HomeMy WebLinkAbout1971-9-29 - 1349 Main Street - Well Completion ReportI 3M H [Mm 5WWillDRIlllNGBOARDSTATEOFCONNECTICUT -PERMIT NUMBER
WDB-4 11-6?Will.DRILLING PERMIT 5 70 2STATEOFFICEBUILDING,HARTFORD,CONNECTICUT 061 15
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APPROVED 'D mm 'i I,?/qz 1 ///REMARKS
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RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
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LOCATION OF WELL (Town)‘(Shae!)(Lof Number)§mmq 7/4/#0’0 0Z5 /
0 ‘DATE ?—a?a?-7/OWNER OF WELL
INDIVIDUAL D BUIwER D omemspeafy)
OWNH'S ADDRESS?X mE/fv gTRceT goat 716’nooJ'o R l (£00
PROPOSED
USE OF
WELL
E DOMESTIC ESTABLISHMENT
BUSINESS I D mm TEST
WELL -I
SUPPLY
PUBLIC D INDusTRIAL CONDITIONING
AIR D (SPECI’Y)
OTHER
Est.No.of
People being
served.‘6
SKETCH OF WELL LOCATION
Locate we"wi‘Ih resped f0 at least Iwo roads,showing dislance from intersection and from of Iot
'Locution of Iof to at least two roads Well location on Iot and to house (if‘present)
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weLL.
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Lo T
M A°l eo STR‘ée/I2‘6
9:2
\"*o/(_l MIL:{——-——;Y;MILo ->
§£
Approximate
nearest source
number
of possible
of feet
contamination:
from well to M5 ’+
The undersigned is aware that upon completion of the‘well,o ”Well Completion Report"containing construction details ond‘information required under Section 6 of
Public Act 659 must be sent to the owner,the Board ond the Water Resources Commission on the form provided by the Board.This permit is not valid until oll informa—
tion is filled m and It has been counter‘signed by the Director of Heolth or his agent
BOARD
WELL COMPLEIION REPORT S'I'A‘I'E OF CONNECTICUT
WDB-5 12-69 WELL DRILLING BOARD
Siate omce Building
HARTFORD,CONNECT'CUT 061 15
Do NOT fill in
STATE WELL NO.
OTHER NO.
OWNER
NAME
MARTIN G.PANDUCCI.ADDRESS'SOUTH WINDSOR
IOCATION
OF WELL
(No.&Street)(Town)(Lot Number)
798 MAIN STREET.
PROPOSED
USE OF
WELL
gDOMESTIC
BUSINESS B FARM D TEST WELLESTABLISHMENT
PUBLIC D INDUSTRIAL
AIR OTHER(Specify)SUPPLY CONDITIONING
DRILLING
EQUIPMENT E]ROTARY AIR
COMPRESSED
PERCUSSION
CABLE
PERCUSSION OTHER(Spedfv)HAND DUG
CASING
DETAILS
LENGTH {feel}28 '
DIAMETER(Inches)
34'
WEIGHT PER FOOT
200 a THREADED D WELDED
VE SHOE
YES BNO
WAS CASING GROUTED?
YES NO‘I'Es‘?HOURSDBAILEDQPUMPEDDCOMPRESSEDAIR 5
G.P.M.
18
YIELD (G.P.M.)
18
WATER
LEVEL
MEASURE FROM LAND SURFACE—STATIC(Speclfy wet)?
21 I DURING YIELD TEST (I99!)—24 'Depth of Ccmplefed Well
in feei below Land surface:23 '
SCREEN
DETAILS
MAKE
>
LENGTH OPEN TO AQUIFER (lee!)
SLOT SllE DIAMETER (inches)IE GRAVEL
PACKED:
Diamelar of wall including
gravel pack (inches):
ERAVEL stzE (incheg FROM (reez)To (leer)
1/4"18 '28 '
DEPTH FROM LAND SURFACE fORMATION DESCRIPTION twoSketch
perggnant
ct IacatlclandmnaTksLv f ell with distances,Io at [east
FEET IO FEET
0 16 Find Sand
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16 28 Coarse sand and light gravel
lf yield was Iesled at diRerenI depths during drilling,Iisl below
FEET GALLONS PER MINUTE
’o
DATE WELL COMPLETED5ee>m 7.1971 PERMIT NO.
M02 REGISTRATION NO.DATE OF REPORTOCTJ/7//DRILLER (Signatura)
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