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HomeMy WebLinkAboutWell New 139 Kent Lane -CPR-a Rev.7)95 PERMIT NUMBER STATE OF CONNECTICUT 226611 DEPARTMENT OF CONSUMER PROTECTION REAL ESTATE&PROFESSIONAL TRADES DIVISION WELL DRILLING PERMIT A` 165 Capitol Av ue„Hartford,Connecticut 06106 v W -ti LOCATION OF WELL (Town) Oftw) for Number) DATE • � �tr. c��� q ' OWNER OF WELL � INDIVIDUAL a BUILDER OTHER(Specify) OWNERS ADDRESS Est.No.of PROPOSED DOMESTIC BUSINESS a FARM .TEST People being USE OF ESTABLISHMENT VVELL served WELL PUBLIC INDUSTRIAL AIR OTHER 6 e0— SUPPLY a CONDITIONING a ( O SKETCH OF WELL LOCATION Locate well with respect to at least two roads,showing distance from intersection and front of lot } location of lot to at least two roads Well location on to and to house jif resent) zo Indicate North 7Z � I t 30 Approximate number of feet from well to '75 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 ennit is not valid until all information is filled in and it has been counter-signed by the Director of Health or his agent. CC S Zo 6 APPLICANT(Signature) APPLICANTS ADDRE�SSS( REGISTRATION NO. APPROVED REJECTED Y(Town Hearth Officer orAgent) DATE ❑ REMARIcs - p fi� kwt r i' lot eL la gyp. 40 t P&PAr- a�Ya�Y RETURN THIS COPY TO DEPARTMENT OF CONSUMER PROTECTION STATE OF CONNECTICUT DO NOT fill in DEPARTMENT OF CONSUMER PROTECTION STATE WELL NO. REAL ESTATE&PROFESSIONAL TRADES DIVISION WELL DRILLLING COMPLETION REPORT OTHER NO. 165 Capitol Avenue,Hartford,Connecticut 06106 OWNER NAME ADDRESS Dana Yanaway 139 Kent lane South Windsor LOCATION (No 6 Street) (ro' ) "Nembap OF WELL 139 Kent Lane South Windsor Well#1 of 2 DOMESTIC BUSINESSESTABLISHMENT FARM ❑ TEST PROPOSED WELL USE OF WELL SUPPLY INDUSTRIAL AIR OTHER ❑ CONDITIONING � (Specify) Geothermal GRILLING ROTARY COMPRESSED CABLE M AIR P RCUSSION PERCUSSION ❑ OTHER EQUIPMENT ) CASING LENGTH@" DIWElER WM) WEGHTPERF00r DRIVE SHOE WASCASINGGROUTID4 DETAILS 100 6 17 ❑7}{READEp WELDED ®YES ❑NO I ©YES ❑NO YIELD TEST 0 BAILED YIELD(GPM)GPM) ED PUMPED a coMPREssEDA1R 4 20 WATER MEASURE MOM LAND SURFACE—STATIC(Spadlyfeel) DURING YIELD TEST(feet) Depth of Completed Well in feet LEVEL 15 270 275 MAKE LENGTH OPEN TO AQUIFER(feel) SCREEN DETAILS SLOTS12E DtAME7ER(mclrs) PACKED L Dialnelerdwell I—GRAVELSIZEFROM(feet)FROM(feet) Toont) ickdeY peck DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION Sketch ex3d location ofwell with distarx es to at least two FEET TO FEET permanentlandnaols 0 100 Sand and gravel 100 275 Bedrock North 0 3' Iyield was leafed aldilfeoent deptlu diain9 tlrilln8.list below C`�, FEET GALLONS PER MINUTE J 275 20 DATE WELL COMPLETED PERMIT NO REGISTRATION NO DATE OF REPORT ) 9124104 226611 4165 10H N04 Owner•Contractor•Dept of Consumer Protection•Dept of Environmental Protection-Water Resources•Local Director of Public Health Form provided by Forms On-A-Disk,Inc.•Dallas,Texas•(214)340.9429 S. SOJIN Sf•i C o . * F Town ap s-ot&A ?di�� y 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074 soR•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 GiWATER WELL USE: DOMESTIC LAWN & GARDEN AGRICULTURAL Well Location BACK DRAWING: 40 FT A FRONT B 30 14 FT RECEIVED WELL STREET FEb o 7t1/10 SOUTH WINusUH ENGINEERING DEPT,