HomeMy WebLinkAboutWell New 439 Oakland Road CONSUMER PROTECTION
WELL DRILLING BOARD STATE OF Cdt NECTICIL -' PERMIT NUMBER
CPR-$REV.11-82 DEPARTMENT OF CONSUMER PROTECTION 140036
WELL DRILLING PERMIT
165 CAPITOL AVE.,HARTFORD,CONNECTICUT 06106
LOCATION OF WELL(Tomx) (S-et) (Lot Nrmber) DATE - 11/14/89
S.WINDSOR 439 OAKLAND RD.
OWNER OF WELL
® INDIVIDUAL BUILDER OTHER(Specify) RICHARD REPOL 644-3248
OWNER'S ADDRESS
- 289-8691-
87 KELLY RD. , S. WINDSOR, CT.
PROPOSED BUSINESS TEST Est.No.of
® DOMESTIC ESTABLISHMENT 1:1FARM El WELL People being
USE OF. served.
lkILIC AM OMEN
WELL D UY .11 INDUSTRIAL CONDITIONING (Specify) 4
SKETCH OF WELL LOCATION- -
Locate well with respeci to of least two roads,showing distance from intersection and front of lot
Location of lot to at least two roods Well location on lot and to house(if present)
�v
Itxlioot.North ��
" "
p/j/<Z1PJ10
Approaimote number of feet from well to `T 5 i
near"source of possible contamination:
The undersigned is aware that upon completion of the well, 0."Well Completion Report" containing construction details and information required under Section
25-131 of the 1969 Supplement to the General Statutes must b-- 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 by the Director of Health or his agent.
grwlr - APPLICANT'S ADDRESS '. REGI.�T�jLON NO,
P.O. BOX 111� S.WILLINGTON, CT. jj,, �uJ
BY(Tome Hedfb Officer or Agew) - DATE p�
2iIPPROVED REJECTED Ole
REMARKS
RETURN THIS -COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT STATE OF CONNECTICUT
CPR-9KV.11-92..- - -- - - DEPARTMENT OF CONSUMER PROTECTION . - -Do NOT fill in -
STATE WELL NO.
WELL DRILLING BOARD
165 CAPITOL AVE.
HARTFORD,CONNECTICUT 06106 OTHER NO.
NAMET ADDRESS �OWNR Rta ?AID REPOL 87 yE LTRD. # S. W: 3Td7OR «
LOCATION (No.3 Street) (Town) (Lot Number)
OF WILL '� ��V.3} s3 ..LTDSO
BUSINESS
PROPOSM DOMESTIC ESTABLISHMENT FARM �.TEST WELL.
USE OF
WELL Cl PUBLICSUPPLY INDUSTRIAL CIONDITIONING (specify)
EQUfMENT ROTARY AIDRILLING RMCOMPRESSED
PERCUSSION PERCUSSION OTHER USSION (Specify)
CASING LENGTH(feet) DIAMETER(inches) --WEIGHT PER FOOT t w CASttVG G TED'
DETAILS r + 2 THREADED WELDED YES n10 YES �NO
YIELD
HOURS YIELD (G.P.M.)
TEST BAILED PUMPED n COMPRESSED AIR
MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet)
WATER Depth of Completed.Well LEVEL 30 175 in feet below Land surface: 205
MAKE LENGTH OPEN TO AQUIFER(feet)
Scam
DETARS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well including GRAVEL SIZE(inches) FROM(feet) TO(feet
PACKED: grovel pack (inches):
DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least
FEET TO FEET two permanent landmarks.
ta
if Yield was tested at different depths during drilling, list below
FEET GALLONS PER MINUTE
_J
DATE WELL'COMPLETED PERMIT NO. REGISTRATION NO:. DATE OF,REPORT W UfR(Sfgnotute)
'00
DEPT.OF ENVIRONMENTAL PROTECTION-WATER RESOURCES