HomeMy WebLinkAboutWell New 148 Maskel Road WELL DRILLING BOARD STATE CONNECTICUT' PERMIT NUMBER
1ND�' "�' WELL DRILLING PERMIT 6 910
STATE OFFICE BUILDING,HAZ D,GONNECTICUT 06115
V .
LOCATION Of WELL(rows) (Street) (Lot Number) DATE
SOUTH WINDSOR FRSKEL ROAD 8 9/21/71
OWNER OF WELL
❑INDMDUAL E9 BUILDER ❑ OTHER(Specify) JAAN LAINE
OWNER'S ADDRESS
44 HENRY ST. , WMMTM9 CONN.
PROPOSED BUSINESS TEST Est.No.of
® DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ WELL People being
USE OF served.
WELL ❑ PUBLIC AIR SUOTHER
PPLY ❑ INDUSTRIAL ❑ IO CONDITNING ❑ (Specify) 5
SKETCH Of WELL LOCATION
Locate well with respect to at least two roadi,.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. an
1
S '00,0Va 0. '
6-
.� AFT` •�Ili �'aFT'
p rrJEcL
K
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 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 permit is not valid until all informs_
tion is filled in and it has been counter-signed by the Director of Health or his agent.
APPU ( re) APPLICANT'S ADDRESS REGISTRATION NO.
Ca. LAKE T. VERNON CONK. 100
El BY(Town tkaffh r or t) DATE
APPROVE) REJECrTED -..,t a.
REMARKS
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT STATE OF CONNECTICUT Do NOT Pil(in
WDB-s 14.69 WELL DRILUNG BOARD
STATE WELL NO.
State OfRc4 Building
HARTFORD,CONNECTICUT 06115
OTHER NO.
NAME ADDRESS
OWNER JAAN LATNE 44 HENRY ST. , MANCHESTER CONN.
LOCATION (No.d Street) (Town) (Lot Number)
OF WELL MASKEL ROAD SOUTH WINDSORINESS
8
PROPOSED
® DOMESTIC ❑ ESTABLI HMENT ❑ FARM ❑ TEST WELL
USE OF
WELL PUBLIC AIR❑ SUPP Y ❑ INDUSTRIAL ❑ CONDITIONING ❑ OTpHEfy)
DRILLING COMPRESSED CABLE OTHER
EQUIPMENT ® ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ (Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT IVE SHOJ:]
(W CASING UTE D4
DETAILS 4 6 19. n THREADED ❑WELDED � YES NO LJ YES �NO
YIELD HOURS G.P.M. YIELD(G.P.M.)
TEST ❑ BAILED ❑ PUMPED COMPRESSED AIR 1 15 1
WATER MEASURE FROM LAND SURFACE—STATIC(Specity/set) DURING YIELD TEST(feet) Depth of Completed Well
LEVEL 30 80 in feet below Land surface: 100
MAKE LENGTH OPEN TO AQUIFER(test)
SCREEN
DETAILS SLOT SIZE DIAMETER(Inches) IF GRAVEL Diameter of well including 17SIZE(inches) FROM(feet) TO(feet)'
PACKED: gravel pack (inches):
DEPTH FROM LAND SURFACE Sketch exact location of well with distances,to at least
FEET to FEET FORMATION DESCRIPTION two permanent landmarks.
0 15 sand & Gravel
15 37 Hardpan
32 100 Red Rock
f71 aoJ'C"
'37FT,
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 WEIL L (Sign lure).
10 14 1 100 1 10 18 1
BOARD
i
WELL COMPLETION REPORT STATE OF CONNECTICUT Do NOT fill in
WDB-5 12-69 WELL DRILLING BOARD
STATE WELL NO.
State Office Building
HARTFORD,CONNECTICUT 06115 Sw I
OTHER NO.
NAME ADDRESS
OWNER
, .AN .fit; 1 rRE 44 F M— '` ' ST. 0Tq1 Lq'RE". C- 1j"I
LOCATION (No. &Street) (Town) (Lot Number)
OF WELL HASKEIs RGAID, SQUUH 6GiNiDS.,+R
BUSINESS
® DOMESTIC ❑ ESTABLISHMENT ❑ FARM
PROPOSED ❑ TEST WELL
USE OF
WELL PUBLIC AIR❑ SUPPLY ❑ INDUSTRIAL El CONDITIONING O(Specify)
e if )
DRILLING
IPMENT ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION (Speif
ER
EQUIPMENT )
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
DETAILS 417 6 103.45 [i] THREADED ❑WELDED YES ❑NO ❑YES FKI NO
HOURS G.P.M. YIELD(G.P.M.)
TIEST ❑ BAILED ❑ PUMPED Ei COMPRESSED AIR
WATER MEASURE FROM LAND SURFACE—STATIC(Specifyfeet) DURING YIELD TEST(feet) Depth of Completed Well
LEVEL 'y 0 in feet below Land surface: 100
MAKE LENGTH OPEN TO AQUIFER(feet)
SCREEN
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 Sketch exact location of well with distances, to at least
FORMATION DESCRIPTION
FEET to FEET two permanent landmarks.
5 Hardnar.
1
If yield was tested at different depths during drilling,list below ?
FEET GALLONS PER MINUTE us�t
` '
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT WELL DRI YL (Signature) f1
t'S _. 1 '4
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