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HomeMy WebLinkAboutWell New 130 Graham Road atate of Connecticut WATER RESOURCES COMMISSION WELL 223 State Office Building This �� ® RE�ORT Hartford, Connecticut repprt must be Corn to State Water Resources Ceted and submitted ®O NOT FILL IN than 30 days after Completion no later WELL Y on of well, State Well No. OWNER ail --- —_ Y � . 7 .$ Other No. WELL Name DRILLER _ - `� -�• � � f L` Street Address ! Icls z � 3 Name { £^ t "� ' (J ✓' ,,! PROPOSED USE O ! ItY and Town R USES Street Address J_.eL ��- (Check): t�+`7�•2.-._._- pitY and Town ,,©+Domestic ❑ Farm CASING ❑ Irrigation Business DETAILS ❑ Establishment YIELD TEST ❑ Municipal ❑ Industrial ❑ Test Well Length: ❑ ailed WATER LEVEL / C Feet or SCREEN ❑ Pumped (measure from land DETAILS Inches Yield: Diameter: �,� Hours su ace) Static: `� 01 Feet Kind- •> G•p.M. When Balled Make: or Pumped Feet " DRILLING EQUIPMENT Length Slot TOTAL D n Cable 700! Ft. Size DEPTH OF WELL f --�—FEET ❑ Rotary l_f�❑ Other (Specify) Diameter: t .. ..1 ....... In Depth From Give descri WELL LOG Ground Surface ption of formations granite, etc. include Penetrated gra �Packed,cemented,sofsize of t rave( (diameter) and sandat' $ilt hard . , sand, gravel For ne example;oft.to 27 ft.medium, coarsejY, hardpan shale FT.to FT. fine,packed,Yellow of mate sandstone rial, structure sand;27 ft.to 134 ft.gray FT.to FT FT.to FT FT.to FT. FT.to FT FT. to F 1 FT.to FT. FT. to F-I- YIELD TEST DATA IN G,p M. W ER RE Give Depths At Which Yield Was Tested FT. G.P.M. And Yield COMMISSIQA FT. G.P.M. FT. G.P.M. — ANSWERED FT. G.P.M. ----- FILED. ................ • . ....... ............................. Well Was Completed: Date of Repo Well Driller (Signature) Certificate No. LOCATION OF WELL: TOWN OF SKETCH SHOWING LOCATION OF PREMISES IN TOWN: (Show distance and direction from road intersection or other landmark.) DIAGRAM SHOWING LOCATION OF WELL ON PREMISES: 4` .. i ROUTE DIRECTIONS FOR REACHING WELL SITE FROM NEAREST CITY OR VILLAGE CENTER: