HomeMy WebLinkAboutWell New 319 Oakland Road i CPR-8 Rauh.T195 PERMIT NUMBER
STATE OF CONNECTICUT ;, 198967
�e g� DEPARTMENT OF CONSUMER T�"");`fQ'1i)(ty,l
sd �Ji REAL ESTATE&PROFESSIONAL TR�ADIVI4��y�r
WELL DRILLING PERMIT
165 Capitol Avenue,Hartford,Co Wicut 0�106
( 0
LOCATION OF WELL• (Town) (SYroet) (Lot Number) WV OATS
50 I '311 O 1-i3•-00
OWNER OF WELL
INDIVIDUAL ® BUILDER OTHER(Specify)
OWNER'S ADDRESS
122-I - dry%cs 6t¢o E Ew►AJ T' 01,111)
Est.Na.of
PROPOSED DOMESTIC BUSINESS FARM TEST People being
USE OF ESTABLISHMENT WELL moved.
WELL
SUPP Y IC INDUSTRIAL CONDITIONING OTHER
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 to and to house(if resent)
Indicate North d�
I? �jy..
/hto
- 3Q
ralf
Rog 63'
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 25-131 of the 1969 Supplement to the General Statutes must be sent to the owner, the Department of Consumer Protection and the Water
Resources Commission on the form provided by the agency. 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.
APP NT( 'na re) APPLICANTS ADDRESS REGISTRATION NO.
e.itl.pa '� � q C/4N7i11C� CTL6v 9 17 o
BY(Town Hearth Officer or Agent) DATE
r'1/kPPROVED ❑ REJECTED
REMARKS
RETURN.THIS COPY.TO DEPARTMENT OF CONSUMER PROTECTION
r �- .CPR-9 F3ev.7/95 -
,,- Do NOT fill in
STATE OF CONNECTICUT STATE WELL NO.
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE do PROFESSIONAL TRADES DIVISION
WELL DRILLING COMPLETION REPORT RF& p(' a 1((j OTHER NO.
165 Capitol Avenue,Hartford,Connecticut 06108
OWNER NAME ADDRESS
• Llr� �ME 6 . G-Ro��utN TE(cu9�ef�
LOCATION (NO.3Slfw) (Town)J (I&NUmber)OF WELL 13M. Q�1i'�4r'..t Q � Sav4h I-Jovids-d1L Vr—
DOMESTIC BUSINESS a FARM TEST
PROPOSED ESTABLISHMENT WELL
USE OF WELL PUBLIC INDUSTRIAL AIR OTHER
SUPPLY CONDITIONING S
DRILLING
ROTARY ®
EQUIPMENTAIR PERCUSSION PERCUSSION S•peciy)
CASING LENGTH(feel) DIAMETER(inches) WEIGHT PER FOOT J[Z DRIVE SHOE WAS CASING GROUTED?
DETAILS 63 A 611 /1 16 THREADED WELDED IK YES ❑ No. GQ YES ❑ NO
YIELD TEST BAILED ❑ PUMPED ® COMPRESSED AIR HOURS YIELD(GPM)6
WATER MEASURE FROM LAND SURFACE-STATIC(Spedfy feet) DURING YIELD TEST(feet) Depth of Completed Well in feel
LEVEL 1� J 00
MAKE LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(itufts) IF GRAVEL Diameter of well I GRAVEL SIZE(inches) FROM(fee() TO(feet)
PACKED: including gravel pads
(inches)
DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION- Sketch exact location of well with distances,to at least two
FEET TO FEET permanent landmarks
0 g Sd*cIt AAAO JAI
0
60 ' �Ycfo '
0 J
N 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 ER 'n re)
00 !9 8 967 /70 89-'7-0 0
AGENCY