HomeMy WebLinkAboutWell New 200 Pierce Road ace Pe( -
WELL CO
MPLETION REPORT STATE of coNNEcncur
CPR-9 REV.n-az DEPARTMENT OF CONSUMER PROTECTION Do NOT 7in
WELL DRILLING BOARD STATE WELL NO.
165 CAPITOL AVE.
HARTFORD,CONNECTICUT 06106 OTHER NO.
NAME ADDRESS
OWNER. UYLAIM MWIRACTORS
LOCATION (No. & Street) (Town)OF WELL n -PIERCE ROB s ° i (Lot Number)
BUSINE41 ESTABLISHMENT FARM (�
PROPOSED. DOMESTIC u TEST WELL
USE OF
PUBLIC AIR
WELL SUPPLY INDUSTRIAL CONDITIONING a(Specify)
DRILLING ROTARY ARMPRESSED CABLE PERCUSSION PERCUSSION
EQUIPMENT �(Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT RI V SH E wASC4SING GROUTED?
DETAILS ii THREADED WELDED Ed YES NO YES NO
YIELD HOURS YIELD )
TEST BAILED PUMPED COMPRESSED AIR
(G.P,M.
a
WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet)
LEVEL O Depth of Completed Well
in feet below Land surface:
230
MAKE
SCREEN LENGTH OPEN TO AQUIFER (feet)
DETAILS SLOT SIZE DIAMETER(inches) GRAVEL SIZE(inches)
IF GRAVEL Diameter of well ih ) FROMf(feet)eet) TO(feet
PACKED: gravel pock(inches):
DEPTH FROM LAND SURFACE
FEET TO FEET FORMATION DESCRIPTION Sketch exact location of well with distances, to at least
two permanent landmarks.
Sand &
�0
120 230Badmook
mac
If_yield was tested of different depths during drilling, list below J L
FEET GALLONS PER MINUTE
lr�(Z67 o.
DATE WELL COMPLETED ERMIT NO. REGISTRATION NO. DATE OF REPORT
WELL (Signatur~�w`"
DEPT. OF ENVIORNMENTAL PROTECTION-WATER RESOURCES