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South Main St. #340
Depi(rtmeh'2 of EnvironmentalManagement/Division of Water Resources • Y� �WATER WELL COMPLETION REPORT WELL LCIC TI N 7� GEUGRAPHIC UESDRIP I IUN Address'�YI F�lvti 1. N SEl W of (reed 4c%m/e/ City/Town lPubl✓11Sr'lLL I� tvb)�i(:>'J al. Well owner11 Address fq� S�A� �Ej/'J/lrzy N i/S) E W of �� _ C� 1 tD l 1 (�nl. in (enthel �'��jdrdO Board of Health permit: .yes ❑ nod© intersect. W/ l "( a/ WELL USE - WELL DATA --2 f )5, U f l Domestic ❑ Public ❑ Industrial ❑ Total well depth ') D ft. Mo[titoringp, Other Depth to bedrock ,- --�-. ft. Water -bearing rocklunconsolidated material: Method. drilled — c Descriptlor V?j! SIL' j.Cy!" rra i�.rJc Date drilled Pi�f� � 1� j..I Water -bearing zones CASING t - 11 From Y y To i Type— Length-1` V 2) From To ID ft. Dia(.LD.) in_ 31 From To Length into bedrock ""•M ft. - Gravel pack well: dia. Protective well seal: - Screen: dia. Grout-0 Other Ci%ti�''t' pll I Slat+" O1 U ian�gfh Lfrnmto`3J PUMP TEST Static water level below land surface ft. Date Drawdown ft. after pumping I r' hr. min, at gpm How measured Recovery_ - ft. after—hr.—min. 0 LOG of FORMATIONS COMMENTS Driller Massa Registrationff s _Y vl fit. r` =P.c 9 rinr brmly B