Loading...
HomeMy WebLinkAboutGW1-2021-06165_Well Construction - GW1_20211025 wBLt.CO ,CUON RECORD � tr No�C+avtmBDs�CEmmdNtAntaf QfwLlEtC WRLL CONTMCTOR CKFOMCATION# 1.WALL M IRACIM a TOP�CASM IS _� FT_AbM Lsod Sterfte 'ropofE ftnv*mftdafwbetcwlmMdstabmmWteW*e // a variance in a000rdmice wsth 15A t+ICAC 2C Ah8, tiif� (tia�ntutttal} ��` �r?ry.:7(4 /.J-. t l eta. 1rnC— Yttet.D Up* S tlE-# oF7EST #%H c�s Narrle £ ab�bb 'rype /y T>tf Amount --r STREETADDRM ��.3 Lug-/ J 9- INATQt20NES(depth): l=tmn 4 n To-a—,*—) Fin_- To a.tt J a r. n CC- ciZ D .� Fta�wQ-39 To a-V D Fraoq_To cd1firTown Stye ZiO Code VJL7 V From To From a To Area code- Phone n is C,ASWe: Depth DbMOb3r Tladme t dal 2 WELL NWGRNAT10W. ter, S1i E WELL ID" _ From To Fi WELL CONSTRUG7'tCliN PERT ,El U o -o 3S ' !-tom To Ft� _ OTk1ERAS90CiATBarPL�M1't'�s�►pbcebtel $. GRQtET: DES! !1 IIRe�tad &WELLt�tt W*APO=kiet�III �� Wd ` J RsoWJ C h F��To�_Ft. lour /4h Po4,j w4wore olou (dstuse PP Yn -Is 1 � _ FtiUL ,,,_,To im-m OFl um Z- Y-d-� Ftam To FL it CODIPMW y:3 O ' AM PW S. S DePM Diameter swam Materw 4.wgLL LwATION: hs. CITY: �D: AG✓ 1ft COUNT- ock)^ L44t F To— F:attj To tlr. kL (5b1ee:11terge.� .sued< oA t d Nto,P�indaL TpC9ode� 1Q BANOMMVEL PICK: TOPOGRAPHIC ILAND SEnmfm mowed O' ops 0 dVredCeppopia0ee DmQ t2 Obi — EnamLTo Ft. LAmTum b° 3 D , , Flom T 1L LA, m s, or LoWmm�D a.5 i in adechnd fomrmt From To FL I.atitudeJlon�ibnde scum jWGPS 11 Topo"bic map ti:DRlilttt6 LAG meow ofwed mustbe sdown on a USGS topo amp anti From TO Fontmfime Der3txipr m afledmdEo dumr7nat C,rS) D - �S Qe C! • &FACOMY-imme ermwme wl�eeette�raBisiocsteo fj~ Sb �ra n.` G FAC LttY iD$pE ie NAME OF FACiLt'fY ' STREkTADDRESS Kr ClyorToem State Zip Code CONTACT'PERSM G a r o 1 Sa.e L a w4- (� MAILING & IV... Q r o-V 9d .----T� IBC cs'ti1C� UTI r1 ;i le {'} c._ L>o y fl ,, REMAIUM Nr�f rm��R Sewn COy arTaam State TV dude Ar6a aode- Phim munba L WAIL DECALS: lOOHEFMfCENN-Yn+ur TMWB WASCQNMT4 T®neacoar wtnw a.TOTAL DEPWIIL D xaoor sr~wa r.t�s s PROVMW'fOWMV s7r �►t�o�r+oF as =7 J-7 5r—Y� Z/ c.VIIAACER LEVEL Below Top a€cmi[W_.,� Fr- (Use �RJE j/ 1FAb WBL CONR3ACTOR DATE (Use' dAtroae Tap of Caste �f� PRIN t1=D NAME OF PERSON CONSTRUh CIM THE WELL 1 T Stenliee C NC 37+689-1 p dabs. Ate k[o t 11 Farm OW-tb w w "w701m ad SBtk RW.12W