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GW1-2021-03926_Well Construction - GW1_20210823
Feb 1611905:43p Clearwater Well Dr1111n9 828�622�72�1 ' p,1 M CONST>�ON RECO JI{GW a Fnr lnlernni Ue nfy: 1• .il<,rinhMtor tnromattap- . s _ -�- - Writ Contlacior Name vC:Walt Mt/ltgiaMion N,anitct FIL �illQ (ar GR RM a To '1111 YI RU►L t'nmtntnyNnmr. it fi. 0'1'9 2.Well Cowtrtittien ro.11#: V y P 1 ' ©-r c, D NA C—L ;.rsrnir o/'Mlrnhh:roallrnmarucunnlarrnrllr(Lrt rJR Goanly Sur/e Yartanep,ar;.j fi. r� In. 3.1Vt it iigr.(cheek tvetl ttsr); h R rc Suppip VNcR:iculhtralMrherntai(klcatiag/Copilag Suppl ffm isiddAtiai Watcrsuppiv(sinatc) R h, toalrlat/Cnmmeraial Rcsidentml warerSuppiy(SbAMI)oiion8 a Cly p� rut MMMAIMMMfierin }DhPlyYlclh 0 �' 1 F F��.l",1� l IVitn �'t77 nn W�i'li,- . 1tRca►vety u f'*ifer]tccharSc R. 7774 1 �itroundwatcrAcnuAialinn fer Storage and ttrr:nvcry DSnlfnity Qnitielt2r Test OSLormwitwDralnuppritncatai.rcelinotngy �5ubsidcnsr Cotrtrnt tt A. PrMst(Closed Loop) Omm.er RID�nnal r_ K p Qp[inR RcnimL (}titer(gtpLMn under fF21 Rcrnnrks} M m Min � ch't'1- — r. Cu e!I i nra►nnne 5 b 1 ft. Z R '' 11 U �, 1 -U-L rt. , l,.-Q f 1"f( ' - .�,�'•-._� ._ l�:trilit};7lnatcrArraq,; - �� ,r"a-,•. Fanitly! '(ifrq,pJlegTtir.) tl. R. ip A 1'Jrvsicnl Addre.tx,Ctry, �-j-'--`�-' lily �'�•� W Cautny PAtecl ldrntilfcattttn No.(ARs) Sb-11'0111de attd lonl;ttude in dcpr.v/mim)resiseconds er Accimni drgrct~v; 61-71 frcld,n.,iRMOngis R"Maicni) a tt / ni '7 I- 21 { 1+(atr)thendl(s)pi 1►crmanent or f TP.mmrary ilgitalurcnrCMtrtodWaltcmmtttmr o,aG :•to tAi.a rcpgfrtn nncxisNag w�l: fff loves of N. r�l ISAJfr rnic we.elh lSA'VcAcn?Y. rO W'dj c�nnr nrMM'. MWa'4f M"t r .r lrrl,/r ixa rr:/Aolr Jill nurkr:r,ttm tantl.ranan,rllnn Ar/nrmrniaaa,u afi tint rxrrnn'nftha rnRy nftGte rr',Y?Il Aarnlu9!pl7►t7d6Mla llu:Will Marti. r.7mrr undrr r171 ramab(t•yugr a nntln:bard nJlA►sjarnr. M.Stte diarm or*"WOW writ drift: R.Far�mprner/Iq'1 orC,lOa¢8-lnap C.ROlbarmfti Wcilr hnv(ng the.sAme YOU may usn the hack of this page W provide ad�tional urell she deMaila or well rx nstnrotinn,nnh I C*W I is needed. 4ldiaaty TUFA L NUMBt?rt nf,.ritc convtrucrit>xt ddails• Yna may a16D tt(tBCh additional pa$eR if r1DRE89nry,tMed JBMIML `a•7f'ntal Writ do,,�f, 1 S r 1•'nrnur/nn/rxal/.cribs, A, ltr:fern ��/,_� prlo•,,,r�-@,lam «'i �• der au Wetr9: Suhmlt OtfC tbtm within 34 tlpys of imnaimmitm tothc 1b1 oldig: comple tion of well lfl.8t8tFr,NAf1tr level below top of rrrxing: �V 4."W1Ix1rdr1t,crmag,rise"." -(R-) Aivisinn of WoUrRetantrees;InformatlonproeagftUnit, ( y G 161TkAailBervlaeCmter,Wtdgh,MCa7k/4-ib17 RerxrMtedlatereter, U1 J �l fla l ?CIA, it tartipj tt O: h)addition Eo Mani IZ Welt colntinictinn mt:thnd: ` r�t wv�l �'�` n8 the farm r t ra igu mnS In 24n HIMYC,ittan submit rate copy oP this form+Wlhin 3t)trays of eomplWnn of,wcjl -tare,cola,dttnetptlRit,ctc.) - rnnsttuetign tO the foilnwinir iYi DNA 1T�R RCf'I'I V y,eNLV: 'Division of Water Reno nzo.Unfierpround/gjwftn Q;omw PruMM. 1636 M01 SeMce Centt!r;tialcig7lt�NC 1636 134.vivid(RPM) MtMheti of tesC Q(. T x+ic.itnr Water 9Dnety&►eiidW Wdtn In,Addition to."ding the rpm to 13h.i)isinlLMgnn type: die addomq(cs) nF de 3 abnvr, also submit an cape Of this form WdihhR f1 y9 ter, Artrntrat: 4comp OttonlRt W41 enilooctlon lie the C+Qlti1) httdth dglinnitMM of tilt tan»pp ' ----__-_-- NcrrtLldnmllnn,:�atrnrtrttontaft!u..frrfamrnm7fjanllN-I�ivintnnet'WaretAaBaatccs -----•-...� RrufRal2 2�-2Md