HomeMy WebLinkAboutWell New 910 Strong Road CP k8 Rev.7/95 PERMIT NUMBER
STATE OF CONNECTICUT 183249
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE&PROFESSIONAL TRADES DIVISION
WELL DRILLING PERMIT
165 Capitol Avenue,Hartford,Connecticut 06106
LOCATION OF WELL (Town) (St+eef) (Cot Number) DATE
S. WINDSOR 910 STRONG RD. 2 10/29/97
OWNER OF WELL
El INDIVIDUAL a BUILDER OTHER(Specify)
VWNERSADDRESS � ;70 )—
TODD MANNARINO 1169 ELLINGTON
PROPOSED ® DOMESTIC BUSINESS FARM Est.No.of
USE OF ESTABLISHMENT TEST People being
WELL WELL served.
PUBLIC
SUPPLY El INDUSTRIAL CONDITIONING OTHERI 4
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 v Well location on to and to house if resent)
Indicate North
w
Approximate number of feet from well to
nearest source of possible contamination: Sanitary Severs
The undersigned is aware that upon completion Of the well,a ell 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
*dTOpctor of Health or bis agent.
AMNT7n� APPLICANTS ADDRESS REGISTRA
TION N0.
men-- ,..�, P.O. BOX 406, WILLINGTON, CT. 42
BY(Town Heahh 5 cerorAgent) DATE
ROVED ❑ REJECTED REMARKS —
/got- � to zit
RETURN THIS COPY TO DEPARTMENT OF CONSUMER PROTECTION
CPR-9 Rev.7l95
STATE OF CONNECTICUT Do NOT Ott In-
r& SIP DEPARTMENT OF CONSUMER PROTECTION STATE WELL NO
REAL ESTATE&PROFESSIONAL TRADES DIVISION
WELL DRILLING COMPLETION DEPORT OTHER NO.
165 Capitol Avenue,Hartford,Connecticut 06106
OWNER NAME
ADDRESS
TODD MAl' NARINO 1169 ELLINGTON RD. , S. WINDSOR, CT.
LOCATION (No.&Street) (Town) (Lot Number)
OF WELL 910 STRONG RD. S- WINDSOR
2
DOMESTIC Q ESTABLISHMENT ❑ FARM Q WELL
PROPOSED
USE OF WELL
Q PUBLIC Q INDUSTRIAL F AIR ❑ OTHER
SUPPLY CONDITIONING (Specify)
DRILLING ROTARY COMPRESSED CABLE OTHER
EQUIPMENT AIR PERCUSSION PERCUSSION (Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING'GROUTED?DETAILS / .4� THREADED ® WELDED
YIELD TEST BAILED PUMPED COMPRESSED AIR HOURS YES ❑ NO YES ❑ NO
YIELD(GPM)
WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet) DURIN25 G YIELD TEST(feet) De
pth epth of Completed Well in feet
LEVEL '
MAKE .115 165
SCREEN LENGTH OPEN TO AQUIFER(feet)
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well GRAVEL SIZE(inches) FROM(feet) TO(feet)
PACKED: including 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 46 TOPSoil & Sand
46 IG6 Gravel & Clay �
106 1-55 Bed ,
'3
hl-b
If yield was tested at different depths during drilling,list below
FEET GALLONS PER MINUTE
a
Aj
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT
L DRIL
DFPT. OF ENVIRONtWNTA,B PR0TF(TInNialt ATFR RF:-q )IIRrF:.