HomeMy WebLinkAboutWell New 1511 Main Street CPR-$Rev.7195 PERMIT
NUMBER
STATE OF CONNECTICUT 235461
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE&PROFESSIONAL TRADES DIVISION
WELL DRILLING PERMIT
165 Capitol Avenue,Hartford,Connecticut 06106
LOCATION OF WELL (Town) (&roery (LotNumbep DATE
South Windsor 1511 Main St 7/18/06
OWNER OF WELL
i a INDIVIDUAL BUILDER .OTHER(Specify) 614-17 8 7 -
I OWNER'S ADDRESS
Rob Tarantino 1511 Main St- South Windsor
Est.N0.of
PROPOSED X❑ DOMESTIC BUSINESS FARM TEST -. People being
USE OF ESTABLISHMENT WELL served.
WELL
PUBud 1:1SUPP Y 1:1, INDUSTRIAL CONDITIONING AIR STHER 4
SKETCH OF WELL LOCATION
Locate well with respect to at least two roads,showing distance from intersection and front of lot
location of M tb at least two roads Well location onto and to house(if present)
• . _ . • . �Desk 1
Indicate North
e..
lei,
.f- Tcaa . 1►Dust,
a•� S�'
Approximate number of feet from well to
no rest source of possible contamination: 481 to sanitary sewer
The undersigned is away ponqWpletion of the well,a"Well Completion Report"containing construction details and information required under
Section 25-131 of the upnt to the General Statutes must be sent to the owner, the Department of Consumer Protection and the Water
Resources Commi n th ovided by the agency. This permit is not valid until all information is filled in and it has been counter-signed by
the Director of or hi ant.
APPLICANT( ' ure) APPLICANTS ADDRESS REGISTRATION NO.
Stavens P.O.. Box 406 Willington 42
BY(Town Health Officer or Agent) DATE
OVED ❑ REJECTED
7_ a�
REMARKS
RETURN THIS COPY TO DEPARTMENT OF CONSUMER PROTECTION
I
CPR-9 Rev.7/95
T.STATE OF CONNECTICUT Do NOT fill inSTATE WELL NO.
gLF DEPARTMENT OF CONSUMER PROTECTION
REAL ESjrATE&PROFESSIONAL TRADES DIVISION
WELL DRILLING,COMPLETION REPORT OTHER No.
165 Capitol Avenue,Hartford,Connecticut 06106
OWNER NAME ADDRESS
Rob Tarantino 1511 Main St South Windsor
LOCATIOFWELOL 1 jNo.Maitn St � (Town) Windsor (Lot Number)
South
DOMESTIC BUSINESS FARM TEST
PROPOSED ESTABLISHMENT WELL
USE OF WELL ❑ PUBLIC a INDUSTRIAL ❑ AIR OTHER
SUPPLY CONDITIONING (Specify)
DRILLING F71 ROTARY COMPRESSED CABLE OTHER
EQUIPMENT t AIR PERCUSSION " PERCUSSION (Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
DETAILS 131 17 X THREADED WELDED
OYES ❑ NO, ❑ YES ❑ NO
YIELD TEST �BAILED � PUMPED [� COMPRESSED AIR HOURS YIELD(GPM)
Il J_�JI 2 20
WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Well in feet
LEVEL 30 265 265
MAKE SCREEN LENGTH OPEN TO AQUIFER(feet)
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well GRAVEL SIZE(inches) FROM(feet) TO(feet)
PACKED: including gravel pack -
(inches)
DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances,to at least two
FEET TO FEET permanent landmarks
9 118 Hardpan
11 :3 265E Gray 'amok
1/4
If yield was tested at different depths during drilling,list below 1
FEET Iucq
GALLONS PER MINUTE
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT WELL DRILLER
7/27i 6 2354 1 4
DEPT. OF ENVIRC)N U PKITAI PRnTI=f1TIF9AI_1A1ATIW 0 D=oe%l sDnrn