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Well New 500 Clark Street
WELL DRILLING BOARD STATE --yNECTICUT _ PERMIT NUMBER -a n wDe -69 WELL DRG PERMIT 10649 STATE OFFICE BUILDING,HARTFORD,CONNECTICUi o611s LOCATION OF WELL(Town) (Street) (Lot Number) DATE SOUTH WINDSOR 500 CLARK ST 6 '12/72 OWNER OF WELL ®INDIVIDUAL ❑BUILDER ❑ OTHER(Specify) DONALD HOOD OWNER'S ADDRESS 1144 MAIN ST. , E. HARTFORD, CONN. PROPOSED BUSINESS TEST Est.No.of USE OF ® DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ WELL People being served. PUBUC AIR OTHER WELL ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING El (Specify) . 5 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<J �iN G /QD k- CAR Ic�j S ,_ ART /ilo uJ'F DONE iL J'T Approximate number of feet from well to nearest source of possible contamination: 125 The undersigned is aware that upon completion of the well;a"Weil Completion Report"containing construction details and information required under Section 25-131 of the 1969.Supplement to the Goneral 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 ignature AMUCANT'S ADDRESS REGISTRATION NO. LAKE STa , VERNON CONN. 100 BY(Town Officer Agent) DATE ElAwoft ❑ REJECTED REMARKS v RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD WELL COMPLETION-REPORT STATE OF CO`N.NECrICUT Do NOT fill in WD8.5 12-69 REV.9-71 WELL DRILLING BOARD STATE WELL NO. State.Office Building " HARTFORD,Office 06115 ' OTHER NO. NAME ADDRESS OWNER DONALD HOOD I 1144 MAIN ST. , E.. HARTFORD, CONN.. LOCATION (No..B Street) ;(Town) (Lot Number) OF WELL 500 CLARK ROAD SOUTH WINDflOR BUSINESS PROPOSED ®•DOMESTIC: ❑'ESTABtISHMENT ❑ FARM ❑ TEST WELL USE OF WELL „ PUBLIC AIR OTHER ❑ SUPPLY . . '❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify) BLE OTHER.* DRILLING ® ROTARY ❑ COMPRESSED ER USSION ❑-PE CUSSION- ❑ (Specify) r .EQUIPMENT - LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT 11_DRIVE SHOE CASING WAS CASING,GROUTED? DETAILS - ` 160 ' I. 6 I - 1.9.4.5 I ® THREADED ❑ WELDED I �YES ❑NO ,❑YES �NO HOURS YIELD(G.P.M.)- YIELD TEST ❑ BAILED . ; ❑ PUMPED COMPRESSED AIR � 4 300 MEASURE FROM LAND SURFACE—STATIC-(Specify feet) DURING YIELD TEST-(feet) WATER I Depth of Completed Well LEVEL 1 I 125 in feet below.Land surface: 16 MAKE LENGTH OPEN TO AQUIFER(feet) -, SCREEN DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL GRAVEL SIZE(inches)FROM(feet)• TO(feet) Diameter'of well including PACKED: ravel ack mches. I 9 p ( ). DEPTH FROM LAND SURFAC FORMATION DESCRIPTION Sketch exact location of well with distances,to at least FEET to FEET •two permanent landmarks. Sand $30 CAN -. fE ..If yield was tested at different'depihs-during'drilling,=list:below FEET- GALLONS PER MINUTE JI'd Q Tx 'r77 DATE,WELL.COMPLETED PERMI,T,NO.;rL REGISTRATION,NO. 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WELL DRILLING BOARD '' STATE OF CONNECTICUT PERMIT NUMBER wD6.4 r1.69 WELL DRILLING PERMIT 10649 STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115 LOCATION OF WELL(To,n) (Street) (Lot y (Lot Number) DATE 5W C A�y 13Ci �►� 2 OWNER OF WELL INDIVIDUAL ❑BUILDER ❑ OTHER(Specify) Boni& 1100101 OWNER'S ADDRESS PROPOSED BUSINESS TEST Est.No.of DOMESTIC - ❑ ESTABLISHMENT ❑ FARM ❑ WELL People being . + USE"OF: served. WELL;: PUBLIC AIR OTHER �-SUPPLY ❑ _INDUSTRIAL ❑ CONDITIONING" ❑ (Specify) x SKETCH OF WELL LOCATION Locate well with respect to at least two roads,showing distance from intersection and front of lot 'St- '- s toot ion 4,f to0to'at least*o-oa''ds = }--- YVell 4!!afionjon lot end tq house{if present).._ LL . i 03, lndicate�North f GiJ PiN G A4 W m S cAR , r Approximate number of feet from.well to nearest source of possible contamination: 12.5 The undersigned is aware that upon completion of the well,a"'Well Completion Report" containing construction details and information required under Section 25.131 t: of the 1969 Supplement to the Gdfieral Statutes must be sent to.the owner,the Board and the Water Resources Commission on the form provided by the Board.This E: permit is not valid until all information is filled in and it has been counter-signed by the.Director of Health or his agent, ' APPU gnature APPLICANT'S ADDRESS REGISTRATION NO. _ 100 BY(Town Off ic!AV Agent) DATE QAMOVED ❑ REJECTED REMARKS p DIRECTOR OF HEALTH