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HomeMy WebLinkAboutWell Repair 151 Windsorville Road WELL COMPLETION REPORT STATE OF coNNEcncuT 7NO. CPR-9REV.11-82 DEPARTMENT OF CONSUMER PROTECTION'- T,fill in WELL DRILLING BOARD STATE W 165 CAPITOL AVE.` HARTFORD, CONNECTICUT 06106 OTHER NO. NAME 7RESS OWNER Rel-c.hl e_. W-4,4r011V6 �A� l�s t �v rr jl s o�� e 7-" LOCATION (No.& Street) 1 (Town) (Lot Number) OF WELL r 5'! 60,17d so'.-V'W e_ R a1. �o ce l fl Gr1:nd 5c� 6-e er lho vs e_ BUSINESS PROPOSED El DOMESTIC ESTABLISHMENT ESJ FARM LISE OF TEST WELL PUBLIC r] WELL SUPPLY INDUSTRIAL a CONDITIONING (specify)((THER Specify) EQUMMENT LJ ROTARY AIR PERCUSSION L PERCUSSION Fi((Specify) GATING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT 1 WAS CASING G TED? DETAILS J.5'� !'7 THREADED WELDED YES NO YES RM NO YRILD HOURS TEST © BAILED PUMPED COMPRESSED AIR 1[ YIELD (G.P.M.) WATO MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) 7 �� LEM / Depth of Completed Well o�(o� in feet below Land surface: '?4-ey SCREEN MAKE LENGTH OPEN TO AQUIFER (feet) . DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well including GRAVEL SIZE(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. 13C) /ys' fi1QRt�� G ,2 61Y A/00s t El- 01 0 Q n /dry' H yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE . '70 r '0t9GttifB- P'9 Ve t> BJ2ft1�t.�Ri W�t Aa°itVC, i> DATE WE l COMPLETED Tpi' RMIT NO. REGISTRATION NO. DATE OF REPORT WELL DRILLER(Signature) /;i+��.'1