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Home My WebLink AboutWell New 83 Maskel Road PERMIT NUMBER WELL DRILLING BOARD STATE OF CONNECTICUT w064 11-6' ' WE"RILLING PERMIT 10960 STATE OFFICE BUILDING,HARTrbR0,CONNECTICUT Do IS LOCATION Of WELL(Town) (Stre.f) - (Lof Number) - DATE SOUTH WINDSOR MASKIEL ROAD 2 7/6/72 OWNER OF WELL ❑INDIVIDUAL ` BUILDER ❑ OTHER(Spedfyj JAM LAM OWNER'S ADDRESS 44 HENRY ST. KANCHESTER CONN. PROPOSED BUSINESS Est.No.of- DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ y� People being USE OF served. WELL PUBLIC❑ SUPPLY El INDUSTRIAL CIR OTHER ONDITIONING ❑ (Specify) 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 lot and to house(if present) i 6AD Indicate North y. I +3y Approximate number of feet from well to nearest source of possible contamination: 75 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 counter-signed by the Director of Health or his agent. APPU �*Ium APPLICANT'S ADDRESS REGISTRATION NO.- WE ST. VFMOX, CONN. 100 th Off ,or Agent). DATE VED ❑ REJECTED - 1 REMARKS RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD WELL COMPLETION REPORT STATE OF CONNECTICUT Do NOT fill in WDB-5 12-69 REV. 9-71 WELL DRILLING BOARD State Office Building STATE WELL NO.. HARTFORD, CONNECTICUT 06115 OTHER NO. NAME ADDRESS OWNER N .iaaA.:.i��' I 4' �.�vZ;fi "L:aptT1xt3 $ ls t LOCATION (No. R Streat) _ (Town) (Let Number) OF WELL 4;C` '.— _0U" t T"'v 2 BUSINESS PROPOSED a DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL USE OF WELL PUBLIC AIR ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING El ((Specify) DRILLING 19CABLE OTHER EOU PMENT ROTARY L_i APRESSED RM ERCUSSION ❑ PERCUSSION El (Specify) LENGTH (feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING CASING GROUTED? DETAILS 19.451 (� THREADED ❑ WELDED I PK YES ❑NO ❑YES IN NO YIELD HOURS YIELD (G.P.M.), TEST ❑ BAILED ❑ PUMPED COMPRESSED AIR MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) WATER I Depth of Completed Well LEVEL 25 200 I in feet below Land surface:- 50 MAKE LENGTH OPEN TO AQUIFER(feet) SCREEN DETAILS SLOT SIZE I DIAMETER(inches) IF GRAVEL Diameter of well including I (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. Sand Gravel 4`� 4 `*/79 /mot If yield was tested at different depths during drilling, list below °¢ FEET GALLONS PER MINUTE stir DATE WELL WELL COMPLETED I PERMIT NO. I REGISTRATION NO. I DATE OF REPORT I WELL RI L (Sign ure f DEPT. OF E VIRON E TAL PROTECTION WELL COMPLETION REPORT STATE OF CONNECTiCUr Do NOT fill in WDB-5 12-69 REV.9-71 WELL DRILLING BOARD State Office Building STATE WELL NO. HARTFORD,,CONNECTICUT 06115 OTHER NO. NAME ADDRESS OWNER JA, LAMI 4 MI Ur 31a♦ M"al I=Mj Gom LOCATION (No.& Street) (Town) (Lot Number) OF WELL MAW i ROAD .., `674rt3 k pINDSM 6 BUSINESS PROPOSED E#DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL USE OF WELL PUBLIC AIR❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ ((Spec fy) COMPRESSEDDRILLING EQUIPMENT Is ROTARY ❑ A RPER USSION ❑ P RCUSSION ❑ ((Specify) LENGTH (feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED? CASING THREADED ❑ WELDED ®YES ❑NO ❑YES [ANO DETAILS �, I 6 �,'�� I HOURS YIELD (G.P.M.) YIELD ElBAILED ❑ PUMPED � COMPRESSED AIR TEST 4 MEASURE FROM LAND SURFACE—STATIC (Specify feet) DURING YIELD TEST(feet) WATER I Depth of Completed Well LEVEL 25 2W in feet below Land surface: MAKE LENGTH OPEN TO AQUIFER(feet) SCREEN DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well including GRAVEL SIZE(inches)(FROM(feet) ITO(feet) PACKED: I 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. 0 ].1 Sam], & G ravo1 11 250 R*ddish Rook If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE �X7 DATE WELL COMPLETED I PERMIT NO. I REGISTRATION NO. I DATE OF REPORT I WELL I LE (Sign re) !I nac inn DIRECTOR OF HEALTH WELL DRILLING BOARD STATE OF CONNECTICUT PERMIT NUMBER wDB-a 11-69 WELL DRILLING PERMIT . 10960 STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115 LOCATION OF WELL(Town) (Street) (Lot Number) DATE SOUTH WINDSOR HASKIL ROAD 2 7/6/72 OWNER OF WELL ❑ INDIVIDUAL 1i BUILDER ❑ OTHER(Specify) JA" IA OWNER'S ADDRESS 44 RMT S2 RMORMU t30NN. PROPOSED BUSINESS TEST Est.No.of DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ WELL People being USE OF served. WELL PUBLIC AIR❑ U�Y ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify) SKETCH OF WELL LOCATION Locate well with respect to at least two roads,showing distance from intersection and front of lot Location of lotto at least two roads Well location on lot and to house(if present) i R°A Indicate North ./I LI p' X ilk p ,r�v v S G ARn/ET y� t , L/(-F, t3y w�1i� � wyEL� i i ..�fif .f`ICF L er Approximate number of feet from well to nearest source of possible contamination: 75 The undersigned is aware that upon completion of the well,a-"Well FCompletion 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 counter-signed by the Director of Health or his agent. APPLI (Si nature) APPLICANT'S ADDRESS REGISTRATION NO. j(7 e�01 �Aqe'nl) DATE 'EiXFP—ROVED ❑ REJECTED REMARKS r' IC aMiCcK 9 tsS1 DIRECTOR OF HEALTH