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HomeMy WebLinkAboutGW1-2021-02143_Well Construction - GW1_20210620 g- -7-- 71 mm�"[X�IGOTU=501P�m ChristopLor Wmhisr —------ Won canhaw Nxne Ex VIM coaua- wr Cefffl[gim]Wamlbw -5QUOU TE gAM ok -;WW4"9Rk=-x Cummings Developments, �nc. calupmy mmm S.IWO coustructiO2 pc�j"t 0. 5 W V L N) is.IMI&CAIM Oa-Imgmm Lve& W zr--i T R 71- �4-47L--v -%��-rmpply-Wd,. m (colter w(H'Adogicooling supply) I3esic7e,ttict11 ater supply(single) hL OndusaUl/Commercie 20 port 0~ Pout W�qUiIbr RadmV PA" SWW and Ikeemery Osalinitv Omier LJitmilwater DrailAw •I T 4=11 ft Ugulmidenm Control (Clow LOOP) V,Tram Geotlrsrrnal eatingCooling Reiaral Fj--4o#h,,t,-Rai' Ok%a�)— ) n muler#21 Ranpsl�s) lIaL.Wall(s)comqjotccos 3-T QoGk &T UY9L PE IV L,- FWmW ID#(ifaPplicable) W. ft L.--- 3 Sal N NC- U 9 H Wk l�urltno�on r. 'JI)N -F A--� Physical AddrM City.and Zip r rotes Pao®l Identificstim NO.(PIN) Ob.HAfmade Dud loneg"'ge Ili deWmdLAUP]tWjO- (if mmll fiejc�one W011B is rUf&jW,) �eWdo or dedmtA&gvm; 10 05, D'Ampo-mi-V C@rli rm.I herOy cwl&IAW lite I mfl(v)VvW,&,ej-,)c=g1jWcf,�'!in 7:8"�; -h W 'm 6 20 8 MOT 1,0 clu enm%ova [Fives or M-No with ,dit., If is a,vam,fill-W 1----11 t a"."'WIZ .I.Pl"m a","a' mpy afOls mvrd kar hem pi vvided to tim r.-JI,G-vner. e,Wllr rz d. all ewmads secaft;j 0).0;?the JYWkfjhJSfOWI, 10-SW dl4vara o7 n6dMouz8 wat deWh: t3,f"01'GOOF"b~r Or Cland-Unp GmUmmal Wells having the swoe YOU May um tile ba&of this pile to provide additional viell sito detsmils ce vj?jj S%Tatftl WeR depth Wiwi inad milfice- INISdIVO Ukft list all APIks IMArml pxample-3@ Submit this %m within ?,0 days of completion of Lill �200-md2@10&) coristruofti to the AbHowing: A% SletrmO;dcdragw[eye? ijigm Bola OT omjqg D MWOU OT Tyntft f�caumc,444nmanton Woes Uurk,V m Wd is UhOW cm 1617 MIN 9-wvIen U"notep;7?eAmph.INC �iigO SlIblilit ORO QIVY,'�)fdlis�Gvfa%Iftill 30&V qf COY4@1@40D UZ rlo"2. 22.IWO comawfte a*ie,&&-ce PL-Sh.etc.) construction to dw fbllovAnB: - VvIater neognm a,u adv fOUU6 HuAetsata ccu ED-tvd u nvo PPOR*ATM OMLV"WNLLS ONLY: Dir'doe of 16%Moil Geyvice Cmt2r,Lblefgh,1�4C 275,39-1629 tk&""(Ipm) m]anonG-! Alf Rcftllf 24e,Vor qIkrfn-r%mp!,�-e. s-1—... vu-m- COPY the addrWK-b)' ftve, also s one of this form within 30 dayy of ImL Obwedion bpe. ortao uciaokkimj UP'vWH conunrofiml tar to county.IWAIt,&AZOWIt of the coinyv w1iff-c constructed. Porm OW-1 NwIli Caralinn rIepwm6nt of (jivniq-Division Clem 1) ,Oil Orjja