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STATE OF CONNECTICUT STATE WELL NO.
gg DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE&PROFESSIONAL TRADES DIVISION
WELL DRILLING COMPLETION REPORT OTHER N0.
I rr:'Capitol Avenue,Hartford,Connecticut 06106
OWNER N7AME ADDRESS
PAUL UCELLO 25 DEXTER RD ROCKY HILL, CT
LOCATION (No.&Street) (Town) (Lot Number)
OF WELL .IN STREET SOUTH WINDSOR1 4 ,
=r DOMESTIC BUSINESS Q FARM TEST
PROPOSED ESTABLISHMENT El WELL
USE OF WELL
SUPPLY INDUSTRIAL ❑ AIR a OTHER PUBLIC F CONDITIONING (Specify)
DRILLING ROTARY COMPRESSED CABLE OTHER
EQUIPMENT 12 NO AIR PERCUSSION PERCUSSION (Specify)
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE =0; YES
GROUTED?
DETAILS L 5 q x THREADED 7 WELDED
L f M YES ❑ NO NO
YIELD TEST ®BAILED ❑ PUMPED ® COMPRESSED AIR HOURS YIELD(GPM)
WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet' DURING YIELD TEST(feet) Depth of Completed Well in feet
LEVEL 50 265 265
MAKE
SCREEN LENGTH OPEN TO AQUIFER(feet)
DETAILS SLOT SIZE DIAMETER(inches) IF GRAVEL Diameter of well GRAVEL SIZE(inches) FROM(feet) TO(feet)
PACKED: including gravel pack
(inches)
DEPTH FROM LAND TO SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances,to at least two
FEET TO FEET permanent landmarks
0 123 Sand. & Gravel
120 265 Granite
r
If yield was tested at different depths during drilling,list below
FEET GALLONS PER MINUTE
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DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT LL DRILLER( i ature
3/29/99 T192047 102 4[12/99
JOH M DU RD
DEPT.OF ENVIRONMENTAL PROTECTION -WATER RESOURCES