HomeMy WebLinkAboutWell Correspondence 585 Griffin Road 10.NN Sf,q
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To� �
�C, 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074
l�asoR•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 al 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 no
have any information regarding how your residence receives its water. ri,
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 jK 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 WATER
WELL USE: DOMESTIC LAWN & GARDEN AGRICULTURAL
Well Location :
BACK DRAWING:
40 FT
FRONT B
30 F 14 FT I? ' eta {^
{ WELL Q P
STREET
WE L L R C E. P T I O N R E Q U E S T
To:
��s� I �
'�
ON—SITE SEWAGE DISPOSAL SECTION
DEPT. OF PUBLIC HEALTH &. ADDICTYON SERVICES
150 WASHINGTON STREET
HARTFORD, CT 0610ra
FROM: UJc-"
TEILEPHONE:
OWNER: —J ��S� rU
'` . REPAIR _� NEW SYSTEM
ADDRESS: l ) i V iN PERC FASTER THAN I Hl-x INCH
TOWN: Vt r CT 0 4�C/" NO. of BEDROOMS
OR, DESIGN FLOW
EXCEPTION FOR INSTALLATION OF TANK----TANK & SYSTEM, . SYSTEH__
WELLS AFFECTED: OWNERS ONLY_ �d—NEIGHBORS ONLY--�_apTii�_
AFFECTED PROPERTY LOT NO- TYPE DISTANCE OF WELL TO:
(Ir APPLICABLE) �° �O�rR, ADDRESS WELL xEW TANK
PROPERTY J '
FRONT .
ADJACENT PROP.
REAR
ADJACENT PROP.
RIGHT SIDE
ADJACENT PROP.
LEFT Si
ADJACENT PROP.
IS REPLACEMENT SYSTEM CLOSER TO WELL(s) THAN EXISTING SYSTEM?
HAS THE WELLS) BEEN ANALYZED RECENTLY FOR POLLUTANTS? O
PLAN PREPARED -BY., PROP.ENG:___ _.INSTALLER: -)�-_OTIM
BUILDING BEEN CONVERTED TO YEAR ROB USE OR ENLARGED SINCE 1977?,
COMMENTS:
ENCLOSURE
SKETCH/PLAN SIGNATURE