HomeMy WebLinkAbout1999-11-18 -17 Brookfield Street - Well Completion ReportCPR-9 Rev. 7195
STATEOFCONNECTICUT
DEPARTMENT OF CONSUMER PROTECTION
Do NOT fill In
STATE WELL NO.
REAL ESTATE & PROFESSIONAL TRADES DIVISION
OTHER NO.
WELL DRILLING COMPLETION REPORT
165 Capitol Avenue, Hartlord, Connecticut 06106
OWNER
fIATAE
1l Ch armGn� i �n�o -
ADDRESS
17 T
LOCATION
WELL
(ft. a -%rw) I
T I . ,(W Number)`�OF
W 14,5-ore / - %
PROPOSED
USE OF WELL
DOMESTIC BUSINESS FARM TEST
ESTABLISHMENT WELL
SUPPLY INDUSTRIAL CIONDITIONING 05 ER
DRILLING
EQUIPMENT
ROTARY COMPRESSED CABLE OTHER
AIR PERCUSSION PERCUSSION (Specify)
CASING
DETAILS
LENGTH (fee
Q
DiRMETER (rxi+es)
W
WEIGHT PER FOOT
'
THREADED ❑ WELDED
NE SHOE WAS Wo GROUTED7
YES ❑ NO, LLL"'777 YES ❑ NO
YIELD TEST
BAILED a PUMPED
COMPRESSED AIR
HOURS
YIELD (GPM)
WATER
LEVEL
MEASURE FROM LAND SURFACE - STATIC (Spedfy Taet)
WRING YIELD TEST (fool) Depth of Compleled Wall in feet
gD ZSo
SCREEN
DETAILS
MAKE
LENGTH OPEN TOAOUIFER (Frei)
SLOT SIZE
DIAMETER (inC»s)
IF GRAVEL
PACKED:
Diameter of well
including gravel Pad*
(Indies)
GRAVEL SIZE (riches)
FROM (reel)
TO (teey
DEPTH FROM LAND TO SURFACE
FEET TO FEET
FORMATION DESCRIPTION
Sketch exact location of well with distances, to at least two
permanent landmarks
Q r
V
4z-I
�� r
Mew 0 t'KISf
�rao�fird Sr�
If yield was tested at different depths during drilling, list below
FEET
GALLONS PER MINUTE
DA WELL COMPLETED
&Z7
PERMIT NO
REGISTRATI N NO
AT PF R POki L RILL E n
y
AGENCY