HomeMy WebLinkAboutWell New 00 Main Street (2) WELL DRILLING BOARD STATE 0 CONNECTICUT PERMIT NUMBER
wDs4 . 11-69 WELL DRILLING PERMIT 10486
STATE OFFICE BUILDING,NAQ,(fORD,CONNECTICUT 06115
LOCATION OF WELL(Town) (Street) (Lot Number) DATE
SOUTH WINDSOR MAIN ST:. 6/1/72
OWNER OF WELL
❑INDIVIDUAL BUILDER ❑ OTHER(Specify) CARLO PRESTILEO
OWNER'S ADDRESS
69 •ASH ROAD WAPPING9 CONN.
PROPOSED BUSINESS TEST Est.No.of
USE OF ® DOMESTIC ❑ ESTABLISHMENT ❑ FARM - ❑WELL People being
PUBLIC AIR served.
WELL ❑ SUPPLY El INDUSTRIAL ❑ CONDITIONING ❑ Spew) 6
SKETCH OF WELL LOCATION
Locate well with respect to at least two roads,showing distance from intersection and front of lot
Location of lot to at least.two roads Well location on lot and to house(if present)
Indicate North
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Oil
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i9iN mil.
Approximate number of feet from well to
nearest source'of possible contamination: 80
The undersigned is aware that 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 form provided by the Board.This
permit is not valid until all information is filled in and it has been countersigned by the Director of Health or his agent.
APPU S' o►ure) 'APPLICANT'S ADDRESS REGISTRATION NO.
�. A LAKE ST. 9 VMPNICONN.. 100
DATE
L_J APPROVED ❑ REJECTED - 4
REMARKS
S _
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT- STATE of CONNECTICUT-
' Do NOT fill in
WDB•5 12.69 REV.vat WELL DRILLING BOARD STATE WELL NO.
State.OW-- Building
HARTFORD,CORAECTICUT 06115
OTHER-NO.
OWNER NAME ADDRESS
CARW PRESTILEO b `ASH •ROAD WA_ PPING CONN.
tOCAT10N a (No:;(A Street) Rownj (Lot Number)
OF WELL MAIN :ST. SOUTH WINDS08•-'
PROPOSED . DOMESTIC ❑ BUSINESS
ESTABLISHMENT ❑ FARM ❑ TEST WELL
USE OF -( PUBLIC -AIR OTHER-
:WELL• ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑
(Specify)'
-DRILLING ® ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ (COMPRESSED CABLE Specify)
- THER
EQUIPMENT •_
LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT• DRIVE SHOE•• WAS CASING GROUTED?
CASING THREADED ❑ WELDED ®YES []NO' FK YES [:]NO
DETAILS':. . 108 6 1 .4 I I
HOURS YIELD(G.P.M.)
YIELD ❑ BAILED •' PUMPED ® COMPRESSED:AIR
TEST . 4 • 8
MEASURE-FROM LAND SURFACE—STATIC(Specify-feet) DURING YIELD TEST(feet)'.,
WATER I I Depth of Completed Well
LEVEL 2 • 150 in feet;below Land surface: 22
' MAKE LENGTH OPEN TO AQUIFER(feet)
SCREEN I .
DETAILS SLOT SIZE. DIAMETER(inches) IF GRAVEL Diameter of well including GRAVEL SIZE(inches) (feet)' ,TO(feet)
PACKED: I gravel pack{Inches}
DEPTH FROM LAND SURFAC FORMATION DESCRIPTION Sketch exact location of well'with distances,to at least
FEET to FEET two permanent landmarks.
0' S Topsoil -
5 34 Gravel
34 98 . ' Hard an . :.
98 225 -Reddish Pock
4.
If yield was tested at different depths during drilling,list below
FEET •GALLONS PER MINUTE.
' t•�
y x4 �. •1. mot. is
DATE WELL COMPLETED PyEpRMIT'NO. ''• REGISTRATION NO. - . DATE-OF-REPORT• .• WEL (Signs re -
t#�:� r i!'ki;A&AA•-talc"���: I'. - .I •� �-� ''` ,
4 BOAW . . `
WELL COMPLETION REPORT STATE OF CONNECTICUT
WDB-5 12-69- REV.9.71 WELL DRILLING BOAR® �O NET fill in
State Office Building STATE WELL NO.
HARTFORD,CONNECTICUT 06115 V3
OTHER NO,
OWNER
NAME I ADDRESS
CE �' �'T O I 6 9 ASH P?gjA A P-Pir � �
LOCATION (No. R Street) (Town) (Lol Number)
OF WELL .. T N S . SOUTH WINDSCOR
BUSINESS
❑ ESTABLISHMENT SHMENT ❑ FARM
PROPOSED DOMESTIC ❑ TEST WELL:
USE OF
WELL PUBLIC AIR❑ SUPPLY ❑ INDUSTRIAL ElCONDITIONING El ((Spec fy)
DRILLING 0 ROTARY ❑ AR PERCUSSION COMPRESSED CABLE OTHER
EQUIPMENTPERCUSSION ❑ (Specify)
LENGTH (feet) DIAMETER(inches) WEIGHT PER FOOT
CASING DRIVE SHOE WAS CASING GROUTED?
DETAILS : I I J. f I THREADED ❑ WELDEDI 1jiYES ❑NO YES ❑NO
HOURS
YIELD YIELD(G.P.MJ
TEST ❑ BAILED ❑ PUMPED L�%j COMPRESSED AIR
WATERMEASURE FROM LAND SURFACE—STATIC(Specify feet)I DURING YIELD TEST(feet) Depth of Completed Well
LEVEL - i5o I in feet below Land surface:
MAKE 225
LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE I DIAMETER(inches) I IF GRAVEL ( GRAVEL SIZE(inches) FROM(feet): TO(feet)
Diameter of well including.
PACKED: gravel pack(inches):
DEPTH FROM LAND SURFACE FEET to FEET FORMATION DESCRIPTION Sketch exact location of well with distances,to at least
two permanent landmarks.
O 5 Topsoil,
34 Grave;
98 e. :
225 Reddish Book.
o
1 `t
If yield was tested at different depths during drilling, list below }
FEET GALLONS PER MINUTE 1 r
/,j 77
DATE WELL COMPLETED I PERMIT NO. I REGISTRATION NO. I DATE OF REPORT WEL -0RYL` (Signatbre f
l f i
DEPT. OF ENVIRONA&ENTAL PROTECTION