HomeMy WebLinkAboutWell New 00 Miller Road (5) CPR-9 Rev.V95-
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STATE OF CONNECTICUT STATE WELL NO.
r,DEPARTMENT OF CONSUMER PROTECTIONAV
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REAL ESTATE&PROFESSIONAL TRADES DIVISION
WELL DRILLING COMPLETION REPORT OTHER No.
165 Capitol Avenue,Hartford;Connecticut 06106
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NAME ADDRESS
YIVE f'ER P.4 C)X 559 S. I �3`C1R CT
(No.&Street) (Town) (Lot Number)
MI L.L.&.tr.1'.•..RD ,
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BUSINES
PROPOSED X DOMESTIC Q ESTABLISHMENT a FARM Q WELL
USE OF WELL
PUBLIC:mow, DUSTRIAL Q ►1R� A J OTHER"
SUPPLY ., -.
CONDITIONIII (Specify
DRILLING ROTARY � COMPRESSED CABLE OTHER
-EGIUIPAAEyT AIR PERCUSSION El PERCUSSION F1 (Specify) '
CASING LENGTH(feet) DIAMETER(inches) WEIGHT PER FOOT " DRIVE SHOE LNAS CASING GROUTED?
DETAILS_ ,,0 , THREADED WELDED 1
✓ 6. Iz� t" t yqT� YES t_t NO C�I YES ® NO
YIELD TEST Q BAILED t—� PUMPED COfMPRESSED AtR HOURS YIELD(GPM)
WATER :' .-� v��1>�`.n�li ��
MEASURE FROM LAND SURFACE-STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Well in feet
LEVEL
MAKE 245 245
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
O 20 Sand & Grave!
20 30 Soft Ledge
30 245 Red Shale
If yield was tested at different depths during drilling,list below
FEET GALLONS PER:MINUTE
4
S
Sjl
1#
DATE WELL COMPLETED PERMIT N0. REGISTRATION N0. DATE OF REPORT WELL-ijDRILLER(Sign re)
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INEPT. OF FINIVIRON UFUTAl PPnT;%-T1nINJ-WA-r=0 0=1-^ee�a���