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HomeMy WebLinkAboutWell Correspondence 20 Pierce Road (2) JUL-10-2008 03 :43 PM EASTERN DRILL CO. 860 870 9377 P. 02 CPR-3 kev.7195 Do NOT t111 In 6(.qv" STATE OF CONNECTICUT STATE WELL NO. DEPARTMENT OF CONSUMER PROTECTION — REAL ESTATE&PROFESSIONAL TRADES DIVISION OTHER NO. =3R4� WELL DRILLING COMPLETION REPORT 166 Capitol Avenue,Hartford,Connecticut 06100 6 NER NAME ADDRESS Ma le Q.cjc �. LOCATION (No.A Srteel) f own) nlcor) % --p- OFWELL GxQ f, , (A.>4 and. o-r C.,...._!�_._.��_ DOMESTIC BUSINESS a FARM TEST PROPOSED 0 ESTABLISHMENT 11 11 WELL USE OF WELL ❑ PUBLIC ❑ INDUSTRIAL l�J AIR Q OTHER SUPPLY I.--� CONDITIONING 8 DRILLING ROTARY COMPRESSED CABLE OTHER EQUIPMENT AIR PERCUSSION © PERCUSSION � (Specify) CASING LENGTH(feet) DIAMETER(Aehes) WEIGHT PER FOOT N TWA$CASINGD DETAILS ++� ® THREADED ❑ WELDED a YES ❑ NO• aLY YES NO r YIELD TEST SAILED (�"1 PUMPED ly COMPRE9 ED AIR H UR IELD(GPM) �. WATER MEASURE FROM LAND SURFACE-STATIC(SvOe�ty feet) DURING YIELD TEST(teal) Depth Lanp et M in NO LEVEL I «. MAKE- LENGTH OP N pet) SCREEN DETAILS 9[ T SIZE DIAMETER(inches) IF GRAVEL Diameter of well ) FROM(het) TO(cell PACI(E0: including gravel Pack (emhes) DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION Sketch exact location Of well With distance .to at least W(o FEET TO FEET permanent landmarks I I d 9-ea rlak Q c4r- W m �. 3RU A 40 4 Isa] 7 ;G O N y)eld was tested at different deptha during ddlllnp,list below , ALL NS PER MINUTE " GATE LL COMPLETLD OMIT N0 I TRATIpN Np DATE OF REP WELL (b ) w 47. 10 r [ter iki-mAr--mo Propane Gas Service INVOICE 420 John Fitch Blvd., P.O. Box 239 South Windsor, CT 06074 10432 Since194l Phone: 860-289-0267• Fax: 860-289-5368 Equipment Service and Appliance Sales are provided by Inergy Services CUSTOMER NAME ACCOUNT NUMBER DATE JACQUES CONSTRUCTION 03429 06/20/08 11 :47 STREET ADDRESS PHONE NUMBER TAKEN BY 20 PIERCE Rl6 (860)305-1861 (HBO CITY.STATE k ZIP PROMISED S. WINDSOR CT 06074 With: J DIRECTIONS:: WILL CALL FOR -1ST FILL ARRIVALTIME C/O TANK - FINISHED JOB REGULATOR TEST TERM CODE: CR 3 $low Pn.a,urt Undcr laud Lock.UPPaxum PRODUCT CODE/STEP RATE:- - -. 5 / �. TOTALTIME Integral Twin Stage IN.W.C. #OF TANKS/TANK CAPACITY: 001/01000 EQUIPMENT INSTALLED/REMOVED' Two Stage Fl—Prv,,. U„&r L-d L.k Up Pressure ITEM CAP.OR MODEL NO. SERIAL NO. IstStage PSI PSI CYL/TANK — 2nd Stage IN.W.C. IN.W.C. CYL/TANK LEAK TEST t. `.. . REG. Integral Twin Stage -Start Pressure End Pressure Time Held- Sniff Test REG. - - -Tank PSI PSI PSI APFLI CNCES' RANGE / WATER / CENTRAL IN.W.C. IN.W.C. Two Stage :'' r < :°Io QF L P`lN"REMOVED TANKS Tank PSI PSI PSI I EST.ANNUAL USAGE-HEAT I st Stage PSI PSI NON HEAT 2nd IN.W.C. . jIv �' ISV 1000 GAL FOR P RCHASE TANK $2650, BAGS 2 , 180, LINE $150 RMIT $65 , LABOR $250, 5 + TAX RK.PERFOR QTY DESCRIPTION COST QTY DESCRIPTION COST SUMMARY P.C. AMOUNT APPLIANCE TRIP 2 INSTALLATION SALES TAX PERMITS PARTS/FITTINGS SALES TAX LABOR SALES TAX MISC. SALES TAX PROPANE SALES TAX Customer received safety information YES TOTAL BILLING Operation of System explained to Customer YES Customer received MSDS'for Odorized Propane YES AMOUNT RECEIVED$ Checked Equipment Operation YES Gas Line Pressure Tested YES ' _ CUSTOMER SIGNATURE DATE SERVICEMAN DATE CR03A-PGS PERMIT NUMBER CPR-8 Rev.7/93 STATE OF CONNECTICUT 233060 y� DEPARTMENT OF CONSUMER PROTECTION REAL.ESTATE&PROFESSIONAL TRADES DIVISION WELL DRILLING PERMIT 165 Capitol Avenue,Hartford,Connecticut 06106 LOCATION OF WELL (Town) (Street) (Lot Number) DATE So . W ; �ds�- -90 P, OWNER OF WELL ® INDIVIDUAL BUILDER OTHER(Specify) OWNER'S ADDRESS 409 91 �'d e IRd , Sd . w ; dsor , cT v� v � � Est.No.of PROPOSED DOMESTIC BUSINESS FARM TEST People being USE OF ESTABLISHMENT WELL served. .WELL PUBLIC INDUSTRIAL AIR OTHER . . ivPLY , El'CONDtrIONIWd i �($pecffo SKETCH OF WELL LOCATION Locate well with respect to at least two road showing distance from intersection and front of lot location of tot to at IVst two roads Well location on to and to house(if present) Indicate North • � 3 J a V 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 inf rmation 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. QPPL ignature) APPLICANT'S ADDRESS Ira err