HomeMy WebLinkAboutWell Correspondence 11 Stonefield Trail ,OWN Sfq ®\
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Dear Homeowner:
The Town of South Windsor Health Department's goal is to keep you informed about the
status of water quality throughout the town whether you are served by and individual well
or by a public water source.
In an attempt to better serve you, we have reviewed our files to ensure we have the
most recent and accurate information possible. Our review has revealed that we do not
have any information regarding how your residence receives its water.
We are hopeful that you will take a moment to help us keep our records current. Please
indicate the type of water service by circling the appropriate entry below and return this
letter no later than in February 27, 2009, in the self addressed stamped envelope
provided.
If,you receive your water from a private well, please let us know the location as it relates
to your home by providing two measurements from the foundation to the well in the
space provided and let us know if the well is used for domestic, lawn and garden, or
agricultural use. See example below.
Thank you in advance for your cooperation.
Any questions can be addressed to the South Windsor Environmental Health Officer,
Robert De Vito at 860-644-2511, extension 248.
Water service:
Circle the appropriate service:
WELL MDC T WA2
WELL USE: DOMESTIC LAWN & GARDEN AGRICULTURAL
Well Location :
BACK DRAWING:
40 FT KECS\fED
A',, , FRONT B
30 14 FT �
WELL SOUTH wINDSOR
ENGINEERING DEPT
STREET
40,
4
CPR-8 Rev.7/95 PERMIT NUMBER
STATE OFCONNECTICUT 211363
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE&PROFESSIONAL TRADES DIVISION
WELL DRILLING PERMIT
165 Capitol Avenue,Hartford,Connecticut 06106
LOCATION OF WELL (rown) (Sliest) (tot Number) DATE
S.WINDSOR 11 STONEFIELD ..'t'� 2/25/02
OWNER OF WELL
9 INDIVIDUAL BUILDER OTHER(Specify)
OWNER'S ADDRESS
PAGANELLI CONST. P.O. BOX 652, S.WINDSOR
Est.No.of
PROPOSED X DOMESTIC BUSINESS FARM TEST People being
USE OF ESTABLISHMENT WELL
WELL served.
AIR
SUPP Y INDUSTRIAL CONDITIONING OTHER4
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 to and to house(if present)
Indicate North
Mltia' 44
ILA
S'rotJi I�.P
TO . .
Sl'ofjwi LTU3 7!L
Approximate number of feet from well to
nearest source of possible contamination- - ABANDONMENT
The undersigned is aware that upon completion of the well,a"Well.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-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.
AP LICANT(Sign APPLICANTS ADDRESS REGISTRATION NO.
P.O. BOX 406, WILLINGTON, CT. 42
BY(Town Health Officer orAgent) DATE
�PPROVED ❑ REJECTED P.O �
REMARKS �/ 2
RETURN THIS COPY TO DEPARTMENT OF CONSUMER PROTECTION
CPR-g Rev.7/95 - '�►s
Do NOT fill in
STATE OF CONNECTICUT STATE WELL NO.
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE&PROFESSIONAL TRADES DIVISION OTHER NO.
WELL DRILLING COMPLETION REPORT
165 Capitol Avenue,Hartford,Connecticut 06106
OWNER ADDRESS
PAGANELLI CONST. -P.O. BOX 652, SUFFIEDL
LOEATION (No.tt SftW) (Town)' (Lon Numtxu)
OF WELL 11 STONEFIELD TR. S.WINDSOR
DOMESTIC BUSINESS FARM TEST
PROPOSED X ESTABLISHMENT- WELL
USE OF WELL a PUBLIC INDUSTRIAL Q AIR OTHER ABANDONEMENT
SUPPLY CONDITIONING
DRILLING ROTARY COMPRESSED CABLE OTHER
EQUIPMENT AIR PERCUSSION PERCUSSION (Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
DETAILS ❑ THREADED1:1 WELDED ❑ YES ❑ NO• JOYES ❑ NO
YIELD TEST BAILED a PUMPED COMPRESSED AIR HOURS YIELD(GPM)
WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet) OURING YIELD TEST(feet) Depth of Completed Well in feet
LEVEL 80 •
MAKE LENGTH OPEN TO AQUIFER(feel)
SCREEN
DETAILS SLOT SIZE DIAMETER(inches) I GRAVEL Diameter of wall GRAVEL SIZE(uxs) FROM(feet) TO(feet)
f I PACKED: vxtudng gravel pack
(inches)
DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances,to at least two
FEET TO FEET permanent landmarks
0 80 CEMENTED
If yield was tested at different depths during drilling,list below
FEET GALLONS PER MINUTE
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT ER(Signature)
2/27/02 211363 42 5/20/02
AGENCY
CPR-g Rev.7/65 • : _
STATE OF CONNECTICUT Do NOT Fill in
DEPARTMENT OF CONSUMER PROTECTION. STATE WELL N0.
REAL ESTATE'&PROFESSIONAL,TRADES DIVISION
WELL DRILLING COMPLETION REPORT orHER No.
165 Capitol Avenue,Hartford,Connecticut 06O
106
OWNERENAMEs �vADDRESs �} �e rqg�ap�
's THi:slte6.wFa7o- « s. VLf, ulr L7VS.4L.at
LOCATION (No.&Street) (Town)
OF WELL `'Q.. ",P:E r .o- lLot Number)
WtF4D oR
DOMESTIC BUSINESS Q FARM
PROPOSED ESTABLISHMENT TEST
USE OF WELL WELL
PUBLIC Q INDUSTRIAL 1:1AIR t
SUPPLY Cab OTHER ANDONEIMEE,•NT
DRILLING ROTARY CONDITIONING (Specify)
COMPRESSED a CABLE OTHER
EQUIPMENT AIR PERCUSSION PERCUSSION Q
(Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT
DETAILS THREADED WELDED
DRIVE SHOE WAS CASING GROUTED?
❑ �
YIELD TEST Q BAILED a PUMPED ❑ YES ❑ NO• ❑ YES ❑ NO
❑ COMPRESSEDAIR HOURS
YIELD(GPM)
WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet) DURING YIELD TEST(feet)
LEVEL Depth or completed Wen in teat
MAKE 80
SCREEN LENGTH OPEN TO AQUIFER(feet)
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL
Diameter well GRAVEL SIZE(inches) FROM(feet)PACKED: including gravel pack TO(feet)
DEPTH FROM LAND TO SURFACE FOR MATION DESCRIPTION (inches)
Sketch exact location of well with distances,to at least two FEET TO FEET permanent landmarks
"#-'
If yield was tested at different depths during drilling,list below #�
FEET GALLONS PER MINUTE
t
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO.
DATE OF REPORT ER(Signature)
J 20/