HomeMy WebLinkAboutWell New 312 Deming Street CONSUMER PROTECTION 31y2 �-�-
WELL DRILLING BOARD sutrE OF coLCflcur PERMIT NUMBER
cPR•s REV.sae STATE
DEPARTMENT OF CONSUMER PROTECTION 71 4.6 3
WELL DRILLING PERMIT
20 GRAND STREET,HARTFORD,CONNECTICUT 06106
LOCATION OF WELL(fovea) (Street) (Lot Number) DATE
S. WINDSOR DEMING ST. 10/6/82
OWNER OF WELL
® INDIVIDUAL ❑ BUILDER ❑ OTHER(Specify) JOSEPH CATARINO 644-3923
OWNER'S ADDRESS
1402 TWIN CIRCLE DR. , S. WINDSOR, CT.
PROPOSED ® BUSINESS ❑ ❑ TEST Est.No.of DOMESTIC ❑ ESTABLISHMENT FARM WELL People being
USE OF
WELL PUBLIC served'
❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify) 4
SKETCH OF WELL LOCATION
Locate well with respect to at least two roods,showing distance from intersection and front of lot
Location of lot to at least two roods Well location on lot and to house(if present)
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O - N p. 1171
Indicate North �tJc•�•I R w` ``�
r !Jl/
x �
Ur!. /
cw c- E"�J'E,A1'ENT
Approximate number of feet from well to
nearest source of possible contamination:
The undersigned is aware that upon-completion of the well, a "Well Completion Report" contoining construction details and Information required under Section
25-131 of the )969 Supplement to the General Statutes must be sent to the owner, the Board and the Water Resources Commission an 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.
f8 APPLICANT'S ADDRESS REGISTRATION NO.
A- P.O. Box 111 S. Willington, Ct. 100
BY(Town Health Off c-or A tntJ DATE
PROVED ❑REJECTED
REMARKS
RETURN THIS COPY TO'CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT STATE OF-CONNECTICUT
CPR-9 REV. 9-79 DEPARTMENT;OF CONSUMER PROTECTION Do NOT fill in
WELL DRILLING BOARD STATE WELL NO.,
20 GRAND STREET
HARTFORD, CONNECTICUT 06106 OTHER NO.
OWNER
NAME am ADDRESS
Jo el W,-g�.1j 1402
]2 N CT
RU rt
LOCATION (No. &Street)
(Town)
°� x� ��g (Lot Number]
OF WELL t+i t t Vti�3 a3 f:s k3 s �l+.a 111 13 0H 4
BUSINESS
DOMESTIC E TABL SHMENT FARM
PROPOSED USE OF 11 TEST WELL
PUBLIC AIR
THER
WELL SUPPLY INDUSTRIAL CONDITIONING (Specify)(
DRILLING ® COMPRESSED ROTARY A R ERCUSSION PERCUSSION OTHER
EQUIPMENT �(Specify) -
CASING LENGTH (feet) DIAMETER(inches) WEIGHT PER FOOTDRI SHO WA&CASING GROUTED? - -
DETAILS s3 -19*4-5 19 THREADED WELDED �:o YES NO YES NO
YIELD G HOURS 3YIELD(G.P.M.)
TEST ❑ BAILED PUMPED 1�j COMPRESSED AIR 4 30
WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet)
LEVEL 20 Depth of Completed Well
in feet below Land surface:
MAKE
LENGTH OPEN TO AQUIFER (feet)
SCREEN
DETAILS SLOT SIZEDIAMETER(inches) IF GRAVELGRAVEL SIZE(inches) FROM(feet) TO(feet
Diameter of well including
PACKED: 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 8 Sand
8 3? 01a7
32 125 :red Roc
3'
If yield was tested at different depths during drilling, list below
FEET GALLONS PER MINUTE
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DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT W L LER(Signature)
DEPT. OF ENVIRONMENTAL PROTECTION - WATER RESOURCES