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CONSUMER PROTECTION ,;,.. .�.
WELL DRILLING•BOARD STATE OF CONNECTICUT PERMIT NUMBER
CPR.&REV.11-82 DEPARTMENT OF CONSUMER PROTECTION ' 15 6 085
WELL DRILLING PERMIT
165 CAPITOL AVE.,HARTFORD,CONNECTICUT 06106
LOCATION OF WELL(roam) (StrtetJ (Lot Number) DATE
S- WINDSOR BUCKLAND ROAD Well # 1 6/4/93
OWNER OF WELL
DIDWIDUAL BUILDER OTHER(Specify) SPAZZARINI CONSTRUCTION CO.
OWNER'S ADDRESS
50 POST OFFICE RD. , ENFIELD, CT. 06082
PROPOSED DOMEIUSINESS ❑ TEST Est.No.of
ElUSE Of
a. ESTAILISHMENT EARN WELL People being
_ .
WELL AIR Abandon- served.
SUS Y INDUSTRIAL CONDITIONING .OVER) Well
SKETCH OF WELL LOCATION
Locate well with respect to at least two roods,showing distance from intersection and front of lot
Location of lot to at least two roods Well location on lot and to house(if present)
IadioMts.North .
Zyt:of
o
• c.�c �,�N,d aftD ^
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' containing construction details and in 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 farm provided by the
Booed.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.
( ttratu APPLICANT'S ADDRESS REGISTRATION No.
O CT.g�APPROV� 100
BY(T ea(tb.Ojjictr or Agr J DA�TrE p
REIECT�
REMARKS
Yll''
ABANDON EXISTING SHALLOW TATETI ACCORDING TO STATE SPECS.
Pet" /-= ya �o
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT STATE OF CON14ECTKW '
CPR-9 EV.1142 DEPARTMENT OF CONSUMER PROTECTION Do NOT fill in
• 'STATE WELL NO.
WELL DRILLING BOARD
165 CAPITOL AVE.
HARTFORD,CONNECTICUT 06106 OTHER NO.
ABANDONED EXISTING WELL.
NAME ADDRESS
owNEit SPAZZARINI CONSTRUCTION CO 50 POST OFFICE RD. , ENFIELD, CT.
(No.i Street) (Town) (Lot Number)-
OF� BUCKLAND RD. S.WINDSOR WELL # 1
BUSINESS
❑ DOMESTIC ❑ ESTABLISHMENT ❑-FARM ❑ TEST WELL
IRE OF
t Elsu�PFLr ❑ INDUUSSTRIAL ❑ CCOONDITIONING OOSTpeecciiiiy) Abandoned Well
BpUIFMMENT ❑ ROTARY ❑ OTHE
RCUUSSION ❑ PERCUSSION- ❑(SPectfY)
CAfNFG LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT l cwSlHc II'�D9
DETAILS ❑THREADED ❑WELDED YES NO vES (J NO
HOURS YIELD(G:P.M.)
TW ❑ BAILED 1-1PUMPED ❑COMPRESSED AIR
of Completed Well
WATH RI
MEASURE FROM LAND SURFACE—STATIC(specify feet) DUNG YIELD TEST(feet) Depth
Llll� in feel below Land surface:
MAKE' LENGTH OPEN TO AQUIFER(feet)
iCRIfNI. -
DfRAU SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well including GRAVEL SIZE(inches)-FROM(feet) TO(feet
PACKED: grovel pack(inches):
DEPTH FROIIA LAND SURFACE FORMATION DESCRIPTION Skekh exact location of well with distances.to at least
FEET TO FEET two permonvid landmarks.
BANDONED EXISTING DUG WEL
ACCORDING TO STATE SPECS.
tp
B yield was sassed of diffaronf depths dur"ArNling,list below .
Ff t GALLONS PER MINUTE 10
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT LER(Sigrtahxe)
6/17/93 156085 100 6/2 1
21 93 �..
(BOARD
WELL COMPLETION- REPORT STATE of CONNEcncuT
CPR-9 REV.11-82 DEPARTMENT OF CONSUMER PROTECTION Do NOT fill in
WELL DRILLING BOARD STATE WELL NO.
165 CAPITOL AVE.
ABANDONEI? EXISTING ��! HARTFORD,CONNECTICUT 06106 OTHER NO.
FBU
ADDRESS
OWNER ZARINI CdTiTS`PR€7CTION CO 5f) PC}ST C3FF'ICE RD. s E1�IFIELD.. CT.
LOCATION (No. & Street) (sown)OF WEII LAND RD. (Lot Number)S-WINDSORWELL # I
rLINO FSTIC E TABLISHMENT FARM TEST WELL
Wql � AIR OTHER
SUPPLY INDUSTRIAL CONDITIONING ®(Specify) Abandoned Well
DMILING a COMPRESSED
EQLlMMENT ROTARY CABLE OTHER
AIR PERCUSSION PERCUSSION (Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT I
DETAILS W 6S CASs c,Ro_urEp7
THREADED WELDED YES NO Luj YES ❑NO
YEW HOURS
TEST ❑ BAILED a PUMPED Fl COMPRESSED AIR YIELD(G.P.M.)
