HomeMy WebLinkAboutWell Abandond 530 Buckland Road (2) STATE •OV CON' : fiE.-CTIC:LXT
DEPARTMENT OP CONSUMER-PROT O
REAL r.STATL`Sc PROFESS04AL TRADES
. 'T R
WELL,kBANDONML+NT,VI.hY ICATYON OF WORK CCi�iPLI TEI3`
Nrnrr+ urr ft�lte�sy¢tl: Ali procedures used to si�u�tctan$.�vel!sha!l followregriliitions established under
'tieerjon 25-US-56-and 25-128-57 of the State of Connecticut Well Drilling Board Regulations (see Attach-
merit). These regulailons require that u registered well drilling contractor perform the Work.
for w*ter supply wells ettach completed form-ta Well-Permit. For non-water supply wells attach sketch
of well IwAtion to completed form. Distribution: DegatItimnt of Consumer Protection,Department of
Environmental Protection,Property Owner,Well Drilling Contractor, Local Director of Health.
tiVC11 inforrnutiost: .• � .
Town: � o.��� �:.nrsitQni�s Date work completed:
Name of Owner:
Acidress: " 3O • s r i ie Dr> j u~ b
Locarion of well(if different from above): ,0 . k
nn �
Type:of well(drilled,proiitt,clue,etc.}: { r-h e� � �: Depth of we)l:
01amever of well: Length of casing:
)York tic{alls and gther lbfprmallon:'
Naive of registered well drilling curt#rRctor pei formrin''worik: o S
Registered well drilling contrncfor's 1'icense type&#: Wl-# W3-4
Materials Used: amount of sand
l/ ('u�7L'1✓'S C f,r '•amount and type(s)ot'.grb,•ut
- '•.• f'►:, �,,: t6vF.ay,.�• •'/"�7T"^'mot ( 3 �� �5.
Description of work completed:
C d i_� f h .r oily La f
siSfteei: _ (well drillingi bi ntratctor)
tb5 C:� itc�1 Avg>nuc, HaWord,Cortnecticcit.Q6106.1610
Nix:(860)566-763b V 1'DD:•(860)566-1547
At Af/itmatitrc,-Artiala/&jii.jf flpportiinity Eritplrn/rrr
t
t .fE:t.:1.11.:4 t'1,%tt�l:;1�t t l: 4:•itil..1:. t'1.I:�r1.Pi 1;tC:1 �'t�•llil''•l1'
E1:4C Itt:►(iU 41' Ittt:•.:rlCttt Brake AgUIIt: e,),
...: ,,Cal tr,.,l•li:.lt;,tltta!lr,t slt:itI Stu t 1rt:It sUttrCK or C-a tiz U L,t'4:Oriturelinarion or politlrion of ground tYarer MtOttrees.
iIE'uL'tit{I s,Vent ahaIl Is jie l'rol•ttlud or tilrviuTc:!bit l} 1]y 2% revyisrered %Yrlt•driller. The registered lvell drillille
,t:rl.,,uts iJte tr�jrit ui stL:tutluuttis urs,l AH b,:;t:aputisible_ for compliance wirli rite procedure of nbantlan-
.n•.0 ,n. ilt'vt•i,ls:,l ii!tJtis parf alld sltall ItU'lll;%• Ilse 10c:lit (te:llt•it :ltithoviry ol'•the ahtiw1onment of The welt.
l_:.•t I'hit:trelllis of 2s112irtdunuierll t
,,. ...r c,:,,t,,S.iLunttetgtu,:tu r,ralty'1YaICr lrs±ll ul'sltJic.r ,t•1�� of velt I.11V proper prO t-dure:tail•materials shall be used
3
sr,.s.uu a ta{r be Pjfq g&l to ttreYcur Vito vurrattce Uj':.urtitt t1 lYilrer,aircul:Etion o1 wa[er between or among pro-
. u!'atty "Wi r 111•ucess restilrin:,h tht,C4 ttrltr'ttirlrtirult OV l>oJlutivn o!'groom! 1%arer resoltrces.
!., fit, iota uC rt;taspurary'-1U;,uldtut elicit t of'discolttitt,::alive Of the else Of;-wy well, the ►fell shall be seated vvith a
:1s 111•t,vitlud by Section 25-128-42 (ci.
I,.:t,,It,lt:ilt b,:eltiuriri:etctt prior to .1baAdollrnt ltt u:,iltif a'clllor•i11e suluric a with:t mirtirnum coneentratioa of one
1riilliurt 1,15o tivin)urr:ltlor•iiir. i;LltlivlrlesiT to >.a Illl:rr'IS of l}lt:tth tt[2.25°/a :lvetilAl}le
„] ,.:.r .4 iit::•ttl,lt.treil(5ttd)grttlouxul'yrlttt'ttrrtluLr111MIUCULl Illit•tY-rttr•ee 033) rcet ol'six (b) inch diamete! well,
..t; t lic lrcti s11:111 be clicil.eel fruln Wild sal•tac(t ca.ihu valtire deprit o the%veil before it is q eiled,•ro insure against rite
;uriCt,tC Of all) obstruction that Will ittrC'ffere'iviih-st:iitlttti upt.rutiorl$. '
c) !lu%tell!tore 51i:ttt be r lets tflld Smiled vVi h, ully ul tlti tullt)winb sttateriAls: ltestt CCmtint grout,SAntl•.CemenT gl'r1ttT,
.:t:is;ruuL or Sand clay'or bentoltite•celtleu�grunt.
J1 Pitt ;rt.ut lttalrri:tl attttJl be 11t:tGCd Ili StrCtl it�ttay to Prevelitvoid'i in'Tt a M'MUt Gr-Clilliri4rt ofthe grout:
,,;r.,,1} %%rtl t elttstruefetl iti it LtaftsriliLl:lTGel rucIC rurrtis[iuti, lllay be fillet[ svith flne wand i n the 28ne tir zones of eonsoli-
rt::t at 1trt L ncc toll of file>:Iurl'till bliali lru at leasr tell'ou) iaer.Wow.tlie bottom of the easing,attd the remainin;por-
si:.111 41 tltC 'A ell shall be:fillCtl %Yitti any or rile at arei•iills'spt:t^:tiCtl'in :Ilibst:c[ion•(e)..
:city trl.t svt'tf or ttttrt shall l)r•;ttr:trtttuttrd itl3tlCll :t rltaieticT HIM it clues licit %%%Iconic a charnel for'she vertical
.l+.=,.utctst ul ti:,lcr arurber setlivitr'tcr ro fife potabltt agrottllr.l lvuter res6urues.
:;,!'Cup ,taste di_%pusal Of-tail%vntts wi[li vusings.fr-M,of:iily br$hl(s,:1utl:e.�tenrtirtg below the poislbie ground %vl[Cr
.rl:ty Dus,:aleti WiTh:1 lvate;r rigilr dill be-rVOItlud t)1:ttt:.
t,ja %;port cuu11t1t tine%of:tb:tfldottttietlt ut'Ctrr►%'e11,filte tula ter Lite L:t3illg oi-grutit niaterhtl Hilly be terrriiaared a*leastluair tot tent buiviv rile ground surl;tee_ , .
CATION
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i+ (ocatieill-ot Nyell with diSbilices tv\'tl permanent landmarks
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