HomeMy WebLinkAbout1964-6-3 - 1281 Main Street - Well Completion Report“mu:§QMPL§F§§N REFQKE
This report must be compleQed and submitted
to S‘iate Water Resources Commiasion n0 £3Wier
than 3O days after compietion of we“.
utate or Connecticui
WATER RESOURCES CQMME3S5GN
317 State Office Buiiding
Hartford 15,Conn.
DO NOT FILL IN
Stata Wen No.WV /99.,,,...__.
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PROPOSED USE OR USES (Check):
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g Domestic [J Farm U Irrigation
a’:
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City and Town
Business
Q Establishment G Municipal E]Industrial L‘]Test Well
TOTAL DEPTH OF WELLLK-Lrii A 1“”FEET
WELL LOG
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CASING DETAILS YIELD TEST WATER LEVEL SCREEN DETAILS
Length:f/&Feet
E BEIedior
Q Pumped éw Hours
(measure frcm land surface)
Static:agar Feet Make:
Diameter:é ’7 Inches Yield:y G.P.M.When BaiiedorPumped Feet SlotLengthFt.Size
Kind:a SWSédv/Diameter:In.
Depth From
Ground Surface
Give description of formations penetrated,such as:peat,silt,sand,gravel,clay,hardpan,shale,sandstone,
granite,etc.Include size of gravel (diameter)and sand (fine,medium,coarse),color of material,structure
(loose,packed,cemented,soft,hard).For example:O ft.to 27 ft.fine,packed,yellow sand;27 ft.to 134 ft.graygranite.
5;;FT.to/‘g/Fr.%a,{1%,,,'
x?”[4f FT.tof‘/’FT.
FT.to FT.
FT.to FT.M emchag to)”:N V‘V’
FT.to FT.
FT .to FT.
FT.to FT.
FT.to FT.if]
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FT.to FT.
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FT.to FT.
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FI‘.to FT.
FT.to FT.
Date Well Was Completed:ozgwf i5?../Qé:§/Date of Report y?!”£31“;.u’y:g)ff
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LOCATXON OF WELL:TOWN O F'
SKETCH SHOWING LOCATION OF PREMISES IN TOWN:
(Show distance and direction from road intersection or other landmark.)
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DIAGRAM SHOWING LOCATION OF WELL ON PREMISES:
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ROUTE DIRECTIONS FOR REACHING WELL SITE FROM NEAREST CITY OR VILLAGE CENTER:
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