HomeMy WebLinkAboutWell New 870 Main Street WELL COMPLETION REPORT STATE OF CONNECTICUT
CPR-9 REV.11-82 DEPARTMENT OF CONSUMER PROTECTION Do NOT fill in
WELL DRILLING BOARD STATE WELL NO.
165 CAPITOL AVE.
HARTFORD, CONNECTICUT 06106 OTHER NO.
NAME o OWNER ADDRESS
cea '. _ �
LOCATION (No. 8 Strees) (Town)
OF WELL —loam " (Lot Number)
BUSINESS
DOMESTIC ESTABLISHMENT HMENT FARM
PROPOSED � TEST WELL
USE OF
WELL PUBLIC SUPPLY INDUSTRIAL AIR OTHER
CONDITIONING �(Specify)
DRILLING
CABLE
EQUIPMENT FJ ROTARY EJ AIR PERCUSDSION ❑ PERCUSSION cify)
LENGTH(feel) DIAMETER (inches) WEIGHT PER FOOT IV H (-�
CASING El THREADED ® WELDED YES NO Q EWAS S CASING GROWE NO
DETAILS t-SL
YIELD ❑ HOURS YIELD (G.P.M.)
TEST BAILED 1z PUMPED COMPRESSED AIR
---TWATER MEASURE FROM LAND SURFACE—STATIC(Specify feel) DURING YIELD TEST(feet)
LEVEL / �„`! Depth of Completed Well
in feet below Land surface:
MAKE LENGTH OPEN TO AQUIFER(feet)
SCREEN n J4f
DETAILS SLOT SIZE g DIAMETER (ihes) IF GRAVEL EDiameter of well including GRAVEL SIZE(inches) FROM If
TO(feet
f -- PACKED: grovel pack (inches):
DEPTH FROM LAND SURFACE
FORMATION DESCRIPTION Sketch exact location of well with distances, to of least
FEET TO FEET two permanent landmarks.
If yield was tested at different depths during drilling, list below
FEET GALLONS PER MINUTE
OF
4-
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT L TILLER nature
DEPT. OF ENVIORNMENTAL PROTECTION-WATER RESOURCES