HomeMy WebLinkAbout1984-7-1 - 130 Graham Road - Well Completion Reportstate of Connecticut
WATER RESOURCES COMMISSION
_ �1L OMPLErfo
223 Stale Office Building
Thisort ���®R�
Hartford, Connecticut
to State Wa must be completed and sub
Water Resources mltted
DO NOT FILL IN
Com
than 30 days after co mtaion IWELL completion p{ well.
W411 No,State - -
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f-i
OWNER
Other No.
WELL
_ DRILLER
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Name
PROPOSED USE OR
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sit Str
Y •_V
Clty and Town Y
USES k
Addrey
V.•
,❑ Domestic
CItY and Town
❑
CASING DETAILS
Farm ❑ Irri Business
9ation ❑Establishment
❑ Municipal
❑ Industrial
ailed
Length;
or
WATER LEVEL
U Test Well
` Feet ❑ Pumped
{+►teasu re from lands
�
SCREEN D ETAILS
Diameter:
to Inches
u
- Hours _ ace)
Static;
Yield:
Kind:
Kind:
'-Feet
�;� When Bailed Make:
G'P M•
or Pumped
TOTAL DEPTH OF WEL- J
L_ � -• s ;�'�
------FEET
- AMLING Fou ENT
Cable Tool
Rotary , E), Other
_ [Sp@cifY?
t, j_ 7 _ Diameter:
Ft. Slot
� Size
In.
Depth From Give descri WELL LOG
Ground Surface ptfvn of formation
f loose,granite etc. Include size r penetrated
packed, cemented, so $ avel (dlameteruch as: Peat- sift, sand
,
granite. ft, hard). Forexa) and sand (fine grav°l. clay, hard
--�_ mpfe: R ft- to 27 ft, fine,um' coarse), color of n' shale, sandstone, FT. to �. --�_ - —---- Aar Yellow sand; 27 ft toIst T84 ru gray
y
FT. to FT.�— --------�_� ~
FT. toFT.---------- -- ~�--
FT. to FT.
FT. -to FT.-�---- ----- — -- --- �+
FT. to FT. ~------------�
FT .to FT,
FT. to FT.
YIELD TEST DqT
�- Give Depths of A IN G. P. M. ER REso ,r
FT. G.P•M• Which Yield Was Tested And Yield COMA#ISSI(N �i �J
FT. G. P• M. �-
-- -- FT. G.P.M. —------------- -- ANSWER=r
FT. G.P.M. ---- -------_� FILED -----------
Well Was ComPleted: __ r- V----------- --�_� -
Date of Report .
Well Driller
(Signature
Certificate No.
LOCATION OF WELL: TOWN OF
SKETCH SHOWING LOCATION OF PREMISES IN TOWN: -
(Show distance and direction from road intersection or other landmark.)
DIAGRAM SHOWING LOCATION OF WELL ON PREMISES:
V,
!E
ROUTE DIRECTIONS FOR REACHING WELL SITE FROM NEAREST CITY OR VILLAGE CENTER: