HomeMy WebLinkAboutWell New 1523 Main Stret h PERMIT NUMBER
CPR-8 Rev.7,95 - - - 195360
STATE OF CONNECTICUT
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE&PROFESSIONAL TRADES DIVISION
WELL DRILLING PERMIT
165 Capitol Avenue,Hartford,Connecticut 06106
LOCATION OF WELL (Town) (street) (Lot Number). DATE
S.WINDSOR 1523 MAIN ST. 8/11/99
OWNER OF WELL
aINDIVIDUAL Q BUILDER OTHER(Specify) 429_9282
OWNER'S ADDRESS -
SOUCY & SONS . 50 LATHAM RD. , WILLINGTON, CT.
Est.No.of
PROPOSED a DOMESTIC a BUSINESS _ F FARM TEST People being -
USE OF ESTABLISHMENT WELL served.
WELL -
SUPPLY AIR PUSUC INDUSTRUIL CONDITIONING S�'y)ER 4
SKETCH OF WELL LOCATION
Locate well with respect to at least two roads,s owing distance from intersection and front of lot
location of lot to at least two roads Well location on to and.to house(if resent)
Indicate North
x (3v
ell
• cs
Approximate number of feet from well to
nearest source of possible contamination: 751+ (Sanitary Sewers)
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 permit is not valid until all information is filled in and it has been counter-signed by
the rector of Hea r hi a ent.
A ANT 'natu APPLICANT'S ADDRESS REGISTRATION NO.
P.O. BOX 406, WIL-LINGTON, CT. 42
dr BY(Town Health Officer or Agent) DATE
PROVED REJECTED ^
REMARKS '
RETURN THIS COPY TO DEPARTMENT OF CONSUMER PROTECTION
_
CPR-9 Rev.7/95
r
STATE OF CONNECTICUT Da NOT fill in
,DEPARTMENT OF CONSUMER PROTECTION STATE WELL NO
REAL ESTATE&PROFESSIONAL TRADES DIVISION
Y WELL DRILLING COMPLETION REPORT oTHER NO.
165 Capitol Avenue,Hartford,Connecticut 0610E
OWNER NAME ADDRESS
SflL,CY & SONS 50 I1 iTH� t�t} 'il3r TniTrrI,INGTONP CT.
LOCATION (No.&Street) (Town) (Lot Number)
OF WELL 1523 MAID ST. S. W`INDSOR
DOMESTIC � ESTABLISHMENT FARM TEST
PROPOSED � WELL
USE OF WELL
Q PUBLIC ❑ INDUSTRIAL Q CAIR ONDITIONING OTHER
SUPPLY (Specify)
DRILLING a ROTARY COMPRESSED CABLE a OTHER
EQUIPMENT Ll AIR PERCUSSION El PERCUSSION (Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT
DETAILS 140 # 17.00 � THREADED S I WELDED ® DRIVE SHOE WAS CASING GROUTED?
YIELD TEST BAILED a PUMPED ® COMPRESSED AIR HOURS L J YES ❑ NO, YES ❑ NO
YIELD(GPM)
WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet). DURING YIELD TEST(feet) 20
LEVEL 4 Q Depth of Completed Well in feet
0 # 3065
MAKE
SCREEN LENGTH OPEN TO AQUIFER(feet)
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well- GRAVEL SIZE -inches
PACKED: ncluding gravel pack ( ) ZFROM(fe=TO
(inches)
DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION
Sketch exact location of well with distances,to at least two
FEET TO FEET permanent landmarks
0 12 Topsoil & Gravel
12 130 Clay
130 305 BedrOCk
If yield was tested at different depths during drilling,list below
FEET GALLONS PER MINUTE ,.
DATE WELL COMPLETED PERMIT N0. REGISTRATION NO. DATE OF REPORT
10'/3€/93 195360 LDRIL re)
42 11l1�99
DEPT.OF ENVIRONMENTAL PROTECTInN_WAT;=n ar=Qnl 1Qf,=o