-
YIELD HOURS - YIELD(G.P.M.)
TEST ❑ BAILED ❑ PUMPED ® COMPRESSED AIR I 4 50
WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Well'
LEVEL 10 . I75I in feet below Hand surface: 100
MAKE. I LENGTH OPEN TO AQUIFER(feet)
SCREEN '
DETAILS SLOT SIZE• DIAMETER(inches) ' IF GRAVEL GRAVEL SIZE(inches)FROM(feet) TO(feet) ,
Diametei of well including
PACKED: ravel pack inches
DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact_location of well w(th`d)stances,to at'least
FEET to FEET two permanent landmarks.
0 31 Gravel
1 -- 100 Red Rock
If yield was tested at different depths during drilling,list below
FEET GALLONS PER MINUTE
t
>�.
DATE'WELL COMPLETED' PERMIT NO. REGISTRATION NO. DATE OF REPORT LL DRILL Signet' e)
2 21 , ; I 14539 I . U I 2/26/73 .
BOARD
WELL COMPLETION REPORT STATE OF CONNECTICUT
WDB-5 12-69 REV.9-71 WELL DRILLING BOARD DO NOT fill In
State Office Building STATE WELL NO.
HARTFORD, CONNECTICUT 06115 S 0.
\� OTHER NO. .
OWNER NAME ADDRESS (�
PHILIP IMUS; I 55 BE F,..;'; R o � . WINDSOR, COMT.
LOCATION (No.&Street)
_ _ (Town) (Lot Number)
OF WELL ... �,MZ:—; 'jT CA- I T R `'
BUSINESS
PROPOSED IJ DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL
USE OF
WELL PUBLIC AIR ElOTHE SUPP Y ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify)
COMPRESSED CABLE
EQUIIPMENT ®LLING ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ ((Spec fy)
LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT ,
CASING DRIVE SHOE WAS CASING GROUTED?.
DETAILS 4 I I 1 ,45I � THREADED ❑ WELDED I r5�YES ❑NO ❑YES ®NO
YIELD I HOURS YIELD
TEST ❑ BAILED ❑ PUMPED COMPRESSED AIR
WATER
MEASURE FROM LAND SURFACE—STATIC(Specify feet)I DURING YIELD TEST(feet) 50
I Depth of Completed Well
LEVEL 10 5 in feet below Land surface:
MAKE
LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE I DIAMETER (inches) I IF GRAVEL I I GRAVEL S1ZE(inches) FROM(feet) TO(feet)
Diameter of well including
PACKED: gravel pack(inches):
DEPTH
FROM LAND SURFACE
FORMATION DESCRIPTION Sketch exact location of well with distances,to at least
FEET to FEET two permanent landmarks.
O 3 11 Gravel
1 �
I !�
1
Rock-
if yield was tested at different depths during drilling, list below eK
!! �L
FEET GALLONS PER MINUTE t �
it
'i
DATE WELL COMPLETED PERMIT NO. I REGISTRATION NO. DATE OF REPORT ELL DRILL 'Sign/at gZ f
.145 I
DEPT. OF ENVIRON&AkE TAL PROTECTION