HomeMy WebLinkAboutWell New 00 Sullivan Avenue (3) State of Connecticut WELL COMPLETION REPORT DO NOT FILL IN
Wa4TER RESOURCES COMMISSION This report mutt be completed and submitted �223 State Office Building to State Water Resources Commission no later State Well No.__�' tj
Hartford, Connecticut than 30 days after completion of well. Other No. V 1
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WELL
OWNER 1411WAY TOBACCO O O J.; hepp r ca Sullivan Ave S WINDS ,
Name Street Address WELL City and Town
DRILLER THE STEPIMN B. CHURCR Co. , P. O, for. 67 SEYMOUR,
Name Street Address City and Town
PROPOSED USE OR USES (Check):
❑ Domestic ❑ Farm Business
[� Irrigation ❑ Establishment ❑ Municipal j Industrial
u Test Well
CASING DETAILS YIELD TEST WATER LEVEL SCREEN DETAILS
❑ Bailed (measure from land su ace)
Length: 1 Feet or
24 g Pumped Hours Static: 5 6 Feet Make: T r
-9-141
or I During Yield Slot
Diameter: 10 Inches
❑ Compressed Air G.P.M. Test: 2- 0 Feet Length Ft. Sire
Kind: DRILLING EQUIPMENT
• steel 1 `Cable Tool
Yield: 20 G.P.M ❑ Other (Specify) Diameter: In,
- ❑ Rotary.
..............................
TOTAL DEPTH OF WELL 2 _FEET
WELL LOG
Depth From Give description of formations penetrated, such as: peat, sift, sand, gravel, clay, hardpan, shale,sandstone,
Ground Surface granite, etc. Include size of gravel (diameter)and sand (fine, medium, coarse), color of material, structure
(loose,packed,cemented,soft,hard). For example:0 ft.to 27 ft.fine,packed,yellow sand;27 ft.to 134 ft.gray
granite.
FT.toI 9FT. Firte red clay, silt and $an
5 9 FT.to I& Red s dS rts
189 FT.tO2j*7• -Very soft rem sandstone
FT.to FT.
FT.to FT.
FT,to FT.
FT .to FT.
FT.to FT.
YIELD TEST DATA IN G.P.M.
If Yield Was Tested At different Depths During Drilling,List Below
FT. G.P.M. --- —
FT. G.P.M.
FT. G.P.M. - -
FT. G.P.M. -----
Nov. 20 , 1967 Y , 1968
Date We!I Was Completed: Date of Report
104 THE ' - 811 r CHURCH.dt Lra AXE
Town Permit Number:
Well Drifte tV
r
4-c, �,,.
243
LOCATION OF WELL: TOWN- OF '" k'£`'' :o
SKETCH SHOWING LOCATION OF PREMISES IN TOWN:
(Show distance and direction from road intersection or other landmark.) 0
INDICATE NORTH
YL
DI HO L CATION OF WELL ON PREMISES:
Y �a
ks
m
C 5kx
�6 kR
ROUTE DIRECTIONS FOR REACHING WELL SITE FROM NEAREST CITY OR VILLAGE CENTER:
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