MEAWATER FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet)
LEM Depth of Completed Well
in feet below Lond surfoce:
MAKE
SCREEN
LENGTH OPEN TO AQUIFER (feet)
DETAILS SLOT SIZE DIAMETER(inches)
IF GRAVEL Diameter of well including GRAVEL SIZE(inches) FROM(feet) TO(feet
PACKED: grovel Pock(inches):
DEPTH FROM LAND SURFACE
FEET TO FEET T{)ItMAi1QN DESCRIPTION Sketch exact location of well with distonces, to of least
two permonent londmorks.
LANDC9NED EXISTING DUG WEE
CCORDING TO STATE SPECS.
63
,-� 14
t
If yield was tested of different depths during drilling, list below
GALLONS PER MINUTE
_ > -f-i ✓
DATE WELL COMPLETED PERMIT NO, REGISTRATION NO: DATE OF REPORT
W LER(Signature)
DFPT CIF f`f�®/i�PtaeeRfett'-rna nntevrreTa.ge, ...._-- --
CONSUMER PROTECTION ,;;.. ..�.
WELL GRILLING-BOARD STATE OF CONNECTICUT PERMIT NUMBER
CPR-$REV.11-U DEPARTMENT OF CONSUMER PROTECTION 156085
WELL DRILLING PERMIT
165 CAPITOL AVE.,HARTFORD,CONNECTICUT 06106
LOCATION OF WELL(Town) (Street) (Lot Number) DATE
S. WINDSOR BUCKLAND ROAD : Well # 1 6/4/93
OWNER OF WELL
OlDri=AL BUILDER OTHER(Specify) SPAZZARINI CONSTRUCTION CO.
OWNER'S ADDRESS
50 POST OFFICE RD. , ENFIELD, CT. 06082
PROPOSED NESS TEST Est. No.of
D DOMESTK ESTABLISHMENT FARM WELL People being
USE OF _ .
WELL PUSUC AIR OTHER Abandon- served'
El SUPPLY � INDUSTRIAL � CONDITIONING �.(Specify) Well
SKETCH OF WELL LOCATION
Locate well with respect to of le'ost two roods,showing distance from intersection and front of lot
Location of lot to of least two roads Well location on lot and to house(if present)
Mdioofe North
l�Ei°nT _ . •
TIN 1A
Approximate number of feet from well to
nearest source of possible contamination:
The undersigned is aware "I upon completion of the well, a "Well 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 Board and the Water Resources Commission on•the farm provided by tFta
board.This permit is not valid until oil information is filled in and it has been counter-signed by the Director of Health or his agent.
(S win AF'PIICANT'S ADDRESS REGISTRATION NO.
-BOX 406, WILLINGTON, CT. 100
By(low lealtb.0 c r or Age J DATE
P�MMVED REJECTED f//�J
6 to--p3
REMARKS
ABANDON EXISTING SHALLOW WELL ACCORDING TO STATE SPECS.
4Lya �go
RETURN! THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT #STATE OF CONNECTICUT -
vR-v REV.1142 DEPARTMENT OF CONSUMER PROTECTION Do NOT fill in
• 'STATE WELL NO. .
WELL DRILLING BOARD
165 CAPITOL AVE.
HARTFORD,CONNECTICUT 06106 OTHER NO.
ABANDONED EXISTING WELL.
bVMAE ADDRESS
opt SPAZZARINI CONSTRUCTION CO 50 POST OFFICE RD. , ENFIELD, CT.
LOCATION (No.6 Street) (Town) (Lot Number)
OF WELL BUCKLAND RD. S.WINDSOR WELL # 1
SINESS
PEOPOSfQ ❑ DOMESTIC ❑ ES ABLISHMENT ❑.FARM ❑ TEST WELL
USE OF
WRA PUBLIC
❑ SUPPLY AIR OTHER
ElItIDUSTRIAL ElCONDITIONING a(SPecify) Abandoned Weil
caum RESSED CABLE OTHER
[QUMEIIENT' ❑ ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION- ❑(Specify)
CASNIG LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT A5 CASwG IED?
MAU El THREADED' 1-1 WELDEDYES NO YES NO
VWD HOURS YIELD G.P.M.)
TEST ❑ BAILED ❑PUMPED ❑COMPRESSED AIR
WAM MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Well
UNK in feet below Land surface:
MAKE LENGTH OPEN TO AOU1FER(feeq
EQWI.
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Oiomeror of well including GRAVEL SIZE(inches)-FROM(feet) TO(feet
PACKED: grovel pads(inches):
OM FROM LArbSURFACEFORMATION DESCRIPTION Sketch ewci location of well with distances,to at least
FEET"TO FEET two psmwneiii landmarks.
ABANDONED EXISTING DUG WEL
CCORDING TO STATE SPECS.
:t
14 €P
If vied was I, at dlffetenl depths duting.drilling,list below .
FEET GALLONS PER MINUTE
DATE WELL OOMPLETEO PERMIT NO. REGISTRATION No. DATE OF REPORT lER(Signotute)
6/17/93 156085 11 6 21 93
BOARD