HomeMy WebLinkAboutWell New 00 Strong Road (4) WELL COMPLETION REPORT
STATE OF CONNECTICUT
CPR-9 REV. 9-79 DEPARTMENT OF CONSUMER PROTECTION' Da NOT fill in
WELL DRILLING BOARD STATE WELL No.
20 GRAND STREET
HARTFORD, CONNECTICUT 06106 OTHER NO.
NAME
OWNER. :::::::::TA�D;DRESS
SER-BEL T e�rrr r t� th [3
LOCATION �j (No.&Street) (Town)
OF WELL: fi.d 014G �� ��� � (Lot Number)
PROPOSED LLLJ DOMESTIC ESTABLISHMENT FARM
USE OF TEST WELL
PUBLIC
WELL AIR OTHER
D SUPPLY El INDUSTRIAL CONDITIONING (Specify)
DRILLING � ROTARY COMPRESSED OTHER
EQUIPMENT CABLE
AIR PERCUSSION PERCUSSION
(Specify)
eet LENGTH f
CASING ( ) DIAMETER(inches) WEIGHT PER FOOT RIVE SH E ®S CASING GROUTED?
DETAILS r�
6 4 � THREADED WELDED
# -YES �NO YES �NO
YIELD HOURS
TEST BAILED PUMPED COMPRESSED AIR YIELD
WATER
MEASURE FROM LAND SURFACE—STATIC(Specify feet) DURING YIELD TEST(feet) 5
LEVEL Depth of Completed Well
in feet below Land surface:
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: gravel pack(inches):
DEPTH FROM LAND SURFACE
FEET TO FEET FORMATION DESCRIPTION Sketch exact location of.well with distances, to 61 least
two permanent landmarks.
0 1? ' tad s
17 118 Clay ESL
If yield was tested at different depths during drilling, list below
FEET GALLONS PER MINUTE
7- A D
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT
E {Signatu 1 ct
DEPT. OF ENVIRONMENTAL PROTECTION - WATER RESOURCES