HomeMy WebLinkAboutWell New 461 Griffin Road STATE OF CONNECTICUT WELL COMPLET �RET DO NOT FILL IN
WATER COMMISSION
317 STATE OFFICE BUILDING This report must be completed and submitted to STATE WELL NO.
HARTFORD 15, CONN. State Water Commission no later than 30 days OTHER NO. ,..»........»........»».
after completion of well.
WELL
OWNERWELL
'?
DRILLER ( �SG� me r ` Y
Street Address City or'Town
LPL'
°� ���`� ''k✓gN f` 1 sti/1/ j' i L C fit. Street 4dress City or Town
PROPOSED USE OR USES (check):
J]Domestic ❑Irrigation ❑Stock (]Municipal ❑ Industrial []Test Well
CASING DETAILS PUMPING TEST WATER LEVEL SCREEN DETAILS
(measure from land surface)
LENGTH: r FEET DURATION: — HOURS STATIC: FEET MAKE:
? --------- -------- SLOT
IAMETER: INCHES PUMPING RATE: — G.P.M. WHEN PUMPING: --_ FEET LENGTH: FT. SIZE
KIND: DIAMETER: IN.
WELL LOG
DEPTH FROM Give details of formations penetrated, such as: peat, silt,sand,gravel,clay, hardpan,shale, stone,rock. Include size of gravel
GROUND SURFACE. (diameter)and sand (fine, medium, coarse),color of material, structure (loose, packed,cemented, soft, hard)
FT.to/ FT.
r
`✓ FT.toOC1 FT.
FT.to FT. AJ C—
FT.to FT. '516,1 i ���-1-C-ice" c3 rja�
FT.to FT.
L'YJ t � �+7—+'G ys'� �y�•�'�c�Yf='+� `I—t� �r .'F- .�2.C?f3 f
FT.to FT. 60 Cc S1'6te
FT.to FT. &n ,, Rd, Gvl VtJ)`anCiSttr i(G t 1— �Y �1 w€ e ,
FT.to FT.
FT.to FT.
FT,to FT.
FT.to FT.
FT.to FT. -------- ------------------ vi MI5 c)
FT.to FT. State� .2[�G: tiuSti?ii i9 �.
FT,to FT.
FT.to FT.
)ATE WELL WAS COMPLETED: f ` ' V �.5
DATE OF REPORT_`!_
r:-
d
WELL DRILLER
(Signature)
CERTIFICATE NO. ----------------------------------
LOCATION OF WELL: TOWN OF
! �u �<
SKETCH SHOWING LOCATION OF PREMISES IN TOWN:
t
H
E
DIAGRAM SHOWING LOCATI N OF WELL ON PREMISES:
Fi
l\�
f r ROUTE DIRECTIONS FOR REACHING WELL SITE FROM HARTFO,RD: 1
oz
�`�;�.lam•-�_-,� w..=:. ..�,�'.���. �;,��