HomeMy WebLinkAbout2012-5-14 - 116 Lisa Drive - Well Completion ReportForm provided by Forms On-A-Disk,Inc,-Dallas,Texas -(214)340—9429
STATE OF CONNECTICUTDEPARTMENTOFCONSUMER PROTECTIONREALESTATE&PROFESSIONAL TRADES DIVISION
WELL DRILLLING COMPLETION REPORT165CapitolAvenue,Hartford,Connecticut 06106
DO NOT fill in
STATE WELL NO.
E
OTHER NO.
%OWNER NAME um
MACPHERSON—D&D HEATING &A/C
ADDRESS 1 has“
116 LISA DRIVE SOUTH WINDSOR
LOCATIONOFWELL
(No &Street)(Town)(LotNumber)11 6 LISA DRIVE SOUTH WINDSOR
PROPOSEDUSEOF WELL
D D E§$A“EEL?§HMENT D TEST
WELLDOMESTICFARM
I
SUPPLY
PUBLIC D INDUSTRIAL AIR
CONDITIONING
OTHER
GEOTHERMAL g
DRILLINGEQUIPMENT D ROTARY $AIR
COMPRESSED
PERCUSSION D ‘OTHER
(Specify)
CASINGDETAILS
YILD IE
LENGTHqeeI)
40
DIAMErERgnms)
6
WEIGHTPERFOOT
17 $D WELDED
THREADED
DRIVE SHOE
$YES D NO
WAs CASING GROUTED?
$YES D NO
I U BAILED D PUMPED E COMPRESSED AIR HOURS
4
YIELD(GPM)
5
WATERLEVEL
MEASURE FROM LAND SURFACE —STATIC (Specify feet)27 DURING YIELD TEST (Ieel)445 Depth of Completed Well in feet450
SCREEN
DETAILS
MAKE l LENGTH OPEN To AQUIFER (feet)
SLOT SIZE DIAMETER (inches)IF GRAVELPACKED hegjgygeter g gravelOf wellpack(inches)
GRAVEL SIZE (inches)FROM(feet)TO(Ieel)
DEPTH FROM LAND
FEET TO
TO SURFACE
FEET
FORMATION DESCRIPTION
§
Sketch exacl location of well with dislances IO al least two
permanent landmarks
RECEIVED30SANDg“
30 RE 450 BEDROCK
HEALTOUTH WI NDSOR
H DEPr
IzJrX%
SI
Ifyield was tested at different depths during drilling,Iist below
FEET
420
GALLONS PER MINUTE m
5
/'—.>-‘TTT.T \we;\>m‘wa/.K m\
DATE OF REPORT
05/1411 2
’“gW/ELTDRILLEB
1x
L DATE WELL COMPLETEDE05/1 111 2
PERMIT NO
2521 38w
REGISTRATION NO
4
Owner -Contractor -Dept of Consumer P%tection -Dept of Environmentai Protection —Water Resourcesjocai Director of—P-ublic Health