HomeMy WebLinkAboutWell New 151 Berle Road WELL DRILLING BOARD STATE OF-CONNECTICUT PERMIT NUMBER
WDB-4 11-69 _
WELL DRILLING PERMIT 7954
STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115
LOCATION OF WELL(Town) (Sfreet)
(Lot Number) 712/1/71
SOUTH 1,+tINDSOR ' I��1 BERLE RD. 20
OWNER OF WELL
❑INDIVIDUAL ®swLDER ❑ OTHER(Specify) CARLO PRESTILEO
owNINs ADDRESS
69 ASH ROAD, WAPPING,. CON-W.
PROPOSED a ❑ BUSINESS TEST Est.No.of
DOMESTIC
USE OF ESTABLISHMENT ❑ FARM ❑ WELL People being
BLIC AIR served.
WELL ❑-SSUUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (0spea'ly) 6
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 o roads Well location on lot and to house(if present)
Indicate North
I
' WEB
/9�p f' �/ D ,�X T 0,9 b �,
Approximate number of feet from well to
nearest source of possible contamination: 75
The undersigned is aware that upon completion of the well,a"Well Completion Report"containing construction details and information required under Section 6 of
Public Ad 659 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 informa-
tion is filled in and it has been counter-signed by the Director of Health or his agent.
APPLICANT'S ADDRESS REGISTRATION NO.
LAKE ST. , VERNON, CONN. 100
By(To Ith Officer or Agent) DATE
APPROVED ❑ REJECTED
REMARKS
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT STATE OF CONNECTICUT
WDB-5 12-69 WELL DRILLING BOARD STATE Do NOT fill in
State Office Building
HARTFORD,CONNECTICUT 06115
OTHER NO.
L,2C
NAME ADDRESS
OWNER
CARLO PHESTIUDO 69 ASH RD. -APPI-111G� GO TITN-
Town
LOCATION (No. &Street)_gyp (Town) (Lot Number)
OF WELL ! t�S B�..URLE �f.,,'.�s.' e € '#`a cEt 3 +s G
DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑BUSINESS
PROPOSED TEST WELL i
USE OF
WELL PUBLIC AIR❑ SUPP Y ❑ INDUSTRIAL ❑ CONDITIONING ❑ OTHER)
DR
COMPRESSEEQUIIPMENT ®LLING ROTARY ❑ A R PERCUSSDION El ❑CABLE OTHER)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT I DRIVE SHOE WAS CASING GROUTED?
DETAILS � e 5 � THREADED El WELDED YES ❑NO ❑YES ®NO
YIELD ❑ HOURS G.P.M. YIELD(G.P.M.)
TEST BAILED ❑ PUMPED Fz� COMPRESSED AIR
WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Well
LEVEL P _ 1r- in feet below Land surface: 150
MAKE LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well including GRAVEL SIZE(inches) FROM(feet) TO(feet)
PACKED: gravel pack (inches):
DEPTH FROM LAND SURFACE Sketch exact location of well with distances, to at least
FORMATION DESCRIPTION
FEET to FEET two permanent landmarks.
0 1-7 Sandy f2o-osoil
15
5 150 Red-Rock M, Da 115
I
hA``ot1 J
2�
If yield was tested at different depths during drilling;list below I '
FEET GALLONS PER MINUTE V
DATE WELL COMPLETED PER NO. REGISTRATION NO. DATE OF REPORT WELL DR LE (Sign at re)