HomeMy WebLinkAbout1971-10-18 - 148 Maskel Road - Well ReportsN$$WSLQQ Qd‘Will DRllllNG BOARD STATE CONNECHCUT 'PERMIT NUMBER
W084 11-69 w‘Eu oliiluue PERM”'691 UsIATEOFFICEauxLulNG,HAfe’éRD,CONNEcncur 061 Is
([oi Number)DATE
SOUTH wINDSOR ‘MASKEL ROAD 8 9/21/71
OWNER OF WELIBINDIVIDUAL E BUILDER D ornamspecify)‘JAAN LAINE
OWNER'S ADDRESS
LoanON OF WELI.frown}(Shae!)
The undersigned is aware thatupon completion of-the we",a “Well Completion Report"containing construction details 'and information required under Section 6 of
Public'Act 659 must be sent to the owner,the Board and the Water.Resources Commission on the‘forrn provided by the Board.This Dermit is not valid until all informa‘
tion is Dlled in and it has been counter-signed by the Director of Health or his agent.
APPLI (re)APPUCANT'S ADDRESS REGlSTRATlON N0.
-5 LAKE T.,VERNON,CONN.100
,.BY (Town Health Icer orA t)DA‘lE
.$:APPROVE l 4REMARKSV
RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
44 HENRY ST .,MANCHESTER ,CONN .
PROPOSED
USE OF
WELL
E DOMESTIC BUSINES
ESTABLISHMENT D FARM TEST
WELL
PUBUC
SUPPLY D INDUSTRIAL E éO'RNDITIONING D (Specify)
OTHER
Esf.No.of
People being
served.
5
SKETCH OF WELL LOCATION
Locate well with resped Io at least Mo rodd§,.showing distance from infersedion and from of Iol
Location of Iot Io at least two roads Well Iocation on lot and to house (if present)
,mxl 5e 'D.
L E;,Ea
Df/(C‘A K D.
§C3
R
$
Q
Q‘Q
DD
§
D
X
Approximate number of feet from well to
nearest source of possibie contamination:'75
BOARD
WELL COMPLETI ON REPORT STATE OF CONNEC‘I'ICUT
WDB-5 '2-69 WELL DRILLINE BOA“
State O$c¢Building
HARTFORD,CONNECTICUT 06115
Do NOT M!in
STATE WELL NO.
OTHER NO.
OWNER NAME
JAAN LAINE
ADDRESS
#4 HENRY ST.,MANCHESTER,CONN;
LOCATIONorWELT,
(No.&sneer)(Town)(Lot Number)
MASKEL ROAD $OUTH WINDSOR 8
Pkoposao
USE OF
WELL
g DOMESTIC
BUSINESS
ESTABLISHMENT D FARM D TEST WELL
PUBLIC a INDUSTRIAL
AIR
CONDITIONING OTHER(Specify)SUPPLY
533$L1§r E nomv AIRCOMPRESSED
PERCUSSION
CABLE
PERCUSSION o‘THER(SPecify)
CASING
DETAILS
LE NGTH (lee!)
47
DIAMETERHnches)
6
WEIGHT PER FOOT
19 .45 THREADED D WELDED
DRIVE 5H0
X YEs No
WA CASING GR UTED?
YES NO
YIELD
TEST
HOURSClmmDPUMPEDECOMPRESSEDAIR l
G.P.M.
15
YIELD (G.P.M.}15
WATER
LEVEL
MEASURE FROM LAND SURFACE—STATIC(SpGCi!y faal)
5O
DURING YIELD TEST (I69!)
8O Depth of Compleied Well
in fee!below Land surface:100
SCREEN
DETAILS
MAKE LENGTH OPEN TO AQUIFER (leet)
SLOT SIZE DIAMETER (inches)IF GRAVEL
PACKED:
Diumeier of well including
gravel pack (inches):
GRAVEL SIZE (inches)FROM (lee!)To (reen‘
DEPTH FROM LAND SURFACE FORMATION DESCRIPTION SketchI‘wa permanent
exact locarloIandiiiarks.o!well with distances,to at least
FEET Ia FEET
O l 5 Sand 8c Gravel
o a \f‘E
\/\”Ff \,’37.t’r.
MAM/é Z.'E 0,40
15 5'7 Hardpan
57 10C)Red Rock
If yield was tested at diRerent depths during drilling,list below
FEET GALLONS PER MINUTE
‘
.L l‘‘ll a "J":~
"
’1“;-,'55
.t if:
I ‘.i i I I
DATE WELL COMPLETED
10 é 14 £2 Z1
PERMIT NO..
6910,,
REGISTRATION NO.
IOO
DATE OF REPORT
10/18/71
WELL L (Slgn ture)‘
STATE OF CONNECTICUT
WDB-5 12-69 WELL DRILLING BOARD
Stafe O§Lce Building
HARTFORD,CONNECTICUT 06115
Do NOT f?“in
STATE WELL NO,
SW 4’20
OTHER NO.
OWNER
NAME ADDRESS
EC s,I.
LOCATION
OF WELL
a(No‘&Street)(Town)(Lor Number)
pROPO$ED
USE OF
WELL
DOMESTIC ESTABLISHMENT
BUSINESS D FARM 11 TEST WELL
D §3IEICY D INDUSTRIAL
AIR
CONDITIONING OTHER
(Specify)
DRILLING
EQUIPMENT r ROTARY AIR
COMPRESSED
PERCUSSION B EEARBCLLEJSSION OTHER
(Specify)
CASING
DETAILS
LENGTH (feet)DIAMETER(inChes)WEIGHT PER FOOT
5 $ig‘;
DRIVE SHOE
THREADED DWELDED ”a:YES NO
WAS CASING GROUT‘ED?
YES NO
YIELD
TEST
HOURSDBAILEDDPUMPEDCOMPRESSEDAIR E
G.P.M.
if},f}
YIELD (G.P.M.)
'?E:
WATER
LEVEL
MEASU RE FROM LAND SURFACE—STATIC(SpeCifyifEEt)
EEK
DURING YIELD TEST (fear)
.F:iu a
Depth of Complefed Well
In fee?below Land surface:
SCREEN
DETAILS
MAKE LENGTH OPEN TO AQUIFER (fee?)
SLOT SIZE I DIAMETER (inches)IF GRAVEL
PACKED:
Diamefer of well Including
gruvel pack (inches):
GRAVEL SIZE (inches)FROM (we!)TO (feet)
DEPTH FROM LAND SURFACE Sketch exact location 0f well with distances,to a?/easttwopermanentIandmarks.FEET To FEET FORMATION DESCRIPTION
l5”;
If yield was fes'I‘ecl at dIHerenf dep’Ihs during drilling,Iisf below
Ax;f»;m2 g;
’3 xx;a
FEET GALLOHS PER MINUTE
DATE WELL COMPLETED PERMIT NO.REGISTRATION NO.DATE OF REPORT WELL DRILLE?{Signature},-