HomeMy WebLinkAboutWell New 00 Main Street State of Connecticut —"— —
WATER RESOURCES COMMISSION WELL COMIP
223 State office Building This re L�'®i®� R��C'RT
Hartford to State report must DO completed and submitted ®® NOT FILL IN
Connecticut Water Resources
than 30 days after co Commission no later State Well No. J
TOW
L mpletion of well.
ZoP Other No.
—Saczava-_—
WELL Name --- main Sty
DRILLER Ne�j . ngiand WaterSo. W
llz� 84rest Addrasi +� SOY' `1'0nn•
i�-'1j-CS Ince
Name 750 Faller St City and Town
PROPOSED USE O street Address e Ludlows Mass,
R USES (Check);
Pity and Town
t Domestic ❑ Farm
❑ irrigation Business
CASING .DETAILS ❑ Establishment
YIELD TEST ❑ Municipal ❑ Industrial ❑ Test Well
❑ Bailed WATER LEVEL
Length; Feet or (measure from an
It Pumped 4 Hours su ace) SCREEN DETAILS
Diameter: � - --__._ Static:
or
Inches 1 t' Feet
❑ Compressed Air' During Yield - Make:
Kind: c��arit G.P.M. --_�
Test:
DRILLING E Peet Length Ft. Slot
Yield: r _L EQUIPMENT Size
TOTAL DEPTH OF 2- G.P.M ❑ Cable Toot
WE ❑ Rotary dU�� Other(Specify) Diameter: In.
'>1-----FEET
Depth From Give description of formations WELL LOG
Ground Surface
granite, etc. Includes.ze of grave
Peenetratea such as:
(loose,packed,cemented (diameter Peat, silt,-sand
granite. ,soft,hard). For example pit to 27f med,umacolarse Y, hardpan, shale,sandstone
27 ft, fine,packed )' color of material st
FT.to FT. ,Yellow sand;27 ft.to 134 ructure
ft. gray
-� T FT. --- ----
FT.to FT. ---
FT.to FT.
r
FT.to FT.
FT.to FT.
1
FT.to FT.
FT. to FT. ----
i
�— YIELD �
If Yield Depths TEST DATA IN G.P.M.
Was Tested'M 6ifferent Deps During i
FT. P.M, 9 Drilling, List Below
FT. G.P.M.
r
---__._ FT. G.P.M. — ---- - - —___-
FT. G.P.M. -- --�_
Veil
Was Completed: S2'Pt. 25,, 1065
Town Permit Number. ' Date of Report
i
x
Well Driller,.��� __-__�.s�
ignature)
Certificate No. 203(;
LOCATION OF WELL: TOWN OF
SKETCH SHOWING LOCATION OF PREMISES IN TOWN:-
(Show distance and direction from road intersection or other landmark.) 0
INDICATE NORTH
DIAGRAM SHOWING LOCATION OF WELL ON PREMISES:
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Of-
C1 All3 0
ROUTE DIRECTIONS FOR REACHING WELL SITE FROM NEAREST CITY OR VILLAGE CENTER: