GW1-2021-01887_Well Construction - GW1_20210429

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uinsinitxien,only I GW 1 is needed. Faduatta TOTAL NUMBER or-kwas cO Wnwlilal details. You may RIM attach a1111116mial pages tfneerasaty.
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u Total wdttteQtp tletaw land tcurlNt o: (R.) 240, Var AM WINI: Submit this fbmt'WIMP 30 dip of compltdion or well
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;2 Wett emtucnic0tat taMltad: 1 v�V l 1,1 alcove,also Submit one copy of this form-hide 30 days of completion of wall
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WATER tSR pPf V pig q t>NLY: Dl�sion ot'Water'Rtaaurft%Und1>11YOand i njImifto Cowl Piomak
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The nddlets(es) abovq also submit one copy of 05 form w7111I 30 days of
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