HomeMy WebLinkAboutWell New 00 Main Street (3) WELL DRILLING BOARD -STATE OF CONNECTICUT PERMIT NUMBER
waste 1149 WELL DRAING`PERMIT 51788
STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115
166 TION OF WELL (Town) ($treet) (Lot.Nr<mber) DATE
S. WINDSOR MAIN ST. I 7/27/77
OWNER OF WELL
® INDmDUAL ❑ BUILDER ❑ OTHER(Specify) RICHARD MELLETJ
OWNER'S ADDRESS
82 CORNELL- ST. , E. HARTFORD, CONN.
PROPOSEDSF ® DOMESTIC BUSINESS❑ ESTABLISHMENT ❑ FARM ❑ TEST People ebe n
.USE OF
served.
WELL PUBLIC❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (SAIR pecify) '4.
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
cS"Tieo N G i2G Is
A9
x /uR► c1 L) 1r
Approximate number of feet from well to
nearest source of possible contamination: ?51
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.
�'P (gio+ ura) APPLICANT' I REGISTRATION N0.
r �• I S VE1MON9 CONN. 100
B oforr or Agent) I DATE
PROVED ❑ MECTRD
REMARKS
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
WELL COMPLETION REPORT STATE OF CONNECTICUT -
Do NOT fill in
WDBS 12-69 REV.9.71 WELL DRMUNG WARD STATE WELL NO.
State Office Building
HARTFORD,CONNECTICUT 06115
OTHER NO.
NAME _ ADDRESS
OWNER RICHARD MELLEN I 82- CORNELL ST. , E. HARTFORD, CONN.
LOCATION (No.&Street) (Town) (Lot Number)
OF WELL- PIAIN ST. S. WINDSOR
BUSINESS
® DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL
PROPOSED '
USE OF
WELL ❑ PUBLIC AIR OTHER
SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify)
DRILLINGCOMPRESSED CABLE OTHER
EQUIPMENT ❑ ROTARY ❑ A R P R USSION ❑ P RCUSSION ❑ (Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
DETAILS 202 I' 6 19.45 THREADED ❑ WELDED( YES ❑NO ❑YES NO
I YIELD HOURS YIELD(G.P.M.)
❑TEST BAILED ❑ PUMPED ® COMPRESSED AIR' 6 - 1.
WATER
MEASURE FROM LAND SURFACE—STATIC(Specifyfeet DURING YIELD TEST(feet) Depth of Completed Well
in feet below Land surface:
LEVEL 4o )� 250 ( 300
MAKE LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well including GRAVEL SIZE(inches)FROM(feet) TO(feet)
'PACKED: I gravel pack(inches): I
DEPTH FROM LAND SURFACI FORMATION DESCRIPTION. Sketch exact location of well with distances,to at least
FEET to FEET two permanent landmarks.
0 2 Topsoil
2 18 Sand ,
l8 58 clay
58 300 Bedrock
0 L v E So'
If yield was tested at different depths during•drilling,list below
FEET. -C GALLONS PER MINUTE
c•
14
DATE WELL COMPLETED PERMIL-NO.' REGISTRATION NO. DATE-OF REPORT LLER Signatur)
10/3 77 5 788 loo 10/11/77
'- r BOARD