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Home My WebLink AboutWell Repair 23 Windshire Drive CONSUMER PROTECTION fe)�.% ice WELL DRILLING BOARD STATE-OF CONNECTICUT PERMIT NUMBER CPR-8 REV.11-82 DEPARTMENT OF CONSUMER PROTECTION 86827 - WELL DRILLING PERMIT _. 165 CAPITOL AVE.;HARTFORD,CONNECTICUT 06106 LOCATION OF WELL(TOWN) (Street) (Lot Nuxm DATE S. WD DSOR WINDSHIRE DR. . 12 5/11/84 OWNER OF WELL ❑ INDIVIDUAL ❑X BUILDER ❑ OTHER{Specify) CAMMU14ITY PLAKNERS 242-2115 OWNER'S ADDRESS 127 SCHOOL 'ST. , BLOOMFIELD, CT. 06002 PROPOSED BUSINESS TEST Est.No.of a DOMESTIC" ❑ ESTARLKHMENT a FARM ❑ WELL People being USE OF PUBLIC- AIR OTHER served. WELL ❑ SUPPLY ❑ INDUSTRIAL � CONDITIONING ❑ (Specify) 4 • i 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) 0 •� Indicate North Q D. G D� XL".M IN X . c�r,� 2f vF vLffli' 416- /{{ice Ax Approximate number of feet from well to nearest source of possible contamination: The undersigned is aware that-upon completion of the well, a "Well Completion Report" .contoiriinq construction details and -information required under Section 25.131 of the 1969 Supplement-to the-General Statutes must be sent to the owner, 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 been counter-signed by the Director of Health or his agent. A ( gsatsn) APPLICANT'S ADDRESS REGISTRATION NO. -- .0. BOX 111. S. WILLINGTON, CT, 100 BY(Tows Hea)tb Officer or Ages) DATE PPROYED ❑REJECTED - 3— � (� REMARKS RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD WELL COMPLETION REPORT STATE of coNNEcncur cPe_g REV.tt_s2 DEPARTMENT"`OF CONSUMER PROTECTION Do NOT fill in WELL,DRILLING BOARD STATE WELL NO. 165 CAPITOL AVE. HARTFORD,CONNECTICUT 06106 OTHER NO. OWNER NME ADDRESS -A LOCATION (No. g Street). .' & HOOL T,, BWOITM,L • OF WELL S m DR a (Town) t } (Lot Numb BUS[NESS re�r) w DOMESTIC ESTABLISHMENT HMENT PROPOSED FARM USE OF TEST WELL WELL ❑ SUPP` I INDUSTRIAL CONDITIONING (Spec, DRILLING COMPRESSED CABLE OTHER EQUIPMENT . ROTARY AIR PERCUSSION PERCUSSION (Specify) CASING LENGTH (feet) DIAMETER(inches) WEIGHT PER FOOT VE O WAS CASING GRO TED? DETAILS . ft THREADED WELDED YES NO YES NO YIELD HOURS YIELD (G.P.M.) TEST BAILED PUMPED COMPRESSED AIR 20 WATER- MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) LEVEL Depth of Completed Well in feet below Land surface: MAKE LENGTH OPEN TO A UIFER (feet) SCREEN DETAILS SLOT SIZE; DIAMETER(inches) GRAVEL SIZE(inches) FROM(feet) TO(feet IF GRAVEL Diameter of well includirig PACKED: grovel pack(inches): .; DEPTH FROM LAND SURFACE - FORMATION DESCRIPTION „4-Sketch exact locatipn of well with distances, to at least FEET TO FEET two permanent landmarks. t Etl� r - -20 15 thL ,> 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 WE LLER (Signature)- I)FPT- OF FNVIIdMIAACKITAI DDe%T1rr1ri^D.r easn- ....a....s�__ AtowM s�� Z 1540 SULLIVAN AVENUE• SOUTH WINDSOR, CT 06074 �OsoR.co�'� TELEPHONE(860) 644-2511 October 11, 2001 A,5 Joan Segal 23 WindseMtrs-RIIaT` South Windsor, CT 06074 Dear Ms. Segal: At your request a sample of your well water was