GW1-2022-00982_Well Construction - GW1_20220107

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lxperimental Tf:clwnlo15y �Subsidrnr�:Control -�-- -'"- -, _
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tnrdrr a21 rmmPrin xcerJgn fit(M J!n'h?rk r+(l1i18 fan°' )-L Site diagram or a11111O nal WS1 dI lk'
R.i%ir Geoprottel 1PT or Cltraed-Loup Geothermal Welir riavim file vantc �r�»qh��1���ti il.sl k o•they n15p (1f(t to provide
Ad lioRNl p�{sl(f>OCiGAgA�t}�+ i1R fir tuiiT
rxmtomcflnn,onlg i GW-I isnrrded, fiKiiaatu'['O•f I.NUMBER or•wrlls
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►.lratat Well tkpth below Ind surfitcrz __f�•) 2,An,/'nr/► WIA; Submit thin farm"xill"n 30 tiff"S of romplrl)nn of aril
Fkr nrvinpl:+erJ/r Jiecntldrp/lry Ifrti((cr.+nr(vmnnlrr-d(nl7q[J'nnd S(n?1f70'j•^ rnnatrprOnil to dlc rollowing:
111.Sintic Water level helot.top of C.-MMng.- _ ___ _ ^� (ft.) T)Iviainn of Warar Aelaur"&Infit madon tt Prnsi"A Untl,
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1 i.Antrtrole dintMrtcr• __�^ _(in,) 2,Itf.Tnr iw cUgA t jb.- G,addition to Sanding the tmm to the eddr n in Ron
almye,ntao suhta{t one miry of this farm wilW 30 days of r emple tJort of Well
17.Welt ronalrncilart inethnd: co,,xstructinn to(he fotinivinlr
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of Water lRraaurcev,Undtrgr»rnd igjerlbn fnntro)Progrnm,
R WATER Sf'PPi j'WF,i,T S ONI.V: 1r361►hfr.4ervtor Conn,Ratctgh.NC 274994636
I.b.Yirid(gPat)^ 'Mothod of MO.- _ -__-- tdr., I nr y!ale r rote►ak iaioaNen AN: 1n udditian to Sanding the ibmt to
tlrr. address(es) nbovo, also suhmii.one copy of this than within 30 days nt'
UK 1/1sinrtcltan type: Ammunt:,�,,,_,,,,,,,_,,,,y___,,,•_,^ 041%pietion of cacti ennsfxacdon to';tha eonnt hcailh depanmam of the enunly
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