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Home My WebLink AboutWell New 470 Foster Street 1 � M WELL DRILLING BOARD STATE Of-ICONr*CnCUT PERMIT NUMBER WELL DRILLING PERMIT 26.850 STATE OFFICE BUILDING,HARTFORD,CONNECHCUT 06115 L LOCATI WELL T n) (8tr ) / (Lot Number) DATE • OWN�E Fes- INDIVIDUAL ❑ BUILDER ❑ OTHER(Specify) OWNER'S ADDRESS PROPOSED BUSINESS El ❑ TEST Est.No.of DOMESTIC ESTABLISHMENT FARM WELL. People being USE OF serve WELL PUBLIC AIR OTHER ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify) 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 Cif present) j Indicate North r'/ 41, T Approximate number of feet from well to f nearest source of possible contamination. The undersigned is aware that up completion of the well,a"We11 Completion Repor 'containing construction details and information required under Section 25-131 of the 1969 Supplement to e�Generat Statutes must be sent!F. �7/1 he Board and the Water R ources Commission on the.form provided by the Board. This pe 1 is not valid un' all information is filled in and unter-sign by the Di r of Health or his agent APPLI �Turd/) I APPL! AD F01 NO. 10 ' BY T h Ofl�c dy ) I APPROVED REJECTED C- DATE REMARKS RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD WELL COMPLETION REPORT STATE OF CONNECTICUT DO NOT fill in WDB-s 12.69 REV.9.71 'WELL DRILLING BOARD STATE WELL NO. State Office Building HARTFORD,CONNECTICUT 06115 OTHER NO. NAME ADDRESS OWNER JOHN SALCIUS- I NORTH ST• NIANCHESTER COM. LOCATION (No.&Street) (Town) (Lot Number) OF WELL 420 FOSTER ST. 'SOUTH WINDSOR PROPOSED DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST-WELL . USE OF PUBLIC AIR WELL OTHER ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify) DRILLING ® COMPRESSED ROTARY :❑ AIR PERCUSSION USSION ❑ CABLE ❑ (S�Rfy') EQUIPMENT PERCUSSION CASING LENGTH(feet) I DIAMETER(inches)I WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED? DETAILS 6 19.45 I ® THREADED ❑ WELDED I YES ❑NO DYES [A NO HOURS YIELD(G.P.M.) YIELD TEST ❑ BAILED ❑ PUMPED ® COMPRESSED AIR 4 MEASURE FROM LAND SURFACE STATIC(Specify feet) DURING YIELD TEST(feet) WATER I Depth of Completed Well LEVEL O in feet below Land surface: MAKE I LENGTH OPEN TO AQUIFER(feet) SCREEN DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL GRAVEL SIZE(inches)ROM(feet) ITO(feat) Diameter of weii including 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. 4 Topsoil 4 20 Gravel o r7 e-,Q J'T 20 25 Hardi2an 25 175 Reddish Rock 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 W l R(Sig tore} 26 I 280 I 100 ( 210 BOARD WELL COMPLETION REPORT STATE OF CON14ECTICUT Do NOT fill in WDB-5 12-69 REV. 9-71 WELL DRILLING BOARD STATE WELL NO. State Office Building HARTFORD,CONNECTICUT 06115 OTHER NO. NAME ADDRESS OWNER J H�,11 3-A tCIU ( 5; RlD T I IT. , rji�a C=V.Snf�s CtaNm LOCATION (No.&Street) (Town) `I �� (Lot Number) OF WELL Li C "11S'2i" SiI'a SO 'i s � R BUSINESS PROPOSED FA DOMESTIC ❑ ESTABLISHMENT ❑ El TEST WELL USE OF PUBLIC AIR OTHER WELL ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify) DRILLING COMPRESSED CABLE OTHER EQUIPMENT ® ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ (Specify) LENGTH (feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED? CASING DETAILS ( I t a THREADED ❑ WELDED I D9YES ❑NO ❑YES NO HOURS YIELD(G.P.M.) YIELD TEST TEST ElBAILED ❑ PUMPED COMPRESSED AIR I 4 5 MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Well WATER _ LEVEL I 150 in feet below Land surface: •�} MAKE (LENGTH OPEN TO+AQUIFER(feet) SCREEN DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of wellincludin GRAVEL SIZE(inches) FROM(feet) TO(feet) g 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. 4 Topsoil r 20 25ar -oan t 25 Reddish Rock 125 I rNO 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 WEIL LyR(Si Lure Elr_i T. OF ENVIRONMENTAL PROTECTION -A ER RE5SO:RCES Y ,. Y pia _ 1v-& _ Y.`*`,. _ S8. �$..:,Y s xyi; .p 44 -:' Wid,CCMPLEj!0N 9EPORT STATE OF CONNECTICUT DO NOT fill in WDB-5 12-69 REV.9-71 WELL DRILLING BOARD State Office Building STATE WELL NO. HARTFORD,CONNECTICUT 06115 OTHER NO. OWNER NAME ADDRESS LOCATION (No.&Street) (Town) (Lot Number) OF WELL 4170 F065"YA W. SO UT WINDSOR BUSINESS ❑ ESTABLISHMENT ❑ FARM PROPOSED DOMESTIC ❑ TEST WELL USE OF PUBLIC AIR R WELL ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ OT�HEfy) COMPRESSEDDRILLING EQU PMENT FAROTARY ❑ q RPER USSION ❑ P RCUSSION ❑ (Specify) CASING LENGTH (feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED? DETAILS 0 1 THREADED ❑ WELDED I ®YES ❑NO I4 ❑YES A NO HOURS YIELD(G.P.M.) YIELD ❑TEST BAILED ❑ PUMPED COMPRESSED AIR 1 4 I r I V MEASURE FROM LAND SURFACE—STATIC (Specify feet) DURING YIELD TEST(feet) WATER ( Depth of Completed Well LEVEL 15 1 I in feet below Land surface: 5 MAKE LENGTH OPEN TO AQUIFER(feet) SCREEN DETAILS SLOT SIZE I DIAMETER(inches) IF GRAVEL Diameter of well including { GRAVEL SIZE(inches)(FROM(feet) ITO(feet) 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. 4 Topsoil Gravel i r� \ 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 O.FF REPORT WELL'DRILLER(Siqeature) l�s 5 I 2685 I I m 1 1( 2 (05 - LOCAL DIRECTOR OF HEALTH 7. W41t.DRI&,LING 13QIARI5 STATE OF CONNECTICUT PERMIT NUMBER WDIWI 11-69 • WELL DRILLING PERMIT 26850 STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115 } LOCATI WELL To n) (Htr t) (Lot Number) DATE e. SY 7 OWNS F WEIL toINDIVIDUAL ❑ BUILDER ❑ OTHER(Specify) OWNER'S ADDRESS BUSINESS TEST Est.No.of PROPOSED DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ WELL People being USE OF serve WELL PUBLIC -AIR OTHER ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify) 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 T a s � Approximate number of feet from well to nearest source of possible contamination: ] k .404W pA-- The undersigned is aware that upon cpmpletion of the well, a 'Well Completion Report containing construction details and information required under Section 25-131 of the 1969 Supplement tot General Statutes must be sent to the wner, a Board and the Water R ources-_Commission on the form provided by the Board. This perm' is not valid unti all information is filled in and it s ee counter-signed y the Dire . 'of Health_or_his agent. APPLI (Si ure) I APPLICA ADDR ��✓vim I REGISTRATION NO. c .f� BY(Town HgOh Officer gent) I DATE ❑ APPROVED REJECTED REMARKS DIRECTOR OF HEALTH