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HomeMy WebLinkAboutGW1-2021-03726_Well Construction - GW1_20210823 828.622-7241 p.1 Feb 151905,43p ClearwaterW911Dr11111119 „q,.e.�r•.• �'E-�'�'!C4 TES i�JCTI<UN LCO) tGGW ><) •rnr lM—CM 1 Ti-.aly. t.WellCnntmetmr lnfnrmatton: slaoas anMIN tl+r,11 C'nnrragor Namr r►, VC;RWrll Cnntngnr CeMS119p11 �Fh1111• !t, t). U IL e'n:nlu,ny Namr. _ 7.Well Comarnellnn t'ennit#: .903 I.Gn rrtt npMrcvmrr.W11 rhnrrMWAIJ pirmrrtt•(I.P.1 !RnRry 51415 v&r1mmR'1--j I,1Vci1 1i5r.(ekek wd1 fr R in Wow PPt9 Wt•R: as m to Agricultttrill Dh4tinicipal/PuhNc tr, tn. K Gemixrmal Q•Ieating/Conling'Supply) residential WaterSuppl-v(single) Q fin. lndnstriagCorawroia) tsidentiai Water Supply(S11mvd) pl 4 •r 1Ri DtIDn 2 O A A ; ✓e AND 1Vnn�'1 nrcr$upp)g V1 ell: n" ManitanIng �ORearoreary p" injection ell: �-�- Aquifer iteelittt a QGrovndwatar tteniedialian 19 A tattrrt Aquifi-rScgragc and r2ccova:ry RRtriet Aquitcr Tcsr aftrinweter Drainage Lxperimrnrol Teehuol o C]5ubsidence COMMI, t) R^ Cjenthcranal(C)owA loop) C)nWDF 2a Cleorlrennat(flealin Olin In 00W eotptoin under 021 RctnWV 4,I)AtrWell(s)Completed•- -4,111Ds/•,,,._,,._--_. ' Uy ft. .u.Wc1!f,Myrttnn: )ber1nQ.. ZCux- lfC 1 R l�acrlitycrtlw,+ct•Nwna fAa'lifr(Di!(ifaPprkgble) n' D' ��,','�T 1�1--�r,e- A)�r 1rr R _ V�11� rh'Mianr Arldmu,City,;' zil, �O01jN Yard 141=01cation No.(PTN) t.atitnde nml longittidr in dcgrmnrs/minvte0seconds or decimal dr.Prctts; (i vv)l 601d,one int4ang in aniiiMcrdj (`,ePH inn: 6.ln(ure)the Wdl(s) annanent or DT mpnrary ,FF eof(7etrfied drtlmnaemr Kato l.;p.rtl,7tag iann,i harrhv rmrlfy Mo:lhh% JIN N=Armed 1:otrarrndM Inoccrudmrc, i.7e thfcn repaIr'to aDexMagwe(l: DXCg or &No ed1N1044VIM,.•D�t:.?IRO eH•I.fA NC.RCA?C.p1:lDn'iK:Cortsnaurnn lYomknAv rnrrl,hmn 04,1x:1 rrp:r fill 1"nknmxm mom/a0min,rifnn/ormallnn rrlerpJMn 1/01!,xmnr ofrhn e.nnu nf:M.t tr aretAarht1:l pmft 11)Me WfU wA r. r•7xrfr rx drr A)/Mmrukc BCt:Mtt orrM:Ae hark of r ft.14rnr. oT addllfWlR1 WRH 8-For Gerrprohv/0FT or(3Dsed-I,onp Geolhormal Wells having fie smut: 1'ou rimy use file hock of this page to pravlde adt&tlwd well site derails ar well Ix)-hurtian,only i ClW.1 is necdad, rndimo TQ-rAL NUMBER oNvellc r..mtstowina details. You may abm altaeh addiflonat p W if rimmary. drilled._ �5 31"ntai well depth balowland surfHee: o NnrmnAtp/crcllrlivnllAaMluifd($crnnr farmap/n-3(g -".—M) W ri'er AQ ftltl: Sllinflit this$8H IVIdlin 30 Aaya of C MIPWDD of Well CDRm Mipn to the follu vft If1.Strtttr,calm tevcl below top ojrmsingr --_V_(R.) Division of Water Rmaireek lafhrmaffon Proftvsft Unik !(�slnr,lrnsrr/x�r:r„arrnr/ng.u��e•Q. 1617 Mo Service cbvfer,R61111 .NCa7k"-1617 l i_RonettoteAramatcr; �.�` I On.) 24R,BE INIM111 fi3veR" To Addition In sanding t11e form l4 the it tm In 20 1�1Vt!It conatrnetinn melaad: TI �liM Ftl>nvr?Aho Rubmti anc copy o!this flmn n+llhia 30 dcyQ of eomplettme of we71 0 n,nunr",minry,arh1e,4itect prrtlr,aed '--�'�'- aonstruetFon m the fallowing: l�()R Dlyfflon of Water RRcollrem Und0grannd Injettlon CoMill Pt'agrnn4 WATCR S1:Pt7 li WELLS ONLY: t 636 MR"Service Cantex�tU1N^14C x71051961636 I ta•Yiefd i13ra,,,,,ofteae:, _ Me FAr Water Suenta&iatecNan W 1lp. in addition to scatting the!lain to t.►a.nrxan£ectson eyPe, Amntmt; UIa nddrass(cs) abavo, Disc submit anti Copy Of INS ftsml VAMIn 30 dnys of trompiC"on of well iaFMUUcft to tho M1111g kilith 4glMW=of 1hC 61111lnly vdmre oonsltna w. y �'-^n^tarm!]arMmnnr.of Fiu�lpmprenmt Qrmah,+-Dloasmn o:!VftW Re9onec= _.__... tteui§al2 27-2Rttl