HomeMy WebLinkAboutWell Correspondence 548 Foster Street CPR-9 Rev.7/95 - --
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STATE OF CONNECTICUT STATE WELL NO.
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE&PROFESSIONAL TRADES DIVISION OTHER NO.
WELL DRILLING COMPLETION REPORT
165 Capitol Avenue,Hartford,Connecticut 06106
OWNER NAME Dennis y ADDRESS y. y
LOCATION (No.&Street) (Town) (Lot Number)
OF WELL 541 "oste " 0,1C
PROPOSED a DOMESTIC BUSINEa ESTABLISHMENT a FARM TEST
WELL
USE OF WELL PUBLIC INDUSTRIAL AIR `� OTHER,;';^"i'ft�a'..t�F-a
SUPPLY CONDITIONING (Specify)
DRILLING a ROTARY a COMPRESSED CABLE OTHER
EQUIPMENT AIR PERCUSSION PERCUSSION (Specify)
CASING LENGTH(feet) DIAMETER(inches) I WEIGHT PER FOOT I DRIVE SHOE WAS CASING GROUTED?
THREADED WELDED
DETAILS 1 X ® YES ❑ NO ❑ YES ❑ NO
YIELD TEST BAILED F-1 PUMPED F] COMPRESSED AIR HOURS YIELD(GPM)
WATER MEASURE FROM LAND SURFACE-STATIC(Specify feet) DURING YIELD TEST(feet) Depth of Completed Well in feet
LEVEL 20 151
MAKE LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE DIAMETER(inches)T7ding
F GRAVEL Diameter of well GRAVEL SIZE(inches) FROM(feet) TO(feet)
PACKED: inclu 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
251
If yield was tested at different depths during drilling,list below
FEET GALLONS PER MINUTE
DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF REPORT WELL DRILLER(Signatur
u.'27,,1 a 252505 12 7 If3.11 2 ! i
LOCAL DIRECTOR OF HEALTH