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Home My WebLink AboutWell Correspondence 287 Strong Road Dec 15 09 09: 17a Cindy Silvestri 8G02918979 P. 1 STATE OF CONNECTICUT DEPARTMENT OF PUBLIC H-EALTH �QV/ �/StdEt r November 23, 2009 Arthur Silvestri 287 Strong Road South Windsor, CT 06074 WATER SYSTEM: South Windsor Stone and Landscape Supply CLASSIFICATION TYPE:.Private TOWN: South Windsor PWSID:N/A DW S Project#: 2009-0472 Subject: South Windsor Stone and Landscape Supply, screening determination Dear Mr. Silvestri: The Department of Public Health Drinking Water Section (DWS)has received your public water system information form. Pursuant to the Regulations of Connecticut State Agencies(RCSA) Section 19-13-B 102(a)(57), a public water system serves at least 25 people for at least 60 days out of the year. Casey Fleming of my staff had the opportunity to discuss your landscape supply establishment with Cindy Silvestri on October 20,2009 to clarify the information you provided. As you have stated 1 understand that South Windsor Stone and Landscape Supply will not have a public bathroom or drinking fountain and will therefore not meet the above definition of a public water system. The proposed private water system is under the jurisdiction of your local health department. Please contact the South Windsor Health Department for more information or any local requirements. If at any point the service provided by this water system is increased to meet the above definition of a public water system,you are required to submit a Screening Application for Water Companies to this office. If you have questions regarding your application,please contact Casey Fleming at this office. 1 Sincerel i9 Steve Mesker '�-- Supervising Sanitary Engineer Drinking Water Section Cc: Gerald Schwartz, South Windsor Health Department Phone: (860) 509-7333 ". , Telephone Device for the Deaf (860) 509-7191 410 Capitol Avenue-MS#51 WAT P.O. Box 340308 Hartford CT 06134 Affirinative Action%An Equal Opportunity Employer CPR-8 Rev.7/95 PERMIT NUMBER STATE OF CONNECTICUT 246158 DEPARTMENT OF CONSUMER PROTECTION REAL ESTATE&PROFESSIONAL TRADES DIVISION WELL DRILLING PERMIT I GS Capitol Avenue,Hartford,Connecticut 06106 LOCATION OF WELL (Town) (Street) (Lot Number) DATE South Windsor 287 Strong Rd 10/20/09 OWNER OF WELL INDIVIDUAL BUILDER OTHER(Specify) 9 8 2—7 4 28 OWNER'S ADDRESS Art Silvestri 724 Strong Rd South Windsor Est.No.of PROPOSED DOMESTIC a BUSINESS FARM TEST People being USE OF ESTABLISHMENT WELL served. WELL a SUPP Y ,a PUBLIC INDUSTRIAL � CONDITIONING F s OTHER '(Specify)",--, 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) rz Indicate North oS o L So Approximate number of feet fr well to nearest source of possible ntamin ' n: 30' to sWale The undersigned is a that n completion of the well, a"Well Completion Report"containing construction details and information required under Section 25-131 of 1969 plement to the General Statutes must be sent to the owner, the Department of Consumer Protection and.the Water Resources Co sion a form rovided by the agency. This permit is not valid until all information is filled in and it has been counter-signed by the Director , ealt agent: APPLICA rgnatu AP 1GANT'SA RESS REGISTRATION NO. P 30 406 Will 42 B (T H h Ofc or A Q DATE APPROVED REJECTED REMARKS DIRECTOR OF HEALTH STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH DRINKING WATER SECTION PUBLIC WATER SYSTEM INFORMATION FORM Water System/Property Name" ISV'2T 1 LVI 6):"!- /Li<;J PWSID"CT (If applicable) Address of Water System 2 .- 5 C.' Town Facilities and/or businesses supplied by water system: What is the source of the water supply for this location?: on site well customer of a water company If the response to the above question was'customer of a water company',please atta py of your most recent water bill so that you can be removed from our inventory.It is not necessary to complete the next 8 items if you are a customer of a water co.and attach a copy of your bill. Water System annual operating period(begin/end dates of operation): From / To Z131 month/day month/day Does this water system supply water to a licensed food service establishment?: Ye se No Does this water system supply water to a public restroom,public sink and/or public drinking fountain?: Yes No (A public restroom,sink or fountain is one that is located in a common area with public access for transient customers,visitors and/or me rs.) Does this water system supply water to a(circle all that apply): hotel/motel municipal building gas station medical facility rest area library park/recreation area campground place of worship Do at least 25 persons(including employees, customers, parishioners,visitors, etc., but not necessarily the same persons)visit the facilities/businesses supplied by the water system daily at least 60 days out of the year? Yes` No Number of same persons(i.e. employees,students, but not residents)regularly using facility on a daily basis for at least 6 months a year: Number of persons whose primary residence is supplied by the water system: Number of service connections(buildings or units supplied by wat ystem): I certify this information to be correct. Signature Armwo.— -e N me(Please Print) Title Relationship to property(owner,operator,tenant, etc.) �+ Q L'— - f f 0 ,/t�—�I Phone ate Return signed form to: CT Dept.of Public Health,Drinking Water Section or fax to: (860)509-7359 TNCPWS Information Form Re:TNCPWS Information Form 410 Capitol Ave.,MS#51 WAT P.O.Box 340308 Hartford,CT 06134