HomeMy WebLinkAboutWell Correspondence 73 West Road WELL COMPLETION REPORT STATE Of CONf4ECTItUT
CPR-9 REV.11-82 - DEPARTMENT OF CONSUMER PRtJTECI'It3W. DO NOT fill in
WELL DRILLING BOARD STATE WELL NO.
165 CAPITOL AVE.
HARTFORD,CONNECTICUT 06106 OTHER NO.
NAME ADDRESS
QWKER I Y' B aCtrd� I fi
LOCATION e7 (No. & Street) -- (Town) (lot Number)
OF WELL f 3 T IRD s S a MDSM 0,d
BUSINEESTABLISHMENT
PROPOSEDSEFDOMESTIC FARM � TEST WELL
USE OF
PUBLIC
WELL ❑ AIR SUPPLY INDUSTRIAL CO OTHER CONDITIONING �(Specify)
ING
DRILL MD CABLE o� OTHEREPMENT �ROTARY ARPERCUSSION PERCUSSION
(Specify)
CASING LENGTH (feel) DIAMETER (inches) WEIGHT PER FOOT WAS CASING GROUTED?
DETAILS ("t• THREADED WELDED l ES H❑NO a YES NO
a
YIELD n HOURS
TEST LJ BAILED � PUMPEDElCOMPRESSED AIR r YIELD(G.P.M)
WATER MEASURE FROM LAND SURFACE—STATIC(Specify feer) DURING YIELD TEST(fee
LEVEL GLISJ Depth of Completed Well
in feet below Land svrface:
285
MAKE
SCREEN LENGTH OPEN TO AQUIFER (feet)
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of ll including GRAVEL SIZE (inches) FROM(feet) TO(feet
PACKED: gravel pock (weincfres):
DEPTH FROM LAND SURFACE
FEET TO FEET FORMATION DESCRIPTION Sketch exact location of well with distances, to at least
two permanent landmarks.
15 90 Clair
90 285 Belt—Ock
t�
s
e
Or
If yield was tested of different depths during drilling, list below
FEET GA
LLONS PER MINUTE
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT WE LER(Signature)
DEPT. OF ENVIORNMENTAL PROTECTION-WATER RESOURCES