HomeMy WebLinkAboutWell New 00 Foster Street (4) WATER RESOURCES COMMISSION w�"•. vvme-`691WIV KCPVRY vO NOT FILL IN
Thls report must be completed and submitted j
223 Stale Office Building to State Water Resources Commission no later State Well No._.__.
Hartford, Connecticut than 30 days after completion of w tl.
�( Other No.
WELL
OWNER _ K&C Construction Co. Rega Lane Bolton Conn.
WELL
Name Street Address
Stave.n.s Bross Lake r S ally and Town
DRILLER t. , Vernon, Conn.
Name street Address
city and Town
PROPOSED USE OR USES (Check):
1k) Domestic ❑ Farm Business
❑ Irrigation ❑ Establishment
❑ Municipal ❑ Industrial ❑ Test Well
FK"d
NG DETAILS YIELD TEST WATER LEVEL
SCREEN DETAILS
❑ Bailed (measure from land su ace)
OQ Feet or
❑ Pumped Hours Static: O Feet Make-
�--——
Inches or During Yield
[2 Compressed AirO G.P.M. Test: O Feet Len th'-'---- Slot
l 9 Ft. Size
DRILLING EQUIPMENT
teel I 60 [] Cable Tool
Yield: G.P.M ❑ Other (Specify) Diameter: ---1n,
(Rotary
TOTAL DEPTH OF WELL__ 00_ _FEET
WELL LOG
Depth From Give description of formations penetrated, such as: peat, silt sand Ground Surface granite, etc. Include size of gravel (diameter) and sand (fine,mediumacotarse)y'color dof material struture
(loose,packed,cemented,soft,hard). For example:0 ft.to 27 ft.fine,, packed,yellow sand;27 ft.to 134 ft. gray
O FT.to 1 OFT. SAN
1Q FT.to 98FT• CLAY ����.�w ����=s� ����PCES
98 FT-tol OOFT' GR9 .
FT.to FT. 4
FT.to FT. } R L
FT.to FT.
FT. to FT.
YIELD TEST DATA IN G.P.M.
------------
If Yield Was Tested'At different Depths During Drilling, List Below
.FT. G.P.M.
FT. G.P.M. —
FTJ G.P.M. ---- ----- - ----
FT G.P.M. -—-- -----------
Date Well Was Completed: Sept• 10, 1964 Date of Report -- Nov. 5, 1964
Town Permit Number: 21 ,/[ t -� -" -
Well Driller � �
{Signature)
1812
Certificate No.
_ I
:LOCATION OF WELL: TOWN OF J� C`
SKETCH SHOWING LOCATION OF PREMISES IN TOWN:
(Show distance and direction from road intersection or other landmark.)
INDICATE NORTH
I
4
DIAGRAM SHOWING LOCATION OF WELL ON PREMISES:
l 7o ✓'
ROUTE DIRECTIONS FOR REACHING WELL SITE FROM NEAREST CITY OR VILLAGE CENTER:
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