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HomeMy WebLinkAboutWell New 47 Ferry Lane CPR-a Rev:7195 _ PERMIT NUMBER STATE OF CONNECTICUT 2 2 5 ` 6 S DEPARTMENT OF CONSUMER PROTECTION REAL ESTATE&PROFESSIONAL TRADES DIVISION WELL DRILLING PERMIT 165 Capitol Avenue,Hartford,Connecticut 06106 LOCATION OF WELL (Town) (Sheet) (Lot Numeeh DATE South Windsor 47 Ferry Lane 7/26/04 OWNER OF WELL aINDIVIDUAL BUILDER OTHER(Specify) OWNER'S ADDRESS Paul Lavey 47 Ferry Lane South Windsor Est.No.of PROPOSED n DOMESTIC BUSINESS 1 FARM a TEST People being USE OF ESTABLISHMENT WEu served. WELL PUSUC INDUSTRIAL —CONDITIONING SKETCH (ETHER; 4 SUPPLY 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 0 (YX!+to t- ct� v 1 � 30� Approximate number of feet from well to nearest source of possible contamination: 1 2 5 r The undersigned is aw t upon completion of the well,a"Well Completion Report*containing construction details and information required.under ; Section 25-131 of S lament to the General Statutes must be sent to.the owner,the Department of Consumer Protection and the Water Resources Conn n form 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 or s agent. APPLICANT rs APPLICANT'S ADDRESS REGISTRATION NO. e P.O. Box 406 Willington 42 BY(Town Health Ofter or Agent) DATE ROVED � REJECTED v^o( REMARKS RETURN THIS COPY TO DEPARTMENT OF CONSUMER PROTECTION CPR-9 Rev.7/95 Do NOT fill in STATE I NNECTICUT STATE WELL NO. DEPARTMENT OF CONSUMER PROTECTION REAL ESTATE&PROFESSIONAL TRADES DIVISION OTHER NO. WELL DRILLING COMPLETION REPORT 165 Capitol Avenue,Hartford,Connecticut 06106 OWNERfT4 ADDRESS Lavey 47 Ferry Ln South Windsor LOCATIONSbeet) (T—) (Lof Number) OF WELLerry Ln South Windsor STIC ❑ BUSINESS FARM TEST PROPOSED ESTABLISHMENT WELL USE OF WELL PUBLIC ❑ INDUSTRIAL a AIR OTHER SUPPLY CONDITIONING S DRILLING a ROTARY a AIR P COMPRCU ON n PE LE ION � OTHER (SpeciN) EQUIPMENT CASING LENGTH(teat) I DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED? DETAILS 150 6 17 ® THREADED a WELDED ® YES ❑ NO. V YES ❑ NO YIELD TEST Q BAILED ❑ PUMPED © COMPRESSED AIR HOURS 8 YIELD(GPM)WATER MEASURE FROM LAND SURFACE-STATIC(Specifyast f ) DURING YIELD TEST(feet) Depth of Completed WJall in feet LEVEL 1020 220 245 MAKE LENGTH OPEN TO AQUIFER(feet) SCREEN DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well I GRAVEL SIZE(inches) FROM(W) TO(feet) PACKED: 6xiu N gravel peck (inches} DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances,to at)east two FEET TO FEET permanent Mndrnarks 0 9 Topsoil/gravel 9 %-IQ Hardpan 245 Gray bedrock 40� r i If yield was tested at different depths during drilling,list below FEET GALLONS PER MINUTE DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT L ILLER(Si(phaturo) 9/17/04 225768 42 9/21/04 AGENCY