Q�.r t t Co REGISTRATION NO. BY(T ea fficer or gent) DATE APPROVED REJECTED REWARKS t a.00 o 415- 09 DIRECTOR OF HEALTH Ca �, 3 STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH ui �rcME ANSTy�r December 10, 2007 Dr. Gerald L. Schwartz, Director of Health Town of South Windsor 1540 Sullivan Avenue South Windsor, CT 06074 RE: Well Permit Exception Application—20 Pierce Road, South Windsor, CT Dear Mr. Schwartz: Pursuant to Section 19-13-1351 m(c) of the Regulations of Connecticut State Agencies, this department has determined that installation of one individual drilled water supply weII to serve the above-mentioned parcel is allowable. Exception is granted to issue, if appropriate, a water supply well permit to develop a drilled well, provided the following conditions are met: a) The well site must be approved by the local director of health. b) The well water samples must be approved by the local director of health in accordance with Section 19-13-B101 of the Regulations of Connecticut State Agencies. c) The well will not adversely affect the purity and adequacy of the public water supply, nor the service of the system. It is your prerogative to issue or deny the well permit in this instance. Sincerely, 'd Darrell B. Smith Public Health Services Manager Drinking Water Section MH/CW/fg Cc: Kathryn Miller, 169 Natsisky Rd. South Windsor, CT 06074 William Kennedy, MDC Bob Deptula, South Windsor HD File copy Phone: (860)509-7333 Telephone Device for the Deaf: (860)509-7191 �i 410 Capitol Avenue-MS# 51 WAT P.O.Box 340308 Hartford,CT 06134 Affirmative Action/An Equal Opportunity Employer 10/15/2007 MON 10:30 FAX 860 644 7280 South Windsor Town Hall 2001 ********************* *** FAX TX REPORT *** ********************* TRANSMISSION OK JOB NO. 4439 DESTINATION ADDRESS 98602918757 PSWD/SUBADDRESS DESTINATION ID DPI ST. TIME 10/15 10:29 USAGE T 00' 31 PGS. 1 RESULT OK VOW fi V! S' � W w4 1540 SULLIVAN AVENUE•SOUTH WINDSOR, CT 06074 r�bsox•co�` TELEPHONE(860)644-2511 October 15, 2007 Mr. Peter DeMallie , Principal Design Professionals P 0 Box 1165 425 Sullivan Avenue South Windsor, CT 06074 Dear Mr. DeMallle, This correspondence Is in reference to a proposed well permit exception request for a proposed new residence at 20 Pierce Road,South Windsor. This department would be in favor of granting the request. There is ample area for a well to be located in compliance with regulations. The separation distance from other wells is sufficient and there are no known water quality problems in the area. The proposed well would not contradict the town's plan of development or any local ordinances. If you require addition information please contact me at the South Windsor Town Hall at 644-2511 ext. 248., Yours truly, Robe lW �p`N N Stq a F Tiov� C-! V� VV G U w° 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074 f�°SOR G° TELEPHONE (860) 644 2511 October 15, 2007 Mr. Peter DeMallie , Principal Design Professionals P 0 Box 1165 425 Sullivan Avenue South Windsor, CT 06074 Dear Mr. DeMallie, This correspondence is in reference to a proposed well permit exception request for a proposed new residence at 20 Pierce Road, South Windsor. This department would be in favor of granting the request. There is ample area for a well to be located in compliance with regulations. The separation distance from other wells is sufficient and there are no known water quality problems in the area. The proposed well would not contradict the town's plan of development or any local ordinances. If you require addition information please contact me at the South Windsor Town Hall at 644-2511 ext. 248.. Yours truly, Robe tWR. P Environmental Health Officer RD/cm P.O.BOX 1167 425 SULLIVAN AVENUE SOUTH WINDSOR,Cr 06074 06LA CRIMP PHONE:860.291.8755 FAX:8onalsi .8757 c.com www.designprofessionaisinc.com CIVIL &TRAFFIC ENGINEERS t PLANNERS I SURVEYORS I GIS ANALYSTS I LANDSCAPE ARCHITECTS Mr. Robert Deptula October 8,2007 Town of South Windsor 1540 Sullivan Avenue South Windsor,CT 06074 Dear Bob: Re: Kathy Miller Residence 20 Pierce Road South Windsor,Connecticut : Our client,Kathryn A. Miller,is proposing to build a new residence at 20 Pierce Road (formerly known as 27 Pierce Road),which is a 4.19 acre parcel situated at the northeast