HomeMy WebLinkAbout2006-8-1 - Well Completion Report'<~~.A.‘
CPR-8 Rev.7/95
PERMIT NUMBER
235461
LOCATION OF WELL (Town)(Street)
South Windsor
OWNER OF WELL INDIVIbUAL V
Rob TaraOntino
STATE OF CONNECTICUT
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE &PROFESSIONAL TRADES DIVISION
WELL DRILLING PERMIT
165 Capitol Avenue.Hartford.Connecticut 06108
(Lot Number)
1511 Main St
B BUILDER
1511 Main St'South WindsorOWNER'S ADDRESS
DATE
7/18/06
OTHER (SPeCW)61 4 —1 7 8 7
Locate well with respect to at least two roads.showing distance from intersection and front of Iot
location of lot tb at least twa roads
INA!‘Indicate North
Well Iocation on to and to house (if present)
itCvI
o5
Approximate number of feet from well to
nearest source of possible contamination
The undersigned Is awa
Section 25131 of th
APPLICANTS ADDRESSPOBox 406 Wllllngton
BY (Town Health Officer or Agent)
REGISTRATION NOI
42
DATE7-;y.06ra
REMARKS
RETURN THIS COPY TO DEPARTMENT OF CONSUMER PROTECTION
ietron of the well a “Well Completion Report containing construction details and information required under
to the General Statutes must be sent to the owner the Department of Consumer Protection and the Water
provrded by the agency This permlt is not valid until all Information Is flled in and It has been counter-slgned by
r .
w
-.-piI
Est No.of
PROPOSED DOMESTIC BUSINESS FARM TEST ..Peopla being
USE OF .ESTABLISHMENT WELL seweq
WELL Pustm INDUSTRIAL AIR OTHER 4
SUPPLY CONDITIONING EASPeCi'Y)
SKETCH OF WELL LOCATION
AGENCY
CPR-9 Rev.7/95
STATE OF CONNECTICUT
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE &PROFESSIONAL TRADES DIVISION
WELL DRILLING COMPLETION REPORT165CapitolAvenue,Hattiord.Connecticut 06 I 06
DoNOT Hm
STATE WELL NO.
OTHER N0.
OWNHR “ME
Rob Tarantino ADDRESS 1511 Main St South Windsor
LOCARONOFWELL
PROPOSEDUSEOF WELL
DRILLINGEQUIPMENT
(Na.s Street)(70W)(Lot Number)1511 Main St South WindsorTa2::;zi.s:m FARM
WELL
TEST
PUBLIC INDUSTRIAL AIR D mSUPPLYCONDITIONINGS MROTARYCOMPRESSEDCABLEOTRER
AIR PEncussION RERCUSSION $mww
CASINGDETAILS
LENGTH (Iago131 DIAMEIER (inches)
6
WEIGHI PER FOOT;
17 Ea mREADED E WELDED DRIVE SHOEm'YES U No.
WAs CAsING snow-En?.m VEST D No
YIELD TEST DAILED D PuuPED conPREssED AIR nouns
8
YIELD (Gm I
20
WATERLEVEL
MEASURE FROM LAND SURFACE -STATIC (Spacity Ieel)
30
DURING YIELD resr (rem)
265
Depth of :omplelea Wen in Ioel
‘265
SCREEN
Balms
MAKE LENGTH DPEN To AUUIFER (tea)
SLDT SIZE DIAMETER (inches)IF GRAVELPACKED:Diamalar of wanincludinggravalpack[inmon
-GRAvEL suzE (inches)FROM Ileel)To (mu
DEPTH FROM LAND TO SURFACE
FEET TO FEET
FORMATION DESCRIPTION Sketch exact location of we"with distances.to at least two
pemlanent Iandrnarks
0 9 Topsoil/gravel
I14
Pr apa se&
VIM/U
IH\GLO\:S%r’
9 118 Hardpan
118 265 Gray bedrock
II yiela was Iesled al dlllerenl deplhs during drilllng,Iisl belaw
FEET GALLONs PER MINUTE
DATE wELL COMPLETED
7/27/06
PERMIT No
235461
REGISTRATION NO
42
DATE or REPORT
8/1/06
wELL DRILLERI
+Mn$
I14
Pr apa se&
VIM/U
IH\GLO\:S%r’
OP H-9 Rev.7/95 Do NOT fill in
DEPARTMENT OF CONSUMER PROTECTION
REAL ESTATE &PROFESSIONAL TRADES DIVXSION OTHER NO.WELL DRILLING COMPLETION REPORT
1 65 Cap1tol Avenue,Hartford Connecticut 081 06
OWNER NAME "’
Rab ?araatia0 ADDRESS “i511 Ian“;St 3 3L3 t1 w‘iniégar
LOCATION
OF WELL
(Town)(Lat Number)
1 *3 1 $auth Win§50r
PROPOSED
USE OF WELL
DRILLING
EQUIPMENT
X DOMESTIC BUSINESS FARM TEST
ESTABLISHMENT WELL
PUBLIC INDUSTRIAL AIR OTHER
SUPPL¥CONDITIONING (Specify)
ROTARY COMPRESSED CABLE OTHER
AIR PERCUSSION PERCUSSION (SpecifY)
CASING
DETAILS
LENGTH (fem)‘I R1 DIAMETER (inches)WEIGHT PER FOOTI;TI x:THREADED WELDED
DRIVE SHOE
D YES D No‘
WAS CASING GROUTED?a VES a NO
YIELD TEST DAILED FuMPED COMPRESSED AIRTi HOURS YIELD {GPM}
WATER
LEVEL
MEASURE FROM LAND SURFACE -STATIC (Specify feel)
3 3
DURING YIELD TEST (feet)
2 Ea E
Dspth of Compleled Well in feel
{4’v’5
SCREEN
DETAILS
MAKE LENGTH OPEN To AQUIFER (feet)
SLOT SIZE DIAMETER (inches)IF GRAVEL
PACKED:
Diameter of well
Includmg gravel pack
(inches)
“GRAVEL SIZE (inches)FROM (feet)TO (feat)
DEPTH FROM LAND TO SURFACE
FEET TO FEET
FORMATION DESCRIPTION Sketch exact location of well with distances,to a!Ieast two
permanent landmarks
J
§r a Qo Sag
IDEA I
5L xx 52+“
E ‘E I 8 Ea3;aL%
If yield was tested at different depths during drilling.|isl below
FEET GALLONS PER MINUTE
DATE WELL COMPLETED
1 I.1 ,3 3
PERMIT NO.
2;3 5 E.7‘‘I REGISTRATION No
F2 Z
DATE OF REPORT’3 g’T f 3 S <WELL DRILLER a u(Emma Em;b
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