HomeMy WebLinkAboutWell New 00 Main Sstreet WELL DRILLING BOARD STATE OF O&NNECTIWT PERMIT NUMBER
1149 WELL DRILUNG PERMIT. 57140
STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115
LOCATION OF WELL (Town) ($treat) (Lot Number) I 11/15/78 DATE
SOUTH WINDSOR MAIN ST.
OWNER OF WELL
❑ INDIVIDUAL ❑ BUILDER OTHER(specify) J.E. SHEPARD CO.
OWNER'S ADDRESS
200 SULLIVAN AVE. , S. WINDSOR, CORN.
PROPOSED ❑ p nC ❑ BUSINESS ® TEST Est.No.of
USE OF ESTABUSHMENT FARM ❑ WELL People being
WELL ❑ SUPPLY PUBLI ❑ INDUSTRIAL served.
❑ CIONDITIONING ❑ (Specify)
SKETCH OF WELL LOCATION G,q�j4,tK
Locate well with respect to at least two roads,showing distance from intersection a 0
Location of lot to at least two roads Well location on lot and to h present)
if
NOUS� CtlrlL
dr
Indicate North fill
. fA
x
5
.,j
D 1 v _
Approximate number of feet from well to /l
nearest source of possible contamination: 9 V
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 Genera
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!ration is filled in and it has been counter-signed by the Director of Health or his agent.
PLI NT( re) I APPLICANT'S ADDRESS I REGISTRATION NO.
LAKE ST. , VERNON, CONN. 100
BY(T�ojwn.Meauh OIN�e* dD ) n DATE
APPROVED ❑ REJECTED
REMARKS
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RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
1
WELL COMPLETION REPORT STATE OF CGNNECTKF
Do NOT fill in
WD" 12-69 REV.9.71 WELL DRILLING BOARD STATE WELL NO.
•State Office Building
HARTFORD,CONNECTICUT 06115
OTHER-NO.
°N1NER NAME I ADDRESS
J.E. SHEPARD CO. 200 SULLIVAN AVE. S.. WINDSOR CORN.
LOCATION (No.3 Sheet) (Town) (Lot Number)
OF WELL MAIN ST. SOUTH WINDSOR
BUSINESS
❑ FARM❑ ESTABLISHMENT ®
PROPOSED DOMESTIC ❑ TEST WELL
USE OF
WELL ❑ PUBLIC AIR OTHER
SUPPLY ❑ INDUSTRIAL
❑ CONDITIONING ❑ (Specify)
DRILLING CABLE
EOU PMENT 0 ROTARY ❑ A PRESSED RMPERCUSSION ❑ PERCUSSION ❑ ((Specify)
CASING LENGTH(feet) (DIAMETER(inches) WEIGHT PER FOOT ? DRIVE SHOE WAS CASING GROUTED?
DETAILS 151 ( 19.4 I ] THREADED ❑ WELDEDI EXI YES ❑NO ❑YES ]NO
YIELDy� HOURS YIELD(G.P.M.)
TEST ❑ BAILED ❑ PUMPED �I COMPRESSED AIR 6 18
MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet)
WATER Depth of Completed Well
LEVEL 30 275 in feet below land surface: 300
MAKE I
LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well including I GRAVEL SIZE(inches)FROM(feet) ITO(feet)
'PACKED: gravel pack(inches):
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 3g,
2 28 Sand wEcc
28 141 Clay 17Ld
3
141 300 Bedrock
i
If yield was tested at different depths during drilling,list below
FEET GALLONS PER MINUTE
DATE WELL COMPLETED IT NO. REGISTRATION NO. DATE OF REPORT I ER ignatur
1-2/15/78 I PERMIT
I 100 - 112/19/78
BOARD