HomeMy WebLinkAboutWell New 390 Niederwerfer Road WELL DRILLING BOARD STI-'or'CMNECTICUT PERMIT NUMBER
wDs a 11•69 WELL DRILLING PERMIT 44406
STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115
LOCATION OF WELL (Town)- (Street) (Lot Number) DATE
SOUTH WINDSOR NIEDERWERFER ROAD 3 I 11/28/77
OWNER OF WELL
11 INDIVIDUAL BUILDER OTHER apecim. UNITED PAINTING CON@RACTORS INC.
OWNER'S ADDRESS
1209 JOHN FITCH BLVD. , S. WINDSOR, CONN. (JACK- GUAY)
PROPOSED ® DOMESTIC BUSIN❑. ESTABLI HMENr '� ❑S. FARM ❑ y� People eing
USE OF served.
WELL PUBLIC❑ UPP Y ❑ INDUSTRIAL ❑ M (S
ITIONING ❑ (Specify) 4
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 presenO
Indicate North L\ll:� �Dp ��• .���
v �a L)
jq
3 v
Approximate number bf•feet from well to 75'
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
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 countersigned by the Director of Health or his agent.
APP �(Sfgnau - APPLICANT'S ADDRESS REGISTRATION NO. '
ST.- - VERNON CONK. , 100
By or AVOW) DATE
APPROVED ❑ REJECTED
RETURN THIS COPY TO CON'NECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT STATF of C9141NECTICUT Do NOT fill in
WDS-5 1269 REV.9-71 WELL DRILLING BOARD STATE WELL NO.
State Office Building
HARTFORD,CONNECTICUT 06115
OTHER NO.
ADDRESS
OWNER UNITED PAINTING CONTRACTOM INC. 1209 JOHN FITCH BLVD. , S. WINDSOR
LOCATION (No.&Street) (Town) (Lot Number) •
OF WELL NIEDERWERFER ROAD SOUTH WINDSOR .3
PROPOSED ® DOMESTIC ❑ ESTABLISHMENT ❑BUSINESS ❑ TEST WELL
FARM
USE OF
WELL PUBLIC AIR OTHER
❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify)
DRILLING CABLE
EQUIPMENT ® ROTARY ❑ A RMPRESSED PERCUSSION ❑ PERCUSSION ❑ ((Specify)
LENGTH(feet)eet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
DETAILS Fjl 6 I ® THREADED ElWELDEDI ®YES ❑NO ❑YES
19*45 I ENO
HOURS YIELD(G.P.M.)
YIELD ❑ BAILED ❑ PUMPED I COMPRESSED AIR - I 4 6
TEST
WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Well
LEVEL' 20 I 150 I in feet below Land surface: 175"
MAKE I LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE; DIAMETER(inches) IF GRAVEL f Diameter of well including GRAVEL SIZE(inches)FROM(feet) TO(feet)'PACKED: gravel pack(incfies): ) I I
DEPTH FROM LAND SURFACE
FORMATION DESCRIPTION Sketch exact location of well with distances,to at least
FEET to FEET two permanent landmarks.
0 14 Sand & Gravel
14 51 Clay
51 175 Bedrock
If yield was tested at different depths during drilling,list below ELL
GALLONS PER MINUTE L�
1W IE,pFe R, ,k_.;-/,
°DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. , DATE OF REPORT WELL DRILLER Signat e).
1/6/70 I 44406 i •100 ( 1/10/78
BOARD ;