HomeMy WebLinkAboutWell Repair 111 West Road H wk!si RBI
WELL COMPLETION REPORT STATE OF CONNECTICUT
CPR-9 REV.11-82 DEPARTMENT OF CONSUMER PROTECTIONDO NOT.fill.�in
STATE WELL NO.
WELT.DRILLING BOARD
165 CAPITOL AVE,
HARTFORD, CONNECTiCUT 06106 OTHER NO.
NAME ADDR
OWNER Alexsander Goldszmidt 188 Russ St. , Hartford, GT.
LOCATION (No. & Street) (Town) (lot Number)
OF WELL West Road South /Windsor
BUSINESS
PROPOSED � DOMESTIC � ESTABLISHMENT � FARM � TEST WELL
USE OF
PUBLIC AIR EJ
S9fE11 SUPPLY ❑ INDUSTRIAL CONDITIONING ((THER Specify)
DRILLING EQUIPMENT ® ROTARY � AIR PERCUSSSION � PERCUSSIOND CABLE OTHER
(Specify)
CASING LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT DRIVE SH WAS CASING GROUTED9
DETAILS 100 r 1THREADED WELDED YES NO ®YES NO
YIELD ( HOURS YIELD (G.P.M)
TEST BAILED LJ PUMPED COMPRESSED AIR
WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST (feet) Depth of Completed Well
LEVEL 3 0 0 in feet below Land surface: 300
MAKE LENGTH OPEN TO AQUIFER (feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of wail including GRAVEL 512E (inches) FROM(feet) TO(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 98 sand, gravel
90 300 1 granite
S�r�p
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 Ck DRILLER(Sig ire)
12/4/E 126952 10 12 �
DEPT. OF ENVIORNMENTAL PROTECTION-WATER RESOURCES