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HomeMy WebLinkAboutWell New 565 Foster Street CPR-8 Rev.7195 PERMIT NUMBER STATE OF CONNECTICUT 212497 DEPARTMENT OF CONSUMER PROTECTION REAL ESTATE&PROFESSIONAL TRADES DIVISION WELL DRILLING PERMIT, . 165 Capital Avenue,Hartford,Connecticut 0610"hECEIVEb LOCATION OF WELL (Town) (Street) (Lot Number) ON UMLK KU IRUATIMN SOUTH WINDSOR 565 FOSTER ST. OCCIV%I�fiO/02 OWNER OF WELL 11 INDIVIDUAL © BUILDER � OTHER M"UN 33 A S. 41 OWNER'S ADDRESS BENSON ENTERPRISES P.O. BOX 109, E.GLASTONBNURY Est.No.of PROPOSED a DOMESTIC BUSINESS FARM EJ TEST People being USE OF ESTABLISHMENT WELL served, WELL PUBLIC SUPPLY INDUSTRIAL AIR CONDITIONING STHER 4 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 resent) WELL Indicate North dwr S7 CI3E--1 • i - e, Fos7-gL S'y- Fos �R— Sz Approximate number of feet from well to 6 0' + SANITARYS SEWERS nearest source of possible contamination: The undersigned is aware that upon completion 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 information is filled in and it has been counter-signed by the Director of Health or his agent. PLICA T( ' APPLICANTS ADDRESS REGISTRATION NO. P.O. BOX 406, WILLINGTON, CT. 42 BY(Town Health OfterorAgent) DATE VAPPROVED REJECTED �2 11 -- REMARKS RETURN THIS COPY TO DEPARTMENT OF CONSUMER PROTECTION CPR-9 Rev.7/95 ,.. Do NOT till in STATE OF CONNECTICUT STATE WELL NO. DEPARTMENT OF CONSUMER PROTECTION REAL.ESTATE&PROFESSIONAL TRADES DIVISION OTHER NO. " WELL DRILLING COMPLETION REPORT -1 65 Capitol Avenue,Hartford,Connecticut 06106 OWNER fBENSONIENTERPRISES ME ADDRESS P.O. BOX 109, E.GI,ASTONBURY LOCATION (No.a Sheet) (Town) (Lot Number) OF WELL 6 5 FOSTER ST. S.WINDSOR " DOMESTIC BUSINESS FARM TEST PROPOSED X ESTABLISHMENT � WELL USE OF WELL •PUBLIC a INDUSTRIAL ❑ AIR a OTHER SUPPLY CONDITIONING (S • DRILLING ROTARY COMPRESSED CABLE - OTHER EQUIPMENT ® AIR PERCUSSION PERCUSSION (Specify) CASING LENGTH(feet) DIAMETER(indm) WEIGHT PER FOOT DRIVE SHOE T—;--VASM-GROUTED? DETAILS` 2 0 6 17.0 O © THREADED Q WELDED C&YES ❑ NO• YES ❑ NO r YIELD TEST a BAILED n PUMPED COMPRESSED AIR HOURS 6 YIELD(GPM) 8 WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Wes in feet LEVEL 40 240 265 . MAKE - LENGTH OPEN TO AQUIFER(fed) SCREEN DETAILS SLOT SIZE DIAMETER(wwhes) IF GRAVEL Diameter d well GRAVEL SIZE(itches) FROM(feet) TO(feet) PACKED_ induding gravel peck (itches) DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION Sketch exact locafion of well with distances,to at least two FEET TO FEET permanent landmarks 0 9 TOPSOIL & GRAVEL (,y 9 265 - GREY BEDROCK n yield was tested at different depths during drilling,fist below tz- FEET GALLONS PER MINUTE DATE WELL COMPLETED PERMIT NO. TRErj1sT RATION NO. GATE OF REPORT ER(Si�ature) 6J21 J02 212497 42 6/'21 /02 AGENCY WELL COMPLETION REPORT STATE OF CONNECTICUT CPR-9 REV.11_82 DEPARTMENT OF CONSUMER PROTECTION Do NOT fill in WELL DRILLING BOARD FSTAATEWELL NO.165 CAPITOL AVE. HARTFORD, CONNECTICUT 06106 NO. NAME �y^� �r }� �t {� ADDRESS OWNER .411�.X3 �is��\t �ftt 709 DMIM ST. S. WINyD34T�Z j OT. LOCATION (No. & Street) (Town) OF WELL .57 0 FOSTER ST. (Lot Number) DOMESTIC ESTABLIBUSINESHMENT _ 23 PR�PCSEt? � FARM -��, � TEST WELL LISE OF WELL, PUBLIC AIR lJ SUPPLY INDUSTRIAL � CONDITIONING a OSpen y) DRILLING COMPRESSED CABLE, OTHER EQUIPMENT �ROTARY � AIR PERCUSSION � PERCUSSION (Specify) CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT IV SH DETAILS THREADED ❑ WELDED:;. YES El NO WAS CASING GROUTED,O —J THREADED ��51 TEST �,BAILED �j PUMPED COMPRESSED AIR i YIELD HOURS � YIELD (G.P M-) WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Well LEVEL 20 1 200 in feet below Land surface: 225 MAKE LENGTH OPEN TO AQUIFER (feet) SCREEN _ DETAILS SLOT SIZE DIAMETER (inches) " GRAVEL SIZE(inche§),FROM(feet) TO(feet IF GRAVEL Diameter of well including PACKED: gravel pack(inches): DEPTH FROM LAND SURFACE _ FORMATION DESCRIPTION Sketch exact location of well with distances, to at lea ` FEET TO FEET •; r two permanent landmarks. 44 If yield was lested of different depths during drilling, list below FEET GALLONS PER MINUTE I DATE WELL COMPLETED" PERMIT NO. REGISTRATION NO. DATE OF REPORT WELL (Signature) DEPT. OF ENVIORNMENTAL PROTECTION-WATER RESOURCES