GW1-2021-01683_Well Construction - GW1_20210429

Feb 1519 05;43p Clearwater Weil Drilling 82$-622-7241 PA
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sxnk MIrtian.only t GW t is needed t'rtdinam TOTAL NUMMR of++tells eon4triwAiondetails. You may aim attach additional pages ifnticeasnry.
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9,retsit well dtptlt below bad sluce; ��� y tKF.1 2y,hCA1.MW : Submit 01.4 f6rm wi0hin 30 days of complrsion of welt
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10.Static water tevll b&w top or tagiog: —00 Dividoe of Water RewwCca.tttibnnadon Procalshe Units
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11.ilot+eltoledtametert (in.) 24b.ft Inferflag.M5W to addition to sanding the to=to the addims in 24n
t V above,also submit submit one copy of this tam within 30 t of completion of well
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FM WATER St.`PPLV WELL. J ONLY: blvlsiott 01636 Mnater Rll&M9*rCenater lsatcigt NC� -tb364 ection Control scam.
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The addresses) about, also submit orm copy of this town within 30 days of
t3A.Dlsink%iloa types ,Amount., camptation of well construction to the county health depadment of the county
aAaare atttsttac�d.
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