HomeMy WebLinkAboutWell New 745 Nevers Road CONSUMER PROTECTION --7q5
WELL"DRILLING BOARD STATE OF CONNECTICUT PERMIT NUMBER
CPR;B REV.8-79 DEPARTMENT OF CONSUMER PROTECTION 71780
WELL DRILLING PERMIT
20 GRAND STREET,HARTFORD,CONNECTICUT 06106
REPLACES VOID #62549
SOUTH. WINDSOR, CONN . NEVERS ROAD #2
LOCATION OF WELL(Gown) (Street) (Lot Number) DATE
FRED P . CIECHOWSKI 1AUG . 27, 1982
OWNER OF WELL
® INDIVIDUAL 11 BUILDER El OTHER(Specify)
OWNER'S ADDRESS
AMATO DRIVE 22G, SOUTH WINDSOR., CONN. 06074
PROPOSED BUSINESS TEST Est. No.of
DOMESTIC11 ESTABLISHMENT FARMWELL People being
USE OF
AIR OTHER
served.
WELL SUPPLY INDUSTRIAL CONDITIONING (Specify)
SKETCH OF WELL LOCATION
Locate well with respect to of least two roads,showing distance from intersection and front of[of
Location of lot to at least two roads Well location on lot and to house(if present)
Indicate North r
•jc;�
44
�A
won—
/r �veas �gG, ev�-ems .
Approximate number of feet from well to
nearest source of possible contamination: 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 Supplemtent%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 b i o„pf th 111 nt.
APPLICANT(Signature) APPLICANT'S ADDRESS ICn� MOUNT AVENUE REGISTRATION NO.
1-149n4all— NEW BRIT_ CONN, A6Q53. 60
BY(Torun Hedth Officer or A nr) DATE
APPROVED REJECTED
�P. J-
REMARKS
V /— _
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
— _
WELL COMPLETION REPORT STATE of CONNECTICUT
CPR-9 REV.9-79 DEPARTMENT OF CONSUMER PROTECTION Do NOT fill in
WELL DRILLING BOARD srarE WELL No.
20 GRAND STRFFT
HARTFORD, CONNECTICUT 06106 OTHER NO.
NAME
�- ADDRESS SOUTH
7�
OWNER FRE P • CI HCWSKI AMA O- DRIV.E�, 22 G SO TH WIADSOR. C01
LOCATION (No. & Street) (Town) (Lot Number)
OF WELL NEVERS RD . SOUTH WINDSOR, CONK . Q.
PROPOSED
DOMESTIC ESTABLISHMENT FARM TEST WELL
USE OF
WELL OTHERPUBLIC AIR
SUPPLY INDUSTRIAL CONDITIONING (Specify)
DRILLING COMPRESSED EQUIPMENT ROTARY AIR PERCUSSION PERCUSSION (specify)
CASING LENGTH (feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE.SHOE WAS CASING GROUTED?
DETAILS 2 r 1 THREADED O WELDED r-1 YES NO &I YES �NO
YIELD HOURS YIELD(G.P.M.)
TEST BAILED PUMPED COMPRESSED AIR
WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) 9 Depth of Completed Well
LEVEL in feet below Land surface:
MAKE LENGTH OP AC�)I ( et)
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 FORMATION DESCRIPTION Sketch exact location of well with distances, to at least
FEET TO FEET two permanent landmarks.
21 205 RED D ROCK
tyo
If yield was tested at different depths during drilling, list below
FEET GALLONS PER MINUTE
/y v PS
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT WELL DRILLER(Signature)
DFPT. OF FNVIDnnIAAI=KITAI D0r1TCr`T1r%K1 %A/Arrn
`OWN Sf4
o
T-0� O-P sio� ?d&U&ot
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1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074
r�Osoe.co TELEPHONE (860) 644-2511
Dear Homeowner:
The Town of South Windsor Health Department's goal is to keep you informed about the
status of water quality throughout the town whether you are served by and individual well
or by a public water source.
In an attempt to better serve you, we have reviewed our files to ensure we have the
most recent and accurate information possible. Our review has revealed that we do not
have any information regarding how your residence receives its water.
We are hopeful that you will take a moment to help us keep our records current. Please
indicate the type of water service by circling the appropriate entry below and return this
letter no later than in February 27, 2009, in the self addressed stamped envelope
provided.
If you receive your water from a private well, please let us know the location as it relates
to your home by providing two measurements from the foundation to the well in the
space provided and let us know if the well is used for domestic, lawn and garden, or
agricultural use. See example below.
Thank you in advance for your cooperation.
Any questions can be addressed to the South Windsor Environmental Health Officer,
Robert De Vito at 860-644-2511, extension 248.
Water service:
Circle the appropriate service:
WELL 9M CT WATER
WELL USE: DOMESTIC LAWN & GARDEN AGRICULTURAL
Well Location :
BACK DRAWING:
`7Lf5 �ll [ ✓t r5 l
40 FT
A FRONT B
30 14 FT
WELL
STREET RECEIVED
FEB o 2?nnq
SOUTH VVINDSOR
ENGINEERING DEpT.