HomeMy WebLinkAboutWell New 300 Long Hill Road CONSUMER PROTECTION
WELL DRILLING BOARD STATE OF CONNECTICUT PERMIT NUMBER
C 'e IiEV.° DEPARTMENT OF CONSUMER PROTECTION 66290 WELL DRILLING PERMIT
20 GRAND STREET,HARTFORD,CONNECTICUT 06106
SOUTH WINDSOR, CONN. L LONG HILL RD. 300
LOCATION OF.WELL(roust) (Street) (Lot Number) DATE
MIKE KRAWFSKY JUNE 30, 1981
OWNER OF WELL
INDIVIDUAL BUILDER OTHER(Specify)
OWNER'S ADDRESS
12-A DEERFIELD COURT, EAST HARTFORD, CONN.
PROPOSED BUSINESS TEST Est. No.of
DOMESTICEJ ESTABLISHMENT ❑ FARM .WELL People being-
USE OF served.
AIR OTHER
WELL PUBLIC SUPPLYINDlKTR1AL CONDITIONING" (Specify)
SKETCH OF WELL LOCATION
-Locate well with respell-lo at least two roods,showing distance from intersection and front of-lot
Location of lot to at least two roads . Well location on lot and-to house(if present)
w
Indicate North
Ir
r fi¢
1 -
LeZ 11oA
Approximate number of feet from well to
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 Board and the Water Resources Commission on the form provided by-the
Board.This permit is not valid until all information is filled in and it has been countervsigned le pir�q�.pfsFjsp�h AL iii"ggent.-
NX
AP (Sig re APPLICANT'S ADDRESS 25 C-IC itMU NNTs-4AL.YvCfiNUE REGISTRATION NO.
NEW WTAw, CoNNt W053. 60
BY(Tows Nedtb Officer or Agent) DATE s�
APPROVED REJECTED
REMARKS
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT STATE of CONNECTICUT
CPR-9 REV..'9-79- DEPARTMENT OF CONSUMER PROTECTION Do NOT fill in
STATE WELL NO.
WELL DRILLING BOARD
20 GRAND STREET
HARTFORD, CONNECTICUT 06106 OTHER NO.
NAME ADDRESS
OWNER MIKE KRAWFSKY 12-1 DEERFIELD COURT EAST HARTF R
LOCATION (No. &Street) (Town) (Lot Number)
OF WELL LONG HILL RD s , SOUTH VINDnR t CONN. 300
BUSINESS
PROPOSED DOMESTIC ESTABLISHMENT FARM TEST WELL
USE OF
PUBLIC AIR 1:1
OTHER
WELL SUPP Y" El INDUSTRIAL CONDITIONING (Specify)
COMPRESSEDDRILLING EQUIPMENT � ROTARY AR ERCUSSION PERCUSSION ((SSpecif
Y)
CASING LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT DRIVE SHOE (W�AS CASING GROUTED?"
DETAILS 43 feet 6 in. 17 lb i �THREADED � WELDED �YES �NO I 1.YES �NO
YIELD HOUR�i J� YIELD (G.P.M.)
TEST BAILED PUMPED El COMPRESSED AIR ours 5 gallon
WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Well
LEVEL water �:t vel 28 feet 250 feet in feet below Land surface:
250 feet
MAKE LENGTH OPEN TO AQUIFER(feet)
SCREEN _ . —7
DETAILS SLOT SIZE _ DIAMETER(inches) IF GRAVEL Diameter of well including GRAVEL SIZE(inches) FROM(feet) TO(feet
PACKED: gravel pack(inches):
DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least
FEET TO FEET two permanent landmarks.
.d SAND & GRAVEL
31 250 RED ROCK
I Qd
If yield was tested at different depths during drilling,list below � .
FEET GALLONS PER MINUTE
X0
z
DATE WE CpMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT WELL DRILLER(Si at re)
7 1 66290 6 6 3C 1 x
DEPT. OF ENVIRONMENTAL PROTECTION - WATER RESOURCES