HomeMy WebLinkAboutWell New 90 Brookfield Street WELL COMPLETION REPORT STATE of CONNECTICUT Do NOT
WD6.5 12-N REV.9-71 WELL DRILLING BOARD , insrnrE WELL No_ -fill
State Office Building
HARTFORD,CONNECTICUT 06115
OTHER.NO.
NAME ADDRESS _
°"f"� MITCHELL TRUCKING CO'.
90 BR00KFIELD ST. , S. WINDSOR, CZ'
LOCATION (No.&Street) (Town) (Lot-Nuiswirmber)
OF WELL BROOKFIMD ST. SOUTH WINDSOR
PROPOSED t=- DOMESTIC ® ESTAB ISHMENT ❑ FARM
❑ TEST WELL
USE OF
WELL PUBLIC AIR OTHER
❑ SUPPLY ❑ INDUSTRIAL
❑ CONDITIONING ❑ (Specify)
DRILLING ® T-1 COMPRESSED (—� CABLE ❑ OTHER -
EQUIPMENT ROTARY Li AIR PERCUSSION Li PERCUSSION (Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GRpL7
DETAILS 1/ J 6 I 1%'45 , 1 ® THREADED ❑ WELDED( YES ❑NO ❑YES jt:]NO P
YIELD
HOURS YIELD(G.P.M.)
3 V
PEST ❑ BAILED ❑ PUMPED ® COMPRESSED AIR t y-
�
MEASURE FROM LAND SURFACE—STATIC(Specify fee:) DURING YIELD TEST(feet)
WATER Depth of Completed Well
LEVEL 25 175 I in feet below Land surface: 20Q
MAKE (LENGTH OPEN TO <_4_-U t
EER(fee
SCREEN
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well including I GRAVEL SIZE(inches)FROM(feet) (TO(fce,[ * �
I PACKED: .I gravel pack(inches):
DEPTH FROM LAND SURFAC FORMATION DESCRIPTION Sketch exact location of well with distances,to at least
FEET to FEET two permanent landmarks.
- 0 16 Sand & Gravel
15 13-5 Clay
135 200 Red Rock
v
W
2.
o
10
IV
aEr1,
If yield was tested at different depths during drilling, list below
FEET GALLONS PER MINUTE P X ✓ ply
-- DATE-WELL COMPLETED--- PERMIT-NO - — - REGISTRATION N0 _ — DATE OF RCPORT 1 (Signet e)
2 ( . 56600 100 I 10/2/79
BOARD
WELL DRIWNG BOARD STATE OP&NNECTiCUT PERMIT NUMBER
wo" TT'" WELL DRILUNG PERM 56600
STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06118
LOCATN ru
OF WELL (Ton) (BtrsstT (Lot Number) DATE
IO
South Windsor Orr Brookfield Street. --- I 8/30/79
OWNER OF WELL ,
El INDIVIDUAL ❑ BUILDER ❑ OTMR(spe�ify> Mitbhell Trucking Co.
OWNER'S ADDRESS
Brookfield Street, South Windsor, Cts,
Lr 1 BUSINESS ❑ MT Est.No of
PROPOSED ❑ DOMESTIC ESTABLISHMENTF� ❑ WELL. People being
USE OF sew'
WELL ❑ SUP Y ❑ INDUSTRLAL ❑ CONDITIONING ❑ (Specify) '
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)
Indicate North \ G
\N,
lull
IP-0y
Approximate number of feet from well to 2�T
nearest source of possible contamination:
i
The undersigned is aware that upon completion of the well,a'Well Completion Report' containing construction details and inforination 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 countersigned by the Director of Health or his agent.
APP T( iynatun APPLICANT'S ADDRESS REGISTRATION NO.
I -Lake Streett .Vernon, Ct. 05066 100
F /rJA BY(Toren S Officer or ) DATE
I— : APPROVED• ❑ REJECTED I
REMARKS
Paid -- Check #27260 -- $1.00
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD