HomeMy WebLinkAboutWell New 00 Oakland Road STATE OF CONNECTICUT WELL COMPLETION REPORT WATER COMMISSION DO NOT FILL IN
317 STATE OFFICE BUILDING This report must be completed and submitted to STATE WELL
HARTFORD 15, CONN. State Water Commission no later than 30 days OTHER NO. .. ,, ,
after completion of well.
WELL ,,-? �
OWNERf: s ? r ��
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WELL ✓dame :S a et
DRILLER - ✓ ); vj City or Town
Stret Address City or Town
PROPOSED USE OR USES (check): a4L�
[D-Domestic d irrigation
El Stock ❑Municipal Lj Industrial El Test Well
CASING DETAILS PUMPING TEST
WATER LEVEL SCREEN DETA
LENGTH: (measure from land surface)
FEET DURATION: HOURS STATIC:
FEET MAKE:
DIAMETER: Z INCHES PUMPING RATE: "
_ G.P.M. WHEN PUMPING: 1__- -FEET LENGTH: ill
KIND: — —
DIAMETER:
WELL LOG
DEPTH FROM Give details of formations penetrated, such ass-peat, silt, sand,gravel,clay,hardpan,shale,stone,rock. Include size of gravel-
GROUND SURFACE (diameter)and sand (fine, medium, coarse),color of material,structure (loose, packed,cemented,soft, hard)
FT.to FT.
t%�61 FT.to n FT. !� �y _r. ly -'--
FT.to FT.
FT.to FT.
FT.to FT.
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FT.to FT
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FT.to FT. -I- E lt�IfSSI
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FT.to FT.
FT,to FT.
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FT.to FT, —._-- -------- --
FT,to FT. ------ ------------------
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lTE WELL WAS COMPLETED:-
DATE OF REPORT
WELL DRILLER—_- G '_' - �L ✓4
(Signature
CERTIFICATE NO. ----------------- --- --------------
LOCATION OF WELL: TOWN OF
SKETCH SHOWING LOCATION OF PREMISES IN TOWN:
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DIAGRAM SHOWING LOCATION OF WELL ON PREMISES: /
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ROUTE DIRECTIONS FOR REACHING WELL SITE FROM HARTFORD:F
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