HomeMy WebLinkAboutWell New 532 Strong Road WELL DRILLING BOARD STATE OF CONNECT CUT PERMIT NUMBER
WD54 11-69 WELL DRILtiNG'PERMIT 3 912-7
- STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115
LOCATION OF WELL (Tows) (Straat) (Lot Numbar) DATE
R OF WELL
SOU
OWNE TH WINDSOR STRONG ROAD 6 , 4/18/77
❑ INDIVIDUAL' BUILDER ❑ OTHER(Specify) RICHARD BELLEY
OWNER'S ADDRESS
20 WILLOW ST. , S. WINDSOR, CONN.
PROPOSED TEST Est.No.of
a DOMESTIC ' ❑ ESTABLISHMENT ❑BUSINESS FARM ❑ WELL People being
USE OF served.
WELL PUBLIC OTHER
❑ SUPPLY ❑ INDUSTRIAL ❑ CIONDITIONING ❑ (Specify)
5
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 lot and to house(if present)
Indicate North u�1L
S�,Qo A) &- 2 D.
-- 47-,4e 0 .vCZ R o 4,
Approximate number of feet from well to
nearest source of.possible contamination: r]
5.
The!undersigried is-aware-that upon completion-of the well,a r Welll 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 pwner,the Board and the Water Resources Commission on the form.provided by the
Board.This permit is not valid until all information is filled in and It has bebn counter-signed by the Director of Health or his agent. '
PPLtCANT( urs) (APPLICANT'S ADDRESS (REGISTRATION NO.
N CON1T. 100 .
Health 0 r o ent) I DATE
® APPROVED ❑ REJECTED '
REMARKS
or
RETURN THIS^.COPY TQ CONNECTICUT WELL DRILLING BOARD
k
WELL COMPLETION-REPORT STATE of CONNECTICUT - Do NOT fill in
WD64 12.69 REV.9-71 WELL DRIUkING BOARD STATE WELL NO.
State Office Building
HARTFORD,CONNECTICUT 06115
OTHER NO.
NAME ADDRESS
OWNER
RICHARD X9= I 20 WILLOW ST.' &winsoR COST
LOCATION (No.&Street) (Town) _ (Lot Number)
OF WELL S- ONG ROAD S. WMS(R
BUSINESS
PROPOSED ® DOMESTIC ❑ ESTABLISHMENT El FARM ❑ TEST WELL
USE PUBLIC AIR OTHER
WELLL ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify)
DRILLING
IR ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ (Specify)
CASING
LENGTH(feet) I DIAMETER,(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING'
GROUTED?
DETAILS I 1 I 9*45 THREADED ❑ WELDED I �YES ❑NO ❑YES : �NO
_
" HOURS YIELD(G.P.M.)
YIELD ❑ BAILED ❑ PUMPED ® COMPRESSED AIR I 6 10
' TEST
MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST L (feet)'- I Depth of Completed Well
LEVEL �
WATER 0 135 JI in feet below Land surface: .175
W
MAKE I LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well including I GRAVEL SIZE.(inches)�FROM(feet) �TO(feet)
PACKED: gravel pack(inches):
DEPTH FROM LAND SURFAC FORMATION DESCRIPTION Sketch exact location of well with distances,,to at least
FEET to FEET two permanent landmarks.
0 2 To soil
2 18 - S
330 Hardpan
j cf E soy
-If yield was tested at different depths during drilling,list below
FEET GALLONS PER MINUTE
DATE WELL COMPLETED I PERMIT NO. REGISTRATION NO. I DATE OF REPORT I WE VLLE (Sigma ure) y
(�U i
BOARD ;
« a
WELL COMPLETION REPORT STATE OF CONNECTICUT DO NOT fill in
WDB-5 12-69 REV.9-71 WELL DRILLING BOARD
State Office Building STATE WELL NO.
HARTFORD,CONNECTICUT 06115
OTHER NO.
NAME ADDRESS
OWNER U z�#� ;�+ egpg �t S. T' ri
LOCATION (No.&Street) (Town) (Lot Number)
OF WELL TIRUI R _D S. V-j7T,,TT1 j
BUSINESS
-PROPOSED
DOMESTIC ❑ ESTABL SHMENT ❑ FARM ❑ TEST WELL
USE OF
WELL PUBLIC AIR❑ THER
SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING El (Specify)
DRILLING COMPRESSED CABLE OTHER
ROTARY ❑ AIR PERCUSSION El PERCUSSION ❑ (Specify)EQUIPMENT y)
CASING LENGTH (feet) DIAMETER (inches)_ WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
DETAILS I I 1 -4 I 0 THREADED ❑ WELDED I i]YES ❑NO ❑YES NO
HOURS YIELD(G.P.M.)
YIELD TEST ❑ BAILED ❑ PUMPED COMPRESSED AIR 10Depth MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) De
WATER p of Completed Well
LEVEL 40 ( 135 ( in feet below Land surface: 175
MAKE I
LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of.well including GRAVEL SIZE(inches)(FROM(feet) ITO(feet)
PACKED: gravel pack(inches):
DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances,to at least
FEET to FEET two permanent landmarks.
0 2 Tonsoil
5+%zx tr9� Sa
01 17
A/ cl
i
If yield was tested at different depths during drilling, Fist below
FEET GALLONS PER MINUTE
Z; '6 .
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT WE L—B ILLE (Signs ure)