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HomeMy WebLinkAboutWell New 595 Felt Road PERMIT NUMBER _CPR4Kev.7/95 STATE OF CONNECTICUT 213124 DEPARTMENT OF CONSUMER PROTECTION REAL ESTATE 81 PROFESSIONAL TRADES DIVISION =!�e� WELL DRILLING PERMIT W5 Cap[tol Avenue,Ha tfo d, nnecti t 08!06 LOCATIO OF WELL (Town) (Street) (Lot Number) DATE OWNER OF WELL INDIVIDUAL BUILDER OTHER(Specify) OWNER'S ADDRESS 0 �C�4js�O' Est. o. f C PROPOSED DOMESTIC BUSINESS FARM a� TEST People beiep. USE OF ESTABLISHMENT WELL served. 0 WELL PUBLIC 11. INDUSTRIAL ❑ AIR OTHER SUPPLY CONDITIONING (Spedw 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) Indicate North Approximate number of feet Wom well to nearest source of possible contamination: The undersigned is aware that upon comple ion of the well,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 Department of Consumer Protection and the Water Resources Commission on the form provided by the agency. This permit is not valid until all' formation is filled in and it has been counter-signed by Director of Health or his agent. A LICA (Signature) APPLICANTS ADDRESS REGISTRATION NO. BY(Yawn H Officer Agent) DATE 1WPROVED ❑ R O n�0 REMARKS "X' 7 j�4—�- G� RETURN THIS COPY TO DEPARTMENT OF CONSUMER PROTECTION CPR-911e¢7/95 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 ADDRESS BEN CLOUTIER 103 'PALMER DR. SO. W_ INDSOR, CT 06074. LOCATION ' (No.a Street) - (Town) (Lot Number); OFwELL, FELT ROAD SO: WINDSOR. 3 DOMESTIC BUSINESS FARM TEST PROPOSED ESTABLISHMENT YYELL , USE OF WELL ' a PUBLIC INDUSTRIAL a' AIR a OTHER SUPPLY CONDITIONING S EQUIPMENT DRILUNG ROTARY AIR COMPRESSED PERCUS ION PER USLE SION (Specify) CASING. LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE. WAS CASING GROl1TED7 DETAILS. 20 6 17# IU THREADED WELDED 91 YES ❑ NO• YES ❑ NO YIELD TEST . .1]NAILED a PUMPED © COMPRESSED AIR HOURS YIELD{GPM) ' 4 12 WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Convieted well in feet LEVEL 15 325 325 MAID LENGTH OPEN TO AQUIFER(feet) SCREEN -DETAILS SLOT SIZE DIAMETER(inches) 1F GRAVEL D ameter of well GRAVEL SIZE(indres) FROM(feet) TO(feet) PACKED: in'ui rg gravel Pads (irKlros) - -DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION 'Sketch exact location of well with distances,to at least two FEET TO FEET permanent landmarks 0 12 SAND & GRAVEL 12 325 RED SHALE d - ae' �51 If yield was tested at different depths during driving,list below ® C �,e FEET GALLONS PER MINUTE �a` �-&qd• DATE WELL COMPLETED PERMIT NO. •REGISTRATION No. DATE OF REPORT RI R(Spoature) 5/1/02 213124 102 5 02 N M. IWFORD AGENCY