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HomeMy WebLinkAboutGW1-2021-06862_Well Construction - GW1_20210429 i`wdI C'naleaeCnir loibrlgatbtn: „�� -- - +it .rnsaaaa ivnme T nPt� °�� t► __ IL 7(c WatlCnnttaQCASM mCatifuxlienNimshar �4 Cnntpnay Atbnc ��! �"' 2-Well Comment tao Penatit tt: S 21`-'ti c %Lrl etll r+/v+Ilarbla well amsrntmlonpofxMs(l u f/l GAm�Stall varlmrrc ere J II ie. AU 3 WC111 lilt(chddt Weil on)_ [AqWfcrSWqCM4RMtWqy 7, to uhuml DManWilaftblie 0. IL �•c'w(Re tiveoming&MM 13Resideo M l� awSupply(9',1*)}rialiConanaftj DltecidORW Waim'Sappiv(shwad) lionht iiTakrt^ttppovmy tr. 0- " fraundwaterttcrocdistitmMtW nt Bendier a A Aqulfeffeg E]SMMM W Draloase n e- i zperia"MI Terinmiogy Control a I Gonth-Mal(Closed Loop) QiTcnad. LOGMIN G;ZX—rAI*eAft6Wl cietsatamat Kasten ii�+m} in tatdar#21 Remarks} l � t� `+,S- tt C� c�-����-' A.INrrewo(n)Com:plew; weil,ihll c. h' �5 1 f4 l _ e� l LC' �C Sot R' mot. rG ^1� ( T P1)CiliZ1}'C�kmCt) me, .�f Fa_M b WIN(ifaPplICINa)N f Physicall Addross,City,and M tt C anraY Ptireel Idamitfcatitm Na(PIM -5a.Wtritade Rod 100 tthde in degreca winattestseea"ds or decimal dcgreas: (iitwttfrelA,AneInvim,iasailawo , t; V .�� 7zeardIIration.. � S 7�9i,-t-1+i LDS �S' w - ti.1s(nm)the well t(a Peinanem or Dr)'i-wpora>ty nitkrtirreLtvldiCanhnator gate ?.ihfillsnrepairtoane*d4gwrA: Elva or ONO will, na,;are TBR+apJA�+Marshr..0200 dJ{ansf diorown WWaW B --'Amer apt+p 15.tAit.:',1C.'02t.'.Oi06m�1SA�Yf;AC'!i?G'!r)HIDWaflCnnslnr+atfa�rY/ahah+aGm►r1+hma lfrbltivargWr.119ma'ifoeownw4.4 dworpwavbh/nrma+lvnmrrtrspfdn+lAtwunrefOho S M,ofik's rewd ImWeen MwvbWfPrIwwdItMwff. rl,•Awrradar R1t rataaft=0W arm rlt:lrarkaflAffiewe' ?Xwite dia rsmoradAtioamhvIVdeMll9: R.nor(ieopraheMVT ar Ctaaeti-t np GeolTserthtal VYt11n having Mccsimc ),*a inay use stew bnak of digs page to povide adtliddml wM site detsita or well extartnrctian,only.,I GW i is needed. fndtm*TOTAL NUMBER orwalls er)li9tlVCtinil dtKnils, YOU MY also atktob MWIR mdt pap$if nn anuy. 1,.�. .*"nC1sM/7'1'tL..itdi3TRitC1701VB 9.'1'otO%wldeptA Now land sartnea 4 `5 . 18,) Submit this form tirift 30 days of com0dion of well Par IXIIIA ltxKllvu.wandrJArltr,'Jiterune(tams*uiml ►'mxi�httr } fi l ihefdloi►lD�t: 1".811109 wat"ltvd belaw top of easing: (tt.) DW49a of Water Ramow e,Infa s don Pftvnft llidt. 1J a pfkr lLor l Jx f+M1tre atttn�r1cc" ( 1617 MA;Satvset Center,lbkilik NCVM-1617 11.IloncholetfJanteter; {ia.) r 24h par:sIECean WAIF in adrdciaa to risrtdittg the Ills"ns ft odhOw in Teo !2 N+el1 cimatraeiiora thahtilasd: �i � ��'i *om+dw submit one oopy of this Jim',within 30 days of asuWadem of wdl Amer. •mbk (�a. ---------, cntisfrntdiattit*ihefoliowinp; ,trirgti Ptah,she,} wATiElz Division ofWater Renourm%Undergkound 1q(ation CoArM Ps'opuffe POR tRf:PPI1fWE1.I,SONLy. IMrwallserviaeCasaw, igh.WC"09-i616 [173o.Yield ) } of test: 3�MC k►`%Jgr 3a }& Imtian itYe1� lit addOlon to�s m tg fc linen to the raldtess(cs) abavr ert�r submit anc copy of phis rotm Within 30 days nF A.Uisla#'cctfan types- Atnotatt a mptetion of wdi Corzaacdon m ibe cefmny heatW d noeihe of the county vdnft oonaftw il. yarn CW-1 iQatrhthMMIFm t?ayaemsantof1:"-Iwn m+awQualitw-owstnnotWaterAffowen Reviaed2-X!2atb