HomeMy WebLinkAbout1970-8-7 - 245 Niederwefer Road - Well Completion ReportWill DRIllING BOARD
WDB—4 .1 1-69
PERMIT NUMBERSTATEOFCONNECTICUT
WEll DRllllNG PERMIT 1 1 3USTATEOFFICEBUILDING,HARTFORD,CONNECTICUT 061 15
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A/E/DgzweFEz .3%)!)3a 'LdlNDS’aE
C’ro H H D ZEN /9U6 ’7 ~70
AL D BUILDER D OTHER (Specify)
5o.,LU][\I D fa’E C‘aIxL/x/
PROPOSED DOMESTIC BUSINESS
ESTABLISHMENT D FARM TEST
WELL .People
Est.No.
being
of
USE OF
LOCATION OF WELL (Town)(Stree!)(Lol Number)DATE
OWNER'S ADDRESS
served.
WELL PUBLIC AIR
SUPPLY B INDusmAL CONDITIONING D (Specify)
OTHER
$KETCH OF WELL LOCATION
Loccfe well wllh resped Io at Ieasf two roads,showmg distance from Intersedlon and from of Iot
Locafion of Io?Io u?|easl two roads Well locahon on Io!and Io house (if present)
Indicate North LWé-é”QO
Approximate number of fee?from we"Io
nearesl source oi possible contamination:
The undersigned is aware Ihaf upcn complelion o!Ihe we“,a ”Well Complefion Repor?”containing construction detoils and information required under Section 6 of
Public Act 659 mustbe‘sent to th ner,the Board and the Water Resources Commission on the form provided by the Board.This permit is not valid until all infamo—
tion is filled in and it has been c er-signed by the Director of Health or his agent
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RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
‘-
BOARDL‘
srAIE 0l:couuacncur
wos;5 12-69 WELI.DRILLING BOARD Do NOT H!inh
Siate O$ce Building
HARTFORD.CONNECTICUT 061 15
STATE WELL NO.‘/\
OTHER NO.I
OWNER NAME
John Dzel
ADDREsS-R.F.D.#5.Rock ille C ‘
IOCATION
OF WELL
(No.&Street)_(Town)(Lot Numbel)
Eiederwerfer Rd.'“S;Windsor
pRoposgp
USE OF
WELL
@ DOMESTIC 'BUSINESS
ESTABLISHMENT D mm D TEST WELL
SUPPLY
PUBLIC E INDUSTRIAL
AIR OTHERCONDITIONING(Sp-CW)
DRILLING
EQUIPMENT E ROTARY AIR
COMPRESSED
PERCUSSION
CABLE
PERCUSSION OTHER(Specify)
CASING
DETAILS
LENGTH (fee!)
78
DIAMETER(inches)
6
WEIGHT PER FOOT
19 .45 B THREADED DWELDED
DRIVE S OEI
EYES DNO
WAS CASING ROUTED?
EYES NO
YIELD
TEST
HOURSDBAILEDDPUMPEDECOMPRESSEDAIR l
G.P.M.10 YIELD (G.F.M.)lO
WATER
LEVEL
MEASURE FROM‘IAND SURFACE—STATIC($paclly Tee!)
50
DURING YIELD TEST (lee!)
IBO Depfh of CampIeQed W:II
in fee!below Land surface:200
SCREEN
DETAILS
MAKE LENGTH OPEN TO AQUIFER (Ieet)
SLOT SIIE DIAMETER (inches)IF GRAVEL
PACKED:
Diamefer cf well including
gruvel pack (inches):
GRAVEI SIZE (inches)FROM (tear)To (we!)
DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Skemh exact location ol welt with distances,to at leastMopermanentlandmarks.FEET To FEET
O 8 Reddish Sand
8 68 Hardpan /53 5mg 6/6 )ts/Q ?b.
68 200 Bedrock (
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D I
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If yield was Iested at diEerenI depihs during drilling,Iist below
FEET GALLONS PER MINUTE
DATE WELL COMPLETED8/10/70
PERMIT NO.
ll50
REGISTRATION NOT
100
DATE OF REPORT
8/22/70
WELL DRILLER (Sly I e)
I
STATE OF CONNECTICUT
WDB-5 12-69 WELL DRILLING BOARD
Smfe ORice Building
HARTFORD,CONNECTICUT 06115 LR,
Do NOT M!in
ISTATE WELL NO.
L w ZO :f
OTHER NO.
OWNER ADDRESS
LOCATION
OF WELL
(No.&Street)(TOM/n)'y .L (ELNumber)
"t
FROPOSED
USE OF
WELL
BUSINESS D FARMDOMESTICESTABLISHMENT TEST WELL
SUPPLY
PUELIC D INDUSTRIAL
AIR OTHER
(Specify)'CONDITIONING
DRILLING
EQUIPMENT
COMPRESSED CABLE OTHERROTARYAIRPERCUSSIONPERCUSSION(Specify)
CASING
DETAILS
LENGTH (feet)DlAMETERHnCheS}IWEIGHT PER FOOT
THREADED I WELDED
DRIVE SHOE
z‘YES NO
WAS CASING GROUTED?
YES NO
YIELD
TEST
HOURSEBAILEDDPUMPEDCOMPRESSEDAIR E;
G.P.M.YIELD (G.P.M.)
WATER
LEVEL
SCREEN
DETAILS
MEASURE FROM LAND SURFACE—STATIC{SDeCify feet)DURING YIELD TEST {feet}Depfh cf CompIeTed Well
in feef below Land surface:f§j~l§K §MAKE “LENGTH OPEN To AQUIEER (feet)
SLOT SIZE DIAMETER (inches)IF GRAVEL Diamefer of well includlng
PACKED:gravel pack (inches):
GRAVEL SIZE (inches)FROM (fee?)TO (feet)
DEPTH FROM LAND SURFACE .13509tgfei,22a;et”lto:;aar$g%wagll(s\fvel/with distances,r0 at leastFEETf0FEETFORMATIONDESCRIPTION
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If yield was tested oi differen?depths during drilling,Iisf below
FEET GALLONS PER MINUTE
DATE WELL COMPLETED PERMIT NO.REGISTRATION NO.DATE OF REPORT WELL DRILLER (Signan’ir‘e)