HomeMy WebLinkAboutGW1-2021-03566_Well Construction - GW1_20210823 PA
Feb 151905;43p GlearwaterWeliDrilling •' ' '
W IG GONS ION)(tECO I (GW_I l For lntelrini Use oty:
t.wc'ilt'.onsrxernr lnformatlon: �. -
Well Conn ela Now f i0. it.
NC WCit CaMM001 Catificatlon Ntrtnttcr R C R1biG for
e
/) ` r, ` tin
I
r1 tR�M I P.
'flit M^ATCIWL
�J/I, Y it; �Z % t l P I (�
Cfwmp"n,Wamr. 6.lNt+f6R C NC tM t
z•Well Comttrnatinn Permit k: 0 D ft. ft 6n.
id'vitliaP141wbletnullCanarrtrcrinnparm0x(lye IJK Canrx�!Sraln Yarlancv crc_l s�
3.1vr1i irgC(cheek well rise- TZt3C N
Witter Supply we": kneel rr► n sea u
Agricultural �MmticipnUPuhEic () Ae n. i"
Geothermal(t4eatingrCooling Supply) ffRalitential Wa%.Suppry(single) R tt• to
IndustriatlCnmmercial Resideriftl Water Stipple(sharod) &
irti otion a � COMMA •crst n o
Nrm�'1'nter: n•
}uFply WA
� .
t\4onitoting Recovery UT
tt� fa
injec:tton Wdl: —n: {t,
Aquifcr)teebt c E30ranndwnwrltemediation 14 p(dp/GRAt�BLFA
�, tat•#•►toa
AquiferStorgc:firdRecovery DSnlinitySorrier �
Aquifer Test [38tnrmwater Drainage R
Experimental Technolaw r3sumidcnec Contmi
Geothermal(Closed Loon) 13Traccr .t1Altd IOC
ew
Ciantilemma!(Hentietp�Cooti(n>;��Raurn) 7Otheriexplain uttdcr i121 Rcmarits} �j TO
-7 ft,
a,Date Weq(s)Completed:UL .`!�'Well iDq.—,-- J ft.
.40.Well i,nwinn:
F3dffty)0%"mrXmn(.- Facility[Oil(tfnliplicebtr) IL r `�
('1111iPill Addm.4,Cl, ,and+Ta'p ft �
li AR ,
Caumy Ptnrct ldemittcation No.(Pit+)
5h.Latitude and longitude in de mm/min»res/seconds or decimal drgrecs:
(ii wgtl Geld,nn+:tttt% is soil' cn1) D n (;f tffi ion:
thewdl(a) Pirrttenent or DTPmpnrary Spnetnranf(kttrficdwetlCnmrnetor Dnre
�.,,/ p.tlmiall rhhr farm,1 hPrrAV c.wfJfj+rho:thr ttw,7(,0 Wo fwmv)f0 n WJW!b ocrnMo.•nr
?,iy thiF a repair to nn oxisting fuel!: ones or No bent iSA Y-r..4r?02C.0100 or MA N(.AC PX.000 Well Cwtrrrnctinn Uraralaala mid ohm
Irrhlr is:I repefr.fill awkmwn to,Jl•roaaremllnn h(/nrmarinnmal eaPlan,the rur)prr nf,ho "•M)y ofsh!s nt rrrd NachreR(lratidialla 1JY!wr!!nwnei.
r.;%nir soda c71 re04*SCdhat ar oalfic ham-n(fhti jam). 23.Sfte dkW m or additional!Vail dee411s:
R-For GeoProhe/ill f or 0osei%4A tp Geotbermal Wells having the same 'tr xt msp usa ilia back of this page to provide additions)Weil site deWla em w0l
txnsmtction,only I G%1•I is needed. fndicwq TWAL NUMBER ofurlis +:on.9wiction details. You mayalto ettash addifimel pages if nocmry.
driNui•
•_—_ ---•--- ;�itiiial�_ Ai.�l�j�$!crsows
A j�T'101 well depth below land surbet: _ 00 2.1a.For All Wells: Submit this knit within 30 das%of completion of well
l�arnn)hipfewelltlitrMldirPrhrrfd ¢rrtnr(eramph 3r�iT!!R'mrdc�n11007 wilmi tiontoThefollmThm
111.StIltic Witter iewcl below top of essing: (fry) Divit(oa of Water Resources,fro rmatlon Procesft Unit,
1f im/rrltnrrlsatn)mcaslrrg tnr".••( 16!?lt)IaR Service CenMi',Wtdgh.MCa71i�-i61?
1 i-Ronehoie diameter: /�(i�n.)J� p� 241►Fm Ialecti�on,n wane: In addition to sending ft form to the nddrm in 24a
f 2 !Yell cRnatrnCtinn methnd� � ►,1 fig
rd>ove,Ow submit one copy of this fm m within`30 days of comple0m of we]t
(;c,m)ge•,MW .rabic,4irarA pttsh,ctc.i construction to the following
Dlvislon of Water Rtaottrerc,Underground injection Centr'el Progrnm.
TY?tt WATER St:PPY-V WELLS ONLY: 1636 Mail Savlee Cam w,WOO,WC 7.7094636
13a.Yirid(gig) .)� MathrW of teat: ! roe.For Willer Burney&tteieelian Wdtia In addition to:amuling The form to
the ndlimm(es) abnvt:, also submit one copy of thi¢ farm within 30 days of
jib.t)rslnfection type: e�mtnmt completion of well a►nsunetioa•m the'cmaily health tle(nMant of the county
_11e otin9tntEnd.
IrmnCal+�t NcvlhCnmlfnnl]apnrmtone.�irin.•Icnnmrnmt Qanlhy-i)ivrstnn oft'Waert Rc9aun;ec Revigetl2 X!2Rtti