corner of Pierce Road and Ellington Road(Route 30)in South Windsor. She has received Inland Wetlands Agency approval,and PZC approval is not required for the residence on this lot of record. WPCA approval for the sanitary lateral to the sewer main in Pierce Road is pending,and we see no reason for it not to be approved. We are writing you in conjunction with our effort to secure a well permit exception from the State Department of Health. The DOH requires a letter from your office providing comments and recommendations in reference to the well permit exception application, and they ask you to address the ability to site wells,the existence of neighboring wells, any concern with water quality or quantity in the area, and compatibility with the Town's plan of development or ordinances. As per the enclosed map, Ms. Miller has three options. The first and preferred option is to install a private well. The second option is to install a 3751.E lateral extension through wetlands to her house. The third is to install a water main extension some 44011 in Pierce Road from the MDC main in Ellington Road. These latter two options are cost- prohibitive for a single-family home, and beyond my client's means. Incidentally,the South Windsor Plan of Conservation and Development identifies this area for Low Intensity Land Use. They call it the"central wetlands area north of Ellington Road." Accordingly,Kathryn A. Miller hereby requests a letter from you meeting the requirements of the State DOH. Thank you. Sincerely, eter R. De allie,Principal Memorandum To: Bob Deptula—Public Health Official CC: Design Professionals From: Jeffrey H. Folger—Environmental Planner/Conservation Officer Date: 10/25/2007 Re: Miller Well application, 20 Pierce Road A site plan was recently approved by the Inland Wetland Commission on 20 Pierce Road. The approved site plan showed a drinking water well for the water supply. In order to hook up to an adjacent public water supply line the applicant would have had to disturb wetlands on the property. This alternative provided the least amount of impact to inland wetlands on the property. PLANNING DEPT. 10%gN Se aU, O-P sloam V&"4-ot 9 � w� 1540 SULLIVAN AVENUE• SOUTH WINDSOR, CT 06074 r�Qsox•co TELEPHONE (860) 644-2511 October 29, 2007 Mr. Florin Ghisa Department of Public Health Drinking Water Division 410 Capitol Avenue MS#51 WAT P O Box 3403038 Hartford, CT 06134-0308 Dear Mr. Ghisa, As requested by Peter DeMallie of Design Professionals enclosed with this correspondence is the packet of information submitted to my office regarding the well permit exception request for 20 Pierce Road, South Windsor. Please direct any questions to Design Professionals. Yours truly, Robert eptu a, R.S. Environmental Health Officer RD/cm 1 V P.O.BOX 1167 425 SULLIVAN AVENUE ■ SOUTH WINDSOR,CT 06074 h PHONE:860.291.87E 5 Is FAX:8onalsi .8757 c.com www.designprofessionatsi nc.com • CIVIL & TRAFFIC ENGINEERS I PLANNERS /SURVEYORS 1613 ANALYSTS 1 LANDSCAPE ARCHITECTS RECEIVE jUu J Mr. Robert De tula Sanitarian p > SOUTH WfNDSOR Town of South Windsor ENGINEERING DEPT. 1540 Sullivan Avenue South Windsor, CT 06074 October 29,2007 • Dear Bob: : Re: Kathryn Miller Residence 20 Pierce Road South Windsor • Enclosed are a number of documents related to Kathryn Miller's request for a Well Permit Exception on her parcel at 20 Pierce Road(formerly known as 27 Pierce Road). On behalf of our client,we hereby request that you transmit these documents to Mr. Florin Ghisa,Dept. of Public Health, Drinking Water Division,410 Capitol Avenue MS# 51 WAT,P.O. Box 3403038,Hartford,CT 06134-0308 (his phone#is 509-7333). These documents include: 1)Your letter dated October 15;2)The letter from the Town's wetlands agent,Jeff Folger,to you dated October 25; 3)My letter dated October 8 to the MDC (incidentally,the MDC informed us that it is their policy not to respond to these well exception requests,per Jennifer at The MDC, 278-7850 ext. 3443); 4)Inland : Wetlands Agency approval letter; 5)Plot Plan map prepared by my firm portraying the proposed house,wetlands,well, sanitary connection and distances for a water main or water lateral connection; and 6)my letter to you dated October 8keter ou. • Sincerely, De allie Cc: Kathryn Miller