GW1-2021-07387_Well Construction - GW1_20210921

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rom erritiiiia 30 of COtgtlelioaa of ataa IB
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Ira addition to senr s—die fore!!8o the s•ia 2'am
M We wastrumm mmftd. ®This foela!Athift 36 dw of ca lla;dola of well
(i a aaunw.amaoty.mm%dam Pm.etas.) conshuclion to die following:
FOR VIAai.3lllNLV wigr�4DFIIl.�ts IIDi�mlom caf�1'J�sBr�meamm II W'MVDU d Eujesdom Coatrrr d lt"mWaw,
Air
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fl3lb IDlslm�aa om�y q __ ¢!ac aadatiaess( ) above, also,submit One COPY of FhisTfOrM arilhin 30 drfl of
ylcsiaaaa a►f a li sssas i 10'ftWMW hasllla dew¢of the coamny
. earlla�colastaal�d.
Form OW-1 . 11YaanllaCeaallna sy taatmat"a��saaari� az�ral _
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