GW1-2021-03770_Well Construction - GW1_20210823

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Owner:
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h Well:
r nit: pair:
I hereby certify that the abo
all County Well rules. referenced well vuas group aPP 'ance in accordance with
Well Driller: �
— C',0w 5 Signed:
Certificate#:
Date Grouted:
Construction:
Grout;
Total Depth: �j SV Type. Mu"0-
(asing Type: `�+- Pe i
_ Thiclmess: (Y)�Gt--{ �
g Depth. Depth. 6Q
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Weight/Thick:
Drive Shoe:
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