HomeMy WebLinkAboutWell Correspondence 746 Burnham Street (2) " MAR 03,2009 11:49A 000-000-00000 page 2
ar 0 644
3f. �4a �540 SULLIVAN AVENUE• SOUTH WINDSOR,CT 06074
f�UN TELEPHONE(860) 644-2511
Dear H meowner:
The TOM 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 ou 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 t e appropriate service: l
WELL MDC CT WATER
� Y
WELL SE: DOMESTIC LAWN& GARDEN AGRICULTURAL
Well Location :
BACK DRAWING:
40 IT
A FRONT F7T
30 1� 14 E'I' W
WELL
STREET C �l�c.�'LAti
l
MAR 03,2009 11:49A 000-000-00000 page 1
JAKE KRIWEY
Please respond I to:
n 9 Parkway W150 McKays Point Road
Goshen,NY 10924 Hilton Head Island,SC 29928
Res.845-294.5909 Res.843.68&4774
Fax 845-294-2805 Fax 843.6W4778
Cell.845+551-4151
FACSIMILE TRANSMITTAL SHEET
•
It
FROM:
COMPAN DATE-
FAX NUMBTOTAL NUMBER OF PAGES
INCLUDING COVER:
Notes/Comments:
CPR-9 Rev.7/95 � �u"' ` V` ✓�
� Do NOT fill in -
STATE OF CONNECTICUT STATE WELL NO.
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE&PROFESSIONAL TRADES DIVISION OTHER NO.
WELL DRILLING COMPLETION REPORT
165 Capitol Avenue,Hartford,Connecticut 06106
OWNER NAME y { 1 y ADDRESS j rt r� p of
J� Venn i re3 ? ±] Sl.-.!'.3 �✓:fit- (?.. 4 ' a o i
LOCATION (No.8 Street) (Town) (Lot Number)
OF WELL =3,urnh�;,ua St. :10!ith 4i-°'>or 1 t-sv .7€ll
DOMESTIC BUSINESS FARM TEST
PROPOSED ESTABLISHMENT Y WELL
USE OF WELL ElPUBLIC Q INDUSTRIAL ❑ AIR OTHER-
SUPPLY CONDITIONING S )
DRILLING a ROTARY COMPRESSED CABLE a OTHER
EQUIPMENT AIR PERCUSSION PERCUSSION (Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
DETAILS 3 3 5 1� a THREADED � WELDED U YES ❑ NO. 11 YES ❑ NO
YIELD TEST BAILED [:] PUMPED COMPRESSED AIR HOURS YIELD(GPM)
WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet) DURING YIELD TEST(feel) Depth of Completed Well in feet
LEVEL 3 ?' 325
MAKE LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well GRAVEL SIZE(inches) FROM(feet) TO(feet)
PACKED: including gravel pads
(inches)
DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances,to at least two
FEET TO FEET permanent landmarks
< s :tar an ) !r✓
<<> ,
f I
i
i
If yield was tested at different depths during drilling,list below
FEET GALLONS PER MINUTE
I
I
DATIE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT WELL DRILLER(Si
LOCAL DIRECTOR OF HEALTH
ST. PERMIT NUMBER
CPR-8 Rev.7/95
STATE OF CONNECTICUT 238521 I
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE&PROFESSIONAL TRADES DIVISION
WELL DRILLING PERMIT
16S Capitol Avenue,Hartford,Connecticut 06106
LOCATION OF WELL (Town) (St (Lot Number) DATE
)
South Windsor LAW St 1 3/8/07
OWNER OF WELL
QINDIVIDUAL BUILDER OTHER(Specify) 91 7—5 0 2—21 0 4
OWNER'S ADDRESS
Tiger Lily Ventures c/o Todd Kriney 530 Boston Post Rd w Haven
Est.No.of
PROPOSED DOMESTIC El
BUSINESS El FARM a TEST People being
USE OF ESTABLISHMENT WELL served.
WELL
PUBLIC INDUSTRIAL AIR OTHER '
SUPPLY El 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 to and to house(if present)
Tes+ We 11
indicate North U
r
O pCc Dj('
�
1 �
1
e
13
�
Approximate number of feet from well to
nearest source of possible ont ination:
The undersigneZof�thesup
upon mpletion of the well, a"Well.Completion Report"containing construction details and information required under
Section 25-131 ent to the General Statutes must be sent to the owner, the Department of Consumer Protection and the Water
t�esources Comrm provided by the agency. This permit is not valid until all information is filled in and it has been counter-signed by
the Director of Hn.
APPLICANT(Si re) APPLICANT'S ADDRESS REGISTRATION NO.
Joel Stavens PO Box 406 Millington p�� ] 42
BY(Town Health Office or A nt) DATE
ROVED ❑ REJECTED e� _ � _b-7
RA
MARKS
- f
L
DIRECTOR OF HEALTH