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HomeMy WebLinkAboutWell 577 Barber Hill Road WELL COMPLETION REPORT STATE OF coNNECTicuT wDBs tsss REV.9-71 WELL DRILLING BOARD Do NOT fill in State Office Building STATE WELL NO. HARTFORD,CONNECTICUT 061.15- OTHER.NO. OWNER NAME ADDRES Onj DIM S CONSTRU091TmT CO. 626 ELLINGTON'RD. , S. WINDSOR, CT. LOCATION (No.JL Street) (Town) of WELL SOUTH WINDSOR (Lot Number) PROPOSED ® DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑USE OF TEST WELL WELL PUBLIC AIR ❑ SUPPLY ❑ INDUSTRIAL OTHER ❑ CONDITIONING ❑ Y) DRILLING ROTARY ❑ COMPRESSED ❑ CABLE ❑ OTHER EQUIPMENT AIR PERCUSSION PERCUSSION (Specify) CASING LENGTH(feet) DIAMETER-(inches) WEIGHT PER FOOT DRIVE SH 40 6 I ],9'e 45 © THREADED ❑ WELDED I X YES O ❑ DETAILS ❑NO MESSING (L��'•ND—GROUTED? YIELD HOURS YIELD(G.P.M.) -TEST ❑ BAILED ❑ PUMPED ❑C COMPRESSED AIR 415 WATER MEASURE FROM LAND SURFACE—STATIC(Specify feet)I DURING YIELD TEST(feet) MAKE LEVEL 30 80 I Depth of Completed Wellsurface: 100, in feet below Land surface: I SCREEN LENGTH OPEN TO AQUIFER(feet] DETAILS SLOT SIZE I DIAMETER(indtes) I IF GRAVEL I Diameter of well including I GRAVEL SIZE(inch..)FROM(feet) _TO(feet) I"PACKED: II oravel pack(inches): DEPTH FROM LAND SURFAC FEET to FEET FORMATION DESCRIPTION Sketch exact location of well with distances,to at least two permanent landmarks. 0 10 Sand & Gravel 10 30 Clay 30 100 Bedrock I r C�L Jo A f If yield was tested at different depths during drilling,list below E FEET GALLONS PER MINUTE CD DATE WELL COMPLETED �PERMIT Q. •�REGISTRATION IOO O. I DATE OF OkC/31/78r W RIL R(S' nature) • 10/25/78 45887 1 I BOARD WIELL DRILLING BOARD STATE OF Cb44EC &lT PERMIT NUMBER WD6.4 11.69 WELL DRILLING PERMIT 4 5 8 8 7- STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115 LOCATION OF WELL (Totam) Wreet) (Lot Number)SOUTH WINDSOR C- I DATE 9/29/78 OWNER OF WELL ❑ INDIVIDUAL El BUILDER ❑ oma(Specify) JMJ MIKE JACQUES CONSTRUCTION CO. OWNER'S ADDRESS " 626 ELLINGTON ROAD, S. WINDSOR, CONN. ,� ��� 7`l YZ- PROPOSED BUSINESS TEST Est.No.aF ® DOMESnC El. ESTABLISHMENT `� ❑ FARM ❑ WELL People being USE OF served. WELL ❑ SUPPLY El AIR ❑ C1ONDMONING ❑ I(Specify) 4 SKETCH OF WELL LOCATION Locate well with respect to at feast two roads,showing distance from intersection and front of lot Location of lot to at least two roads Well location on lot and to house ff present) L i �, 9 6T Indicate North. 0ir c_ .S ION 90 CIA 10. Approximate number of feet from well to 801 nearest source of possible contamination: The undersigned Is aware that upon completion of the well,a'Well Completion Report'containing construction details and information required under Section 25-131 of the 1969 Supplement to the General Statutes must be sent to the owner,the Board and the Water Resources Commission on the form provided by the Board. This permit is not valid until all information is filled in and it has been counter-signed by the Director of Health or his agent. APP iyratrre) APPLICANT'S ADDRESS REGISTRATION NO. LAKE ST. , VERNON, CONN. I 100 BY Tam eauk OJfioer or Ay ) DATE APPROVED ❑ REJECTED REMARKS :sr— Z.L1 5-r 0" SCANNED RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD