HomeMy WebLinkAboutWell Repair 54 Overlook Road CONSUMER PROTECTION
WELL DRILLING BOARD STATE OF CONNECTICUT PERMIT NUMBER
CPR-8 REV.11-82 DEPARTMENT"TF CONSUMER PROTECTION
WELL DRILLING PERMIT 81074
165 CAPITOL AVE.;HARTFORD,CONNECTICUT 06106
outh'.Windsor Overlook Road 54
LOCATION 7WELL(Torten) (Street) (Lot Number) DATE
l 8
OWNER Of WELL Ar 2
INDIVIDUAL BUILDER OTHER(Specify)
OWNER'S ADDRESS
Overiook Road, So.Windsor
BUSINESS MT Est.No.of
PROPOSED DOMESTIC D ESTABLISHMENT FARM WELL People being
USE OF
WELL PUBLIC AIR SUPPLY INDUSTRIAL xrv .
CONDITIONING � (Specify) '
.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 present)
Indicate North
t
i Wool
Approximate number of feet from well'to
nearest source of possible contamination:
- The undersigned is aware that upon completion of the well, o "Well Completion Report" .contoining 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 counter-signed by the Director of Health or his agent.
(Sig re) APPLICANT'S ADDRESS REGISTRATION NO.
81 Hebron Ave.POBox 109,Glast a8iiy,ct
BY(['own Xe�Qffwx# DATE
ROVED R ECTED �? O
REMARKS ^ /� �- n
a44V ✓'"" ...1��"c"" rd'`�'�".� �jr/(,J ��21C1�
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION-REPORT' ST.ME DF CONNECTICUr
CPR.9 REV.9.79 DEPARTMENT OF•CONSUMER PROTECTION Do-NOT fill in
WUL DRILLING BOARD STATE WELL NO.
_ 20 GRAND STREET-
HARTFORD,CONNECTICUT 06106 OTHER NO.
NAME ADDRESS '
OWNER
AnthonyChiarenza
LOCATION (No.&Street) (Town) (Lot Number] ig
OF WELL' -54 Overlook Road
BUSINESS
PROPOSED L DOMESTIC ❑ ESTABLISHMENT D FARM .D TEST WELL
USE Of
WELL PUBLIC AIR D SUOTHER
PPLYD-INDUSTRIAL D CONDITIONING D(Specify)
DRILLING COMPRESSED CABLE OTHER
EQUIPMENT D ROTARY AIR PERCUSSION a PERCUSSION a(Specify)
CASING LENGTH(feet) DIAMETER(inches) -WEIGHT PER FOOT_ DRIVE OE wAs clstt�GROUTED?
DETAILS G 17#1 bs _ ®THREADED D WELDED ®YES D NO D YES NO
YIELD HOURS YIELD(G.P.M.).
TEST D BAILED D PUMPED D COMPRESSED'AIR
WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Well
LEVEL 30 in feet below Land surface: 225
MAKE LENGTH OPEN TO AQUIFER(feet)
...SCREEN
7-[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 distonces,to at least
FEET TO FEET two permanent landmarks.
0 32 gran4 Sand & gravel
32 40 Granite Aj seiv,�
40 225 Granite
$'
If yield was tested at different depths during drilling,list below iV"adtG+s... .QLO
FEET GALLONS PER MINUTE
AA
-DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT WELL ILLER(Signature) ,
4-27-83 81074 10 12-7-83
. .BOARD:-: ' -