HomeMy WebLinkAbout1974-9-20 - 1609 Main Street - Well Completion ReportPERMIT NUMBR
2 6 0-5 14WELLDRILLINGBOARDsTATEOFCONNECTICUT
wnaca‘1H?)WELL DRILLING PERMIT
STATE OFFICE BUILDING HARTFORD CONNECTICUT 06115
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RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
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OWNER'S ADDRESS ‘
DATE ‘-7‘’15 v7l/
I I
PROPOSE
USE OF
WELL
m nomasnc BUSINESSESTABLISHMENT D
'surpq‘PUBLIC D D é'okunmoume (Specify)
OTHERINbusmAL
Est.No.of
People being
served.i f"
SKETCH OF WELL LOCATION
.v Locate well with resped to at least Mo roads,showing distance from Intersection and front of lot
--1ocation of lot to at least two roads Well location on lot and to house ('rf present)
Indicate North
t
[1 L A/
Approxlmafe number of fee?fromglvell IO ~J
nearest source of possuble contamination
The underslgned Is aware that upon completion of the well a ”Well pletlon Report’mng constructlon details and mforrnahon requn'ed under $ectuon
25—131 of thel969 Supplemen to the Ge —l Statutes must be sent to the owner,the Boar nd the Water Resources Commission on the form proVIded by the
y the Dnredor of Health or his agent.
-AI.
1
REGISTRATION NO.4.4
APPROVED
DATE '
a IVA
I IREMARKSl
REPORT ~‘smr:o‘r couuicncur ;I ‘.wuss 1269 REV 9.71 ~._WEI.I.DRILLING BOARD '
..'‘‘37 "'State Office Budding'g HARTFORD CONNECTICUT 06115
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m PERCUSSION
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I CABLE
PERCUSSION
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CASING .’
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LENGIH (feet)/07 mAMErER (.nihu)wslsm PER Eoo-I
‘_~/7 '[ETHREADED D WELDED ..-
"E aAuED -‘.‘gcom’kEssED AIR ..v
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MEAs'URE Fab—M 'L'A ‘NoTURFACE—smno(speafy feet)‘'
oumue YIELD resr (fem)“._‘
'Dep'h of ComPImd We"‘V
In feet belcw Land surface .,'_-'0 -'
."IENGTHo EN Io AQUIFERIIeeII
IF GRAVEI;PACKED:;
'Dlameter cf well‘Includlng I
;--gravel pack (nches)~'~oEpnI FROMIAND sunFAcsh I ‘
dlfferenf depths during drllllng,Ilst below
.PERNI‘II'NO:.;=.-~gx.
_..._R_EGI51RAI;ON N9.
_
DAT OF REPORT
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