HomeMy WebLinkAboutWell New 628 Foster Street WILL COMPLETION REPORT
State of Connecticut State Well No.---•
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WATER RESOURCES COMMISSION This report be compioted and submitted
223 State Office Building to State Water Resources Commission no later Other No.___--------
than da s a or co lotion of well.
Hartford, Connecticut -'—
WELL ls" ItY a"
OWNER rn Address
WELL City end Town
DRILLER 8troet Address
Name
USE OR USES :(C7heck Business Municipal ❑ Industrial ❑ Test Well
PROPOSED Farm ❑ Irrigation ❑ Establishment ❑
meal ❑
WATER LEVEL SCREEN DETAILS
CASING DETAILS YIELD TEST (measure from an su ace)
_
0 Boiled Feet Make:
or Hours Static: Slot
Length: Pest Length
Feet ❑ Pumped During Yield Ft, Size
i
or i G.P.M. Test:
Inches ,npressed Air' DRILLING EQUIPMENT
Diameter' f ❑ Cab oo1 ❑ Other (Specify) Diameter: In.
G.P.M otary ................
Kind
' Yield: ..............
TOTAL DEPTH OF WEL FEET
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WELL LOG -avel, clay, hardpan, shale,sandstone,
color of material, structure
silt,sand, gr
Depth From Give description of formations penetrated,For example-as:
ft t'27 ft fine, packed,yellow sand;27 ft.to 134 ft.gray
and Surface granite, e c- Iic Ade size Of cemented,soft,ha djdiarrteter) and sand (fine, medium, coarse),
round (loose,packed,
granite.
FT.t FT. 10
FT.to
FT.to FT.
FT.to FT.
FT.to FT.
FT.to FT.
FT .to FT.
FT. to FT.
YIELD TEST DATA IN G.P.M.
if Yield Was Tested-At different Depths During Drilling,List Below;
�— G.P.M.
FT. —
G.P.M.
FT. G.P.M. -------
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G.P.M.
FT.
lei Date of Report
Date Well Was Completed:
ZZZ Well Driller (gignature)
Town Permit Number.
c7?
Certificate No.
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LOCATION OF WELL: TOWN OF 8
SKETCH SHOWING LOCATION OF PREMISES IN TOWN:
(Show distance and direction from road intersection or other landmark.)
INDICATE NORTH
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DIAGRAM SHOWING LOCATION OF WELL ON PREMISES:
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ROUTE DIRECTIONS FOR REACHING W L §ITE FROM NEAREST CIT OR VIL AGE CENTER:
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