collected and analyzed at the State Health Department Laboratory for trichloroethene and other compounds. As is evident by the enclosed report none was detected. If you have any questions please call me at 644-2511 extension 248. Yours truly, Robert Deptula, R.S. -Environmental Health Officer RD/cm if I� I STATE OF CONNECTICUT • Department of Public Health Division of Laboratory Services INR;-WIN72—:33 1 b 129237 IA00142 0 Ll 10 Clinton St. P.O.Box 1689 INFORMATION Hartford,CT 06144 132SOUTH W I NDSOR TELEPHONE:(860)509-8500 SEGAL �— 23 WINSHIRE SOUTH WINDSOR CT 06074 DEP—P.E.R.D. POTABLE WATER 79 ELM ST. 09/06/01 09/07/01 09/17/01 L HARTFORD CT 06106 � 12:45 08:40 08:47 REPORT FINAL REPORT COMMENT TEST(S) RESULT(S) SAMPLING POINT; RAW WATER COLLECTOR; SENYK , M I CHAEL TITLE: ANALYST DATE ANALYZED 9/8/01 ---------------------------------------------------------- ANALYTICAL METHOD: EPA METHOD 5:24.2 MEASUREMENT OF ORGANIC COMPOUNDS IN WATER BY CAPILLARY COLUMN GAS CHROMATOGRAPHY/MASS SPECTROMETRY. ---------------------------------------------------------- EPA 524.2 INAL RESULT: COMPOUND QUANTITY (UG/L) ENZENE ND ROMOBENZENE ND ROMOCHLOROMETHANE ND ROMODICHLOROMETHANE ND ROMOFORM ND ROMOMETHANE ND --BUTYLBENZENE ND EC—BUTYLBENZENE ND ERT—DUTYLBENZENE ND ARBON TETRACHLORIDE ND HLOROBENZENE ND HLOROETHANE ND HLOROFORM <,0.5 • HLOROMETHANE: ND � � �� CHLOROTOLUENE ND —CHLOROTOLUENE ND SEP 1 9 2001 IBROMOCHLOROMETHANE ND 1 ,2—DIBROMO-3—CHLOROPROPANE ND 1 ,2—DIBROMOETHANE ND WATER MAR;8EMENT BUREAU DIBROMOMETHANE ND 1 ,2—DICHLOROBENZENE ND 1 ,3—DICHLOROBENZENE ND 1 ,4-DICHLOROBENZENE ND I CHLOROD I FLUOROMETHANE ND R��l�� 1 , 1—D I CHLOROETHANE ND 1 ,2-DICHLOROETHANE ND CONTI r UED * :ORM NO.OL-6A REV.10-99 STATE OF CONNECTICUT I.D. ACCESSION NO. • Department of Public Health Division of Laboratory Services �NR-'WIN23 116129237 IA00142 10 Clinton St. P.O.Box 1689 INFORMATION Hartford,CT 06144 132SOUTH WINDSOR TELEPHONE:(860)509-8500 SEGAL F 23 WINSHIRE SOUTH WINDSOR CT 06074 DEP—P.E.R.D. POTABLE WATER 9 79 ELM ST. 09/06/01 L 12,'45 HARTFORD CT 06106 REPORT COMMENT MMM7��R�ESULT(S)— TEST(S) -1. 71—DICHLOROETHENE ND `IS-1 ,2—DICHLORDETHENE ND RANS-1 ,2---DICHLOROETHENE ND ,Z—DICHLOROPROPANE ND ,3—DICHLOROPROPANE ND 2,2—DICHLOROPROPANE ND 1 , 1—DICHLOROPROPENE ND --IS-1 ,3—DICHLOROPROPENE ND TRANS-173—DICHLOROPROPENE ND —7THYLBENZENE ND iEXACHLOROBUTADIENE ND ISOPROPYLBENZENE ND 4—ISOPROPYLTOLUENE ND IETHYLENE CHLORIDE ND IETHYL T—BUTYL ETHER ND qAPHTHALENE ND aROPYLBENZENE ND 3TYRENE ND 1 , 1r1y2—TETRACHLOROETHANE ND l , 1v2,2—TETRACHLORDETHANE ND rETRAtHLORDETHENE ND rOLUENE ND ,2,3—TRICHLOROBENZENE ND 1 ,2,4—TRICHLOROBENZENE ND C; V7 1 , 171—TRICHLOROETHANE ND pIc— 1 , 1 ,2—TRICHLOROETHANE ND rRICHLOROETHENE ND SEP 1 tRICHLOROFLUOROMETHANE ND 1 ,2,3—TRICHLOROPROPANE ND VJATER OURF-AU 1 ,2,4--TRIMETHYLEEN2.ENE ND 1 ,3,5—TRIMETHYLBENZENE ND VINYL CHLORIDE ND I,OYP—XYLENES (TOTAL) ND N3TE; ND = NONE DETECTED f�/�+j/U Mr—THOD DETECTION LIMIT IS 0.5 UG/L FOR ABOVE CIMPOUNDS. ------- END OF REPORT FORM NO.OL-6A REV.10-99