shall, within 60 days of completion of a water supply well or a geothermal
system, file a completion report on a form and in a manner prescribed by the
Commissioner of Consumer Protection. The completion report shall be
concurrently submitted to the owner and the department. Such report shall
include but not be limited to the following:
(1) Contractor information: Name of the
contractor; address; registration number; and type of work completed (e.g.,
drill bore holes, install and grout loops, bore hole abandonment,
(2) Water supply well or
system location: Town; driller map number; GPS coordinates to the nearest fifth
decimal; address; zip code; nearest two cross streets; casing details (length,
diameter, weight per foot, manner of connection sections of casing, information
on use of a drive shoe, information on grouting of well casing and type of
grout used); yield test information (bailed, pumped, compressed air, duration
of yield test in hours, yield in gallons per minute); water level information
(static water level, water levels during yield test); depth of completed well;
well screen details; geological materials and thickness of materials penetrated
in feet; date well was completed; permit number; registration number; date of
report; signature of well driller; and schematic diagram showing location of
completed well with measurements to at least two fixed points.
(3) Well or system owner: Name; address;
town; state; zip code; and telephone number.
(4) When applicable, bore hole
specifications: Date first bore hole drilled; date last bore hole drilled;
total number of bore holes drilled; total number of bore holes used in system;
diameter of bore holes; depth of bore holes in feet; spacing intervals of bore
holes in feet; average depth to bedrock in feet; geologic materials and
thickness of materials penetrated; amount and type of casing, if any; static
water levels; type of grout used; and amount of grout used.
(5) When applicable, loop field installation:
Installer name; registration number; piping loop material used; number of loops
installed; depth of closed-loop in feet; date last loop installed; date bore
hole grouted; type of grout used; average number of bags to grout each loop;
pounds per bag of grout; and cubic feet of grout used for each bore hole. The
type and volume of closed-loop geothermal fluid to be used in closed loops
shall be denoted, and the form shall provide for a confirmation that detectable
underground tape has been installed above the bore hole location.
(b) Attached to each form shall be
a diagram prepared or approved by the contractor showing geothermal bore holes,
major buildings, septic systems, and water supply wells on site.