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of well location to com pleted 'or
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Location Of,
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Type of well ove):
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point, d-aa
'Diameter
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Wor1;details and D'pth of ivell:
other• information: nth {
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1Yame of r�'g e b °f casing:
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egistered well drilling contra ctor' Ming vvorlc:
lbraterials s license type #, s
ntOfsand
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type(s) °fgrout
Description ot'rvorl; completed:
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765 P (well dt°illiag
Ca itolAvenue b contractor
flax:(860 ' Hartford, Co )
At. )566-7610 p ecticut 06106-163
Aflirrnafivc TD : (860 U
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REGULATIONS FaR_VVI LL ABANDONMENT
(Regulations of Connectictit State Agencies)
Sec. 25-128-56: Abandonment of wells, responsibility
Any well that is abandoned shall not be a source or cause of contamination or pollution of ground water resort
Abandonment procedures shall be performer] or directed only by a aegistered well driller. The registered well u
contractor who performs the work of abandonment shall be responsible for compliance ww-ith the procedure of a resources.
Ment of the well, as provided in this part and shall notify the local health authority of the abandonrn drilling
bandon-
(Effective May 21, 1993) ent of the well.
Sec. 23-128-57. Procedure of abandonment
In the event of abandonment of any water well or other type of well the properro
Procedure and materials shall
as follows: be used
(a) The well shall be plugged to prevent the entrance of surface water, circulation of water between or among p ro-
tiucing zones, or any other process resulting in the contamination or pollutions of ground water resources.
b
b) In the event of temporary abandonment or discontinuance of the use of any wvell, the well shall be sealed with
wvatertiglht cap or seal, as provided by Section 25-128-42 (c). th a
(c) The well shall be chlorinated prior to abandonment using a chlorine solution with a minimum concentration
hundred fifty parts per million (150 ppm) of chlorine. This is equivalent to 5.5 quarts of bleach at 2.2 0
chlorine to five hundred (500) gallons of water or three hundred thirty-three (333) feet ol'six 6 ion of one
/, available.
(d) The well shall be checked Pram land surface to the entire depth of the wve[I before it is sealed,-to iitsttre ate• '
( ) inch diameter well.
presence of any obstruction that will interfere with sealing operations. b�iinst the
(e) The well bore shall be filled and sealed.with any of the following materials: heat cement grout,sand cement grout,
bentonite bentonite clay grout, or sand clay or bentonite cement grout.
(1) The grout material shall be placed in such a way to prevent voids in the grout or dilution of the grout.
(g)Any well constructed in a consolidated rock formation, may be filled with fine sand in the zone or zones of
dated rock. The top of the sand fill shall be at least ten (10) feet below the bottom of the casing, and the remaining poi-_
tions of the well shall be tilled with any of the materials specified in subsection (e). coiiso[i-
(h) Any test Well or bore shall be lbandoned in such a manner that it does not become a channel for the vertic
movement of water or other substance to the potable ground water resources, al
(i) Beep waste disposal or oil wells with casings tree of any breaks, and extending below the potable a water
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zones, may be sealed with a water right cap or welded plate,
b Zt(r
U) Upon completion of abandonment of the well,the top of the casing or grout material may be terminated a
four(4) feet below the ground surface. t least
(Effective May 21, I993)
SKETCH OF 'WELL LOCATION
Sketch exact location of well with distances to at least two permanent landmarks
hidicate North
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