HomeMy WebLinkAbout1975-8-25 - 1 Christine Lane - Well Completion ReportWELL COMPLETION REPORT STATE OF CONNECTICUT Do NOT fill in
WDB-5 12-69 REV. 9-71 WELL DRILLING BOARD STATE WELL NO.
t i / State Office Building
HARTFORD, CONNECTICUT 06115
OTHER NO.
OWNER
NAME
COTE CAR-e-tS1 ERS
ADDRESS
I 101 S.
W11ITNEX ST.9 HARTFORD, CON -it.
LOCATION
(No. & Street)
(Town) (Lot Number)
OF WELL
GMISTIKE LANE
BUSINESS
f] DOMESTIC ❑ ESTABLISHMENT
❑ FARM
GOUTH WINDSOR
❑ TEST WELL
PROPOSED
USE OF
WELL
PUBLIC
ElSUPP Y ❑ INDUSTRIAL
AIR
❑
❑ OTHER
CONDITIONING
y)
DRILLING
COMPRESSED
FK1 ROTARY ❑ AIR PERCUSSION
CABLE OTHER
❑ ❑
EQUIPMENT
PERCUSSION
(Specify)
CASING LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT
DRIVC SHOE WAS CASING GROUTED?
❑
DETAILS
42 6 19 045
THREADED
WELDED RYES ❑ NO ❑ YES C NO
YIELD
❑ BAILED ❑ PUMPED F91 COMPRESSED AIR
HOURS YIELD (G.P.M.)
4 10
TEST
1
WATER
MEASURE FROM LAND SURFACE --STATIC (Specify feed —DURING YIELD TEST (feet)
�
Depth of Completed Well
LEVEL
75
in feet below Land surface:
100
KE
LENGTH OPEN TO AQUIFER.(faet)
SCREEN
I
DETAILS SLOT SIIE j DIAMETER (inthe5) IF GRAVEL
1 Diameter of well including GRAVEL SIZE (Inchaa) (feet) (fw)
PACKED:
4
(PROM �TO
gravel pack (inches):
DEPTH FROM LAND SURFAC
FORMATION DESCRIPTION
Sketch exact location of well with distances, to at least
FEET to FEET
two permanent landmarks.
0
18
Sand & Gravel
18
32
Clay
32
100
Bedrock
ri 2- �• i
-ICA
xg�10
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
WfUL DRIL4&R (SI tur
s fns
■ »
y r..c» — 7-1Y3
I Q IBC
�.v-�_ . ,:.e _ :� i
LOCAL DIRECTOR OF HEALTH