HomeMy WebLinkAboutWell New 97 Rosemary Lane WELL DRILLING BOARD STATE OF CONNECTICUT PERMIT NUMBER
wD&4 119 WELL DRILLING PERMIT 25431
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STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115
LOCATION.OF WELL (Torun) (street) (Lot Number)SOUTH WINDSOR ROSEMARY LANE 7 DATE I 9/5/74
OWNER OF WELL
® INDIVIDUAL ❑ BUILDER ❑ OTHER{specify) DONALD M. GOODWIN
OWNER'S ADDRESS
BOX 4511 SOUTH WINDSOR, CONN.
PROPOSED DOMESTIC ❑ BUSINESS ❑ n fA TEST Est No..of
ESTABLISWMNT l_.J WELL People being
USE OF served.
WELL ❑ PUBit OTHER
SUPPLY ❑ INDUSTRIAL ❑ CIONDMONING ❑ (Specify) 5
SKETCH OF WELL LOCATION
Locate well with respect to at least two roads,st T ing distance from intersection and front of lot
Location of lot to at least two roads Well location on lot and to house(if present)
1
Indicate North �W
oR� t3e& �Q E�LtAQi D(JJ'E
y�. [r4N6-
Approximate number of feet from well to
nearest source of possible contamination: Sanitary Sewers
The undersigned is aware that upon completion of the well,a`'Nell 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 Board and the Water Resources Commission on the form provided by the
Board.This permit Is not valid until all infoimation is filled in and it has been counter-signed by the Director of Health or his agent
A�P - APPLICANTS ADDRESS REGIS11tAT10N NO.
C� I LAKE ST• , VERNON, CONK. 100
BY(Town S f ver Or anty DATEi
❑ APPAOVEP - t ❑•REJECiED IVVI ID f ._,/
/ '—
• REMAItICS
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL GC3MPLETION REPORT STATE OF CONNECTICUT
WDB-5 12.69 REV. 9-71 WELL DRILLING BOARD Do NOT fill In
State Office Building STATE WELL NO.
HARTFORD,CONNECTICUT 06115 (I(f
OTHER NO.
OWNER NAME ADDRESS
DONALD M» GOOD WIN I BOX 461 SOUTH WINDS01i G010.
LOCATION (No.&Street) (Town) (Lot Numher)
OF WELL h AIR
_ SOUTH WINDSOR
Fil DOMESTIC ESTABLISHMENT ❑ FARM BUSINESS
PROPOSED ❑
❑ TEST WELL
USE OF
WELL ❑ PUBLIC AIR OTHER
SUPPLY El INDUSTRIAL ❑ CONDITIONING ❑ (Specify)
DRILLING PMEN � ROTARY ❑ ARMPRESSED PERCUSSION ❑ CABLE {--( (SpeCR)
EQUIPMENT PERCUSSION I�I
LENGTH (feet) DIAMETER(inches) WEIGHT PER FOOT CASING DRIVE SHOE WAS CASING GROUTED?
DETAILS I Q I 1 9-45 I z THREADED ❑ WELDED ®YES ❑NO [:]YES NO
YIELD HOURS YIELD(G.P.M.)
TEST El ❑ PUMPED COMPRESSED AIR I �^ 1p�
MEASURE FROM LAND SURFACE—STATIC(Specify feet)I DURING YIELD TEST(feet)
WATER I Depth of Completed Well
LEVEL I 100 in feet below Land surface: 150
MAKE (LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE I DIAMETER(inches) I IF GRAVEL ) I GRAVEL SIZE(inches)FROM(feet) ITO(feet)
Diameter of well including
PACKED: gravel pack(inches):
DEPTH FROM LAND SURFACE
FEET to FEET FORMATION DESCRIPTION Sketch exact location of well with distances,to at least
two permanent landmarks.
0 5Gravel
15 24 Clad'
24 3 5 Red mock
0Lj'�
i qe
q
1�
p J cj' C
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If yield was tested at different depths during drilling, list below 17 t
FEET GALLONS PER MINUTE —
C�
DATE WELL COMPLETED I PERMIT NO. REGISTRATION NO. !DATE OF REPORT' WEL�DRI� signatu ) �
DEPT. OF ENVIRONMENTAL PROTECTION � WATER RESOURCES