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HomeMy WebLinkAboutWell New 00 Nevers Road STATE OF CONNECTKUT WELL COMPLETION REPORT WATER COMMISSION DO NOT FILL IN 317 STATE OFFICE BUILDING This report must be completed and submitted to HARTFORD 15 STATE WELL N0. .....::�?..!�F.`,CONN. State Water Commission no later than 30 days OTHER NO. WELL after completion of well. OWNER WELL N DRILLER Street Address i City or Town Name St�ddre.s ---+— �T — PROPOSED USE OR USES (check): omestic �Irrigation Stock El Municipal 0 Industrial ©Test Well CASING DETAILS PUMPING TEST WATER LEVEL SCREEN DETAILS LENGTH: LIC: om lana surface) F FEET DURATION: . Z 7 -7 HOURS `"� FEET MAKE: DIAMETER:- INCHES PUMPING RATE: SLOT _ �} G.P.M. G; SFEET LENGTH: SIZE,r ----FEET F T. KIND: DIAMETER: IN. WELL LOG hardpan,shale,stone'rock. Include size of grave! 'r GROUND SURFACE (diameter)and sand (fine, medium, coarse),color of material, structure (loose, packed,cemented, soft, hard) DEPTH FROM Give details of formations penetrated, such as: peat,silt, sand, gravel,clay, o _ J9 FT.to of FT. FT.to 1-0114�FT. — FT,to FT. ------- FT.to FT. FT.to FT. FT.to FT. FT,to FT. FT.to FT. i — FT,to FT. FT.to FT. FT.to FT. FT.to FT. -- — FT.to FT. ----------- — � FT.to FT. ATE WELL WAS COMPLETED: DATE OF REPORT— �� rj'j'& WELL DRILLER (Signature) CERTIFICATE NO. —_—_� ---- -------- --- LOCATION OF WELL: TOWN nF = >!�Z SKETCH SHOWING LOCATION OF PREMISES IN TOWN: t DIAGRAM SHOWING LOCATION OF WELL ON PREMISES: 67 ' - 4c( ROUTE DIRECTIONS FOR REACHING WELL SITE FROM HARTFORD: ✓, T -'`- -4P .o� r-