HomeMy WebLinkAboutWell New 41 Deming Street WELL DRIWNG BOARD STATE RNN6s`TICUT" PERMIT NUMBER
wDs~ T1 69 WELL DRILLING"PERMIT 5 Q 7 4 5-
STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115
LOCATION OF WELL(Town) (Street) (Lot xumSer)OWNER OF WELL DATE
SOUTH WINDSOR 41 DEMING ST. g/4/fig
D INDIVIDUAL ® BUILDER D OTHER(sp"4) U-& R HOUSING CORP. (Lionel Souey)
OWNER'S ADDRESS
99 E. Center St. , Manchestetq Conn,
PROPOSED ® DOMESTIC BUSINESS❑ TEST Est.No.of
ESTABLISHMENT ❑ FARM D VAIL People being
USE OF served.
WELL D SUPPLY I
D INDUSTRIAL ❑ CONDITIONING ❑ (Specify) 'f.(,
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
40sc
715`� 0Ew
C
c
G-
Approximate number of feet from well to t
nearest source of possible contamination: gQ
The undersigned is aware that upon completion Of the wall,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.
(S re APPLICANT'S ADDRESS I REGISTRATION NO.
4.✓�.c.�- I LAKE ST. , VERNONs CONK. 100
BY(Tom»HeWh 0 'er or dpent DATE
APPROVED ❑ REJECTEDI
REMARKS �l
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT -STATE OR CONNk"CUT Do NOT fill in
WDBs 12-69 REV.9-71 WELL DRILLING BOARD
STATE WELL NO.
State Office Building
HARTFORD,CONNECTICUT 06115
OTHER NO.
OWNER NAME ADDRESS
U & R HOUSING CORP. 199 E. CENTER ST. ,' MANCHESTER, CONN.
LOCATION (No.&Street) (Town) (Lot Number)
OF WELL 41 DENTING ST. SOUTH WINDSOR
PROPOSED ® DOMESTIC ElBUSINESS
DOMESTIC ❑ FARM ❑ TEST WELT.
USE OF
WELL PUBLIC AIR OTHER
❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify)
EPRESSED CABLE OTHER
QUIPM ENT 1X RDRILLING OTARY ❑ q RMPERCUSSION ❑ PERCUSSION ❑ (specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
DETAILS 101 ( 6 I 19.45 I a THREADED ❑ WELDED YES ❑NO DYES ❑X NO
HOURS YIELD(G.P.M.)
TEST
YIELD BAILED ❑ PUMPED ❑ COMPRESSED AIR I 6 8
MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet)
WATER I Depth of Completed Well
10
LEVEL 10 in feet below Land surface: 250
MAKE I LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL I Diameter of well including GRAVEL SIZE(inches)FROM(feet) �TO(feet)'PACKED: I 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.
0 - 2 Topsoil
2. 14 Sand & Gravel
14 91 Clay
1 250 Bedrock
�0If Syr
jdC
If yield was tested at different depths during drilling, list below
FEET GALLONS PER MINUTE U O
L
17 <M I t.•J Cr ',P 7
DATE WEjL CQMP8LETED PERMIT N00�45 I REGISTRA1TiON NO. DATE OF)EP7T78
Ell DRILL '(Sig re)
BOARD