HomeMy WebLinkAboutWell New 00 Kelly Road (5) STATE OF CONNECTICUT -
WATER COMMISSION WELL COMPLETION REPORT
317 STATE OFFICE BUILDING DO NOT FILL IN
HARTFORD 15, CONN. This report must be completed and submitted to STATE WELL NO.
State Water Commission no later than 30 days
WC -L after_completion of well_ OTHER NO.
OWNER
WELL Name E' C,
c / $
DRILLE r � - Street T"dss�
/ City or Town
Name rw i
CAl� f i'j t � City or Town
PROPOSED USE OR USES (check): ��// f GV {" el�,
CASING DETAILS L�jDomestic
Irrigation []Stock 0Municipa(
El industrial (Test Well
PUMPING TEST
WATER-LEVEL SCREEN DETAILS
LENGTH: "A-�� FEET DURATION: (measure from Jana surface)
HOURS STATIC: j
IAMETER:
---�+ _ FEET MAKE: _—D INCHES PUMPING RATE: --'
�� G.P.M. WHEN PUMPING: 3_ FEET LENGTH: FT. S LOT
KIND: t d
DIAMETER: IN.
------ ----- - _______ WELL LOG
DEPTH FROM Give details of for mations�y� --��-- ------"-""--------
GROUND SURFACE (diameter)and sand (fine penetrated, such as: peat, silt`sand,gravel clay, M-,hale stone,-rock.
Inc--'--'-'-(fine, medium,medium,coarse),color of material structure �loose hardpan,shale,stone,rock. Include size of gravel(loose, packed,cemented, soft, hard)
CJ F T.to v�i F T. �I"-/70
€/e
"U FT.to p�
FT. l�
CS C
- --FT.to FT.
FT.to FT.
FT.to F T aLJ 96J1 ° V LC C
.
G 7-a �.
i ,�—
FT, to FT.
FT.to FT t � 74)` ✓y. ° � a t
FT,to FT.
FT.to FT. ---------
i
FT.to FT. I
----_-o--FT. -------
FT. _
FT.to FT. -- --- I
-------____ -hall -- ------
FT.to FT. ---------------
FT.to FT. f
WELL WAS COMPLETED:— ,f
i
- j DATE OF REPORT
WELL DRILLER__
(SigUdture)
CERTIFICATE NO.
S
LOCATION OF WELL: TOWN OF s o yc, > , —
SKETCH SHOWING LOCATION OF PREMISES IN TOWN: Al
/r
J ,
t c` �7 e Af J AM /V
83
DIAGRAM SHOWING LOCATION OF WELL ON PREMISES:
ROUTE DIRECTIONyS FOR REACHING WE(L=L SITE FROM HARTFORD: g F
17 i e 6 /,f e