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HomeMy WebLinkAboutWell New 1043 Foster Street Extension CPR-a Rev:7I95 PERMIT NUMBER STATE OF CONNECTICUT 211138 DEPARTMENTOF CONSUMER PROTECTION REAL ESTATE&PROFESSIONAL TRADES DIVISION WELL DRILLING PERMIT 165 Capitol Avenue,Hartford,Connecticut 06106 LOCATION OF WELL (Town) (Street) (Lot Number) DATE S.WINDSOR 1043 FOSTER ST.EXT. 2/8/02 OWNER OF WELL 0 INDIVIDUAL BUILDER OTHER(Specify) OWNER'S ADDRESS PAGANELLI CONSTRUCTION P.O. BOX 652, SUFFIELD Est No.of PROPOSED © DOMESTIC BUSINESS FARM TEST People being USE OF ESTABLISHMENT WELL seared WELL PUBLIC SUPPLY 'INDUSTRIAL AIR CONDITIONING L� OTHER) 4 SKETCH OF WELL LOCATION Locate well with respect to at least two roads,s owing distance from intersection and front of lot location of lot to at least two roads Well location on to and to house(if presentt)), �V( Indicate North C0 5'T M s� 071 k r,-r it lu g Approximate number of feet from well to ABANDONMENT 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 Heafth or his agent. PLICANT(Sign APPLICANTS ADDRESS REGISTRATION NO. P.O. BOX 406, WILLINGTON, CT. 42 BY(Town Heaith OM orAg nt) DATE ErPPROVED ❑ REJECTED Z REMARKS RETURN THIS COPY TO DEPARTMENT OF CONSUMER PROTECTION CPR-9 Rev.7/95 y --�:. Do NOT 811 in iq STATE OFCONNECTICUT STATE WELL NO. DEPARTMENT OF CONSUMER PROTECTION REAL ESTATE a(PROFESSIONAL TRADES DIVISION OTHER NO. WELL DRILLING COMPLETION REPORT . I"Capitol Avenue,Hartford,Connecticut 06106 OWNER NAIVE ADDRESS PAGANELLI CONST. P.O. BOX 652, SUFFIELXD LOCATION (NO.6 Sfneo (Town) (Lof Number) OF WELL 1043 FOSTER ST.EXT. S.WINDSOR DOMESTIC BUSINESS FARM TEST PROPOSED ESTABLISHMENT WELL USE OF WELL PUBS INDUSTRIAL AIR. OTHER SUPPLY CONDITIONING (S . ABANDONMENT DRILLING ROTARY COMPRESSED CABLE OTHER EQUIPMENT � � AIR PERCUSSION � PERCUSSION � (Specify) CASING LENGTH(feet) DIAMETER(indm) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED? DETAILS D THREADED WELDED ❑ YES ❑NO- ❑ YES ❑ NO YIELD TEST. a BAILED ❑ PUMPED .n COMPRESSED AIR HOURS YIELD(GPM) WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet) DURING YIELD TEST(feet) Depth of CompRted Well in feet- LEVEL 160 MAKE LENGTH OPEN TO AQUIFER(feet) SCREEN DETAILS SLOT SIZE DIAMETER IF GRAVEL Diameter of well GRAVEL SIZE(indkes) FROM(feet) TO(feet) PACKED: including gravel pack (inches) DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances,to at least two FEET TO FEET permanent landmarks 0 160 CEMENTED �ts 33 CM X 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 LLER(Signature) 2/10, 21' 42 5/20/02 AGENCY V`c �0W N S fq C S t. 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074 f�OSOR-CO TELEPHONE (860) 644-2511 Dear Homeowner: The Town of South Windsor Health Department's goal is to keep you informed about the status of water quality throughout the town whether you are served by and individual well or by a public water source. In an attempt to better serve you, we have reviewed our files to ensure we have the most recent and accurate information possible. Our review has revealed that we do not have any information regarding how your residence receives its water. We are hopeful that you will take a moment to help us keep our records current. Please indicate the type of water service by circling the appropriate entry below and return this letter no later than in February 27, 2009, in the self addressed stamped envelope provided. If you receive your water from a private well, please let us know the location as it relates to your home by providing two measurements from the foundation to the well in the space provided and let us know if the well is used for domestic, lawn and garden, or agricultural use. See example below. Thank you in advance for your cooperation. Any questions can be addressed to the South Windsor Environmental Health Officer, Robert De Vito at 860-644-2511, extension 248. Water service: Circle the appropriate service: , WELL MDC CT W WELL USE: DOMESTIC LAWN & GARDEN AGRICULTURAL Well Location BACK DRAWING: 40 FT A FRONT B ECG 30 , 1�4 FTI_ WELL STREET