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HomeMy WebLinkAboutGW1-2021-02989_Well Construction - GW1_20210521 Jan. 24. 241E 10:5EAM Env. Health No. 6711 P. 1_ WELL CONST uII ON WC0RD,L Al or bumd use ODty_ i.W coouasty lion — Weil tam 70 DEmmulm- -- �'f R it Ncwd,coaaaaaCuffx JmNsmibw - FaQM TO DIAMEImt- IMMAL z_wcncoDsiraceenPa®tts�13��2 OR .�= or go di oppllb*b-il=nMw fmrpr ams PA I=Comy.sa,sr*IfagM gq L ft. IL3.well Use(ebeeknell a t)- .R Agr euttaas) �MmssespaUPobfie ft. m Gmdusmel( �SPPiY) �ResidEotimlWa[�Supgty(Sfigle) d. tt is - lrtdushiaUCamanaoiel lion T AAMMM- lYon-WaterSnpptyWail• Pcwxe4t, -tw MB r£ . ❑Rtxavety R h eetioD d _ Aqui6erReehmge MGmumlw teritaaedWan _ StotagesadB=.jyI JDMWgrSevW TO aurtesw. - - _AgiftT* �StormwVBterDraitDage a d - �paanalTeebaofogy �sneeo�ol d � -Gmdttsutai(dated Loop) OTmeer ,�lnetm - -•- '.-=-i- -�-`.:•,`- Geottramat(Heatiag/Caoliag RPdima Other tmdetSlt Remelts �t To araa+trr�xt a>.rtmuo.m, _ _ fur y-a?>' i/ 4.Date weXs)Completed: wea>nu 6 Q 50 I Sa.WeV Locsftm 90 doo h 61,11,111, IL ft. FacOiryidwncrName 'iT FaeiitrIDs( oFD b1s) m % sy. . d6 G'lon, �a it/ 3 ,ti PkpW .tm.U44 n tE i3yY-,col+ 5/%� ®`r --- comw Pmaeltdemitieasmat.o(PAi) v u i ,s - Lxfituat and totem to dtgtreWinsautestatxonds or dedmal degrees: CitwaltBeld aaatuAmtgies.6rimi) 22.CerhTumfim N z Z r%I*rc)Ihotr R4"of or OTemporuy s- cf we]ICanoscmr Date JbIliA g"Aft Wr do vww rat timv emaonard a ecmrdoeca 7.is ibis a repair to ao ealsting wen: QYes or Io pnti 1xtXGc oac.ar�m rst NGtc oic.olda�.RCmnusrarms ao tts msa o j/rsds/soxpot►,�Uanbma.,.dlmnwuumtrJmmaia,mdmplaDtrheisa6nrofiFa �PYeldarroanHEasbnrapoostafiAro�amaocnxr. rep�rtmda�I.eamv�.e�orororrdrebo�afrbtrform. ' 23.Site diagram or addfflout Nell details; &For GeoprobeWr or Clmed.Loop Geothermal Wdh bnviog the tame ifou m W we ft back ofthia page io.pmvide ambio®i wag gibe dtmils or mn eonstmctiaa,otO I GL-l is needed.IbdIcm TD rAL NilA4M*fvm& Combis ion detmis.Ym mag aisa Dumb wtiosml peget tfammmy. �� CfiahRl7TAL1T1577t 1[_-`�OrfS . 9.Total well depth below lu dnftcu 4900 ((L) w,Fa All wed Submit this AOM wiUtia 30 days of eompletiaa of well cmummdonforaudaple.rdtrtnrarl tJd enr(orampde.3�10o•mdi�tog� leffmf nowiag 10.Static tracer level Leber top of aft. a 7 (It) Dwalan otwataRmourm.iDfettnatton Protesttag un% i61 AMI S rvtee CcWw,Rate%lr*C27S19-1617 It.Borehole diamaGsY: X4 (iti.) M Ror Tnieetlaa WrJ1s: bt addNioa to seadhsg dp:fam to the e!ddtes iu 29a ]2.wensossslrDctlah IDelhod: ahave,aim mbmk me copy of nos hun wA&m 30 days of compkttan of wait C�mc rmery..ume amI)wsb;dQ corotsaatiaa>atbefoltovvu� Divis<mD ofwatu 8etourcm,iJAdexgiroupd I�eedoa Coastal PraErem, IFOR WATER SUPPLY WZ SONLY: 106M211SurvasCentep.BduskmxM9426 7 5 kc- 13a.Yield(QiaD) � Hawoftat: ,• For Wafer t3aeWv 6k 3aiedt we�a; to addition to siding tie tote to eatdatss(as)shave,aim sabmk oat:ew of this 2 m within 30 deps of- 13k Distttfeedon Wpft L Attm a completion of well eonstroction to the cotmW health dasaumeat of the county whoa cmChuctI