Loading...
HomeMy WebLinkAboutGW1-2021-05192_Well Construction - GW1_20210527 i May r =mow RE= WELL CONSTRIICTION RECORD WELL CONTRACTOR CERTSPTCATION# y-LO i.WELL. d"OF CASING 1S_.�_iT_AboMe Lw d Surfed' /I. ''top of rang tewl d ellor below lend smtaos mayrequae a uanoe in accordace n TM 15A NCAC2C J1118. � Web COrd adOr(ft YIELD Wro):1 -- MEntOD OF TEST Won Contractor c6mpany Nmne S,a WA7ERmIiES(deplb): STREETADDRE3S � 117Q�ee e� Rwn LP To_ yl Rom To yYf a��i iJ li.. n L a70).7 typm 2- To a- o FMM—TO— OWtrTMM State zo t:ode Fromm To From To 3 T 3.7- yr/Z L - oimnete� l**Mms+wele�+ Area cods-ptane number 7. CASUtG: DePdr mat" 5 LWELLOWORMA110M. Ftmn L To Ft, 6`AL— PIQSt,� ��a 1 SITEWBJ_®#t5 - �, To R, W91 CONMUGI PHUr1Td(d E G7 ,1 D -G Raq.To Ft. MHERASSOMATEDPEFWrJW ) L GROUT-6 Deplft Metdl MaWn S.WELL USE g3mmkApOubb Bo*Mo O M+aeaip MobiM D p o A6LariII F.L-D— o s jw�p rp OMM (Muse) bg kn e5 ,G Ffom To FL GATE DRRLED 4^ 1 u -a-1 Rom To Ft. '<<iI�C00lLETED 5; 1 S' AM P4 S. Sl Depo D �ot�ae Malarial 4.WELL LOCATION: Rom— eTo b+- �- 1fa _ ppUfdTl� lPock:n �, T43 k- , 4 BopG.-r I� r e,,l e r jfl oZ 70.Z 7 Faun To (SEteetMe�ne�NrnWeis.t�aamunilr.Sm ltaRtdo.P�ioa��paode) ILSANDMMVELPACIL. TOPOGRAPHICILANDSETTING:O �L peps She Material From To bale IATifUDE �.•3—r I& /9.x y, IU!rA= or. � To FL �-' �' �. inadedmelfommt LONGITUDE o _ 1i.DRILL ING L.OG Latitaddiongitude sours /�(RS 0 TopgMbic mapBorn F�bm Desm*ft g pbwlTarrofwe5rmatbbaft m on a 11Sf�S EOpo napd J TrL !� t :Mc dtedlbMbfarmffirctuaft.GPS) /l- 7S S0J'c e- 7 t e l l e.FAcnjTT-saarw=oi e6iatoeo b l u e f FACRnYIDIW J.4"o -1 �o Ae I (�., e NAME OF FACE ftY76 SiRi�TADDRESS MarTmn Shia Epcoft _ COMM PEW //1 d.'C ry�Y o i a MAMGADDRESS 3 0 2 / re ✓ ✓' Kd - I��tr�r,Qo. - (SlyatToam Slate Mocode Area code-Pbm number S.WaJ_DETAu.S: Iooaeas+r�rTfWTT SWULWnscors'rtetwreortA000 wmt j-�D M.WELL GV�=VW3J.GWNEP- b. ^NO7rw7wr�oP+roFnasa.TOTALDEpilr ; 4 DOES VfELL REPLACE EXIS I WELL? YES0 No waJ.ooNTw►CTOR DATE c.WATER LEVEL Lte�Of r:� 1� Pr;n I NAME OF PLMN 6ONS7RUCtaG IM We.L SLboat the la the Di WOU of W Mom QLiilW WE&130 days. ASM WO 116d011 MBLs Form GW-tb 1et7 MA SarA=tom- ,aC l7S994Ot7 PhaM Wo.(9l9)r33-7ois erd SB8.' Rey IM