HomeMy WebLinkAboutWell New 96 Maskel Road WELL DRILLING BOARD STATE OF CONNECTICUT PERMIT NUMBER
wDB-a >I I-69 WELL DRILLING PERMIT 8966
STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115.
LOCATION OF WELL(Town) (Street) (Lot Number) DATE
SOUTH $INDSOR MASKEL ROAD 30 4/6/72
OWNER OF WELL
❑ INDIVIDUAL - 11 BUILDER ❑ OTHER(Specify) JA AN LAINE
OWNER'S ADDRESS 44 HENRY ST. , MANCIIESTER, CONK.
PROPOSED BUSINESS TEST Est.No.of
IN DOMESTIC-'' ❑ .ESTABLISHMENT ❑ FARM ❑ WELL People being
USE OF served.
WELL ElSUPP Y El BLIC AIR INDUSTRIAL El CONDITIONING El ,OTHER 5
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)
Indicate North
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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 6 of
Public Act 659 must be sent to the owner,the Board and the Water Resources Commission on the form provided by the Board.This permitis not valid until all informa-
tion is filled in and it has been counter-signed by the Director of Health or his agent.
APP C ignotu ) APPLICANT'S ADDRESS REGIST TI NO.
. LAKE ST. , YERNON, CONNAf
!
BY(Town h Officer or Agent) DATE
APPROVED ❑ REJECTED
REMARKS
DIRECTOR OF HEALTH
WELL COMPLETION REPORT STATE OF CONNECTICUT
WDB-5 12-69 WELL DRILLING BOARD DLL NO.
NOT frll in
STATE WELL
State Office Building
HARTFORD,CONNECTICUT 06115 12
OTHER NO.
NAME ADDRESS
OWNER
LOCATION (No. &Street) (Town) (Let Number)
OF WELL ►'ate�".E RCji SOUTH I..-L"e. SOR 30
BUSINESS
PROPOSED
51 DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL
USE OF
WELL PUBLIC AIR❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING El (specify)
if l
DRILLING
IPMENT ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION El
Ope if
EOU )
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT I DRIVE SHOE WAS CASING GROU ED?
DETAILS 22 19.4 THREADED ❑WELDED YES ❑NO ❑YES ®NO
YIELD ❑ HOURS G.P.M. YIELD(G.P.M.)
❑
TEST BAILED PUMPED x COMPRESSED AIR 8 8
WATER MEASURE FROM LAND SURFACE—STATIC(Specify fee I t) DURING YIELD TEST(feet) Depth of Completed Well
LEVEL 20 100 in feet below Land surface: 125
SCREEN LENG
MAKE TH OPEN TO AQUIFER(feet)
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.
12 Gand. Gravel
L E EGray Gr b
If yield was tested at different depths during drilling, list below
FEET GALLONS PER MINUTE
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT WELL R Llpt(Sign lure
WELL COMPLETION REPORT STATE OF tONNECTICUT Do NOT fiff in
WDB-5 11-69 WELL DRILLING BOARD
STATE WELL NO.
State Office¢wilding
HARTFORD,CONNEf:'TICUT 06115
OTHER NO.
NAME ADDRESS
OWNER JAAN LAINE 44 HENRY ST. , MANCHESTER, CONN.-
LOCATION (No.&Street) (Town) (Lot Number)
OF WELL MASMZ ROAD SOUTH WINDSOR 30
BUSINESS
PROPOSED
®DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL
USE OF
WELL PUBLIC AIR❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ O�Efy)
DRILLING COMPRESSED CABLE ER
EQUIPMENT ® ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ ((SSpeci y)
CASING LENGTH(feet) 176
ETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING QM
] ED?
DETAILS 22 19*4.5 ® THREADED ❑WELDED ®YES ONO
❑YES 5NO•
YIELD HOURS G.P.M. YIELD(G.P.M.)
TEST ❑BAILED ❑ PUMPED ® COMPRESSED AIR 1 4 8 8
WATER MEASURE FROM LAND SURFACE—STATIC(Specify fee tJ DURING YIELD TEST(feet) Depth of Completed Well
LEVEL 20 100 in feet below Land surface: 125
MAKE LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(inches) T11
F GRAVEL Diameter of well including GRAVEL SIZE(inches) FROM(feet) TO(feet)ACKED: gravel pack (inches):
DEPTH FROM LAND SURFACE Sketch exact location of wall with distances,to at least
FEET to FEET FORMATION DESCRIPTION two permanent landmarks.
0 12 Sand &Gravel
12 125 Gray Granite
Gfc j� sL.
i
If yield was tested at different depths during drilling,list below /e1V
FEET GALLONS PER MINUTE y
• J' EL u D .
DATE WELL COMPLETED• PERMIT NO. ]REGISTRATION NO, DATE OF REPORT WELL L R(S!g turd
4/12/72 8966 100 4/17/72
BOARD