GW1-2021-02144_Well Construction - GW1_20210620

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Well Contmaor Name
'Wall Co;.trzaNCOWAICulim NuuuisrU OUTIM't^d,SdRIG ffor sue! awi sue _ fl.�C,i�3 i8 n E - -
Cummings Developments, Inc. TO i �aara�.n_�s�tcas >tanrat:w:
tiwntwny Name
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Pteaat Wentificohm No.(PIN)
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u.Irian)We cteu(a) °e au¢aaE oe. of Certified well c:ontrt*w fete
Yj+AtARInl{thh,OrK I hwrd y aea10 that the uvg(s) caaastruded aN avowd lm
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(fthis is a MAWF,,All Ow&ao,eaa cmll construction trobrnfmtor and aspla in dw aami m ofth2 twpy(l h's mordhas hewn pim i ed to the Weil ormar.
"epnir?w*;-aai rumar.'rs sesttoaa na•on the Iaact of thlfo s ra,
?;l.Site Ciifa$'a'raFs3 OS'addi4louaB.tcli a�etalls:
& my Qwed-L3vp GeoMea uial'Pella haft tiro sfir�je 10"MAY Laic die bad:of this a,")to provide additionai well site details or rmll
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t n;aiultip/e wells lis!add,/saXhs ffcli(eresa,t(cxamplw-3�?00'atad a(a�100) _-- Submit this Yorin within 30 days of compledoia of VNII
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_--- 4�L rtla,• 24 )Loa•hW29tloa WA4. In addition to sending the foim to the ti�cli=-in 21n
R1 Weii ooust eden aiaeviaed: 6 i }F y aabr vn,WSO SlIbmit Onc G9py Of this tbmi kl tiitn 30 dwA of m aglWon Of mail
0-aul,rotary,ecbl0.alfi Ee Iamb,eta) '-- constmetion to the following:
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i&a^r yld( ) IN�t^t0ti t�rc�,c -Par��al�� _� to - ......:.
Z4_ .of IVrte Saar�:• R.
h n ! Sac aWress(es) Ekove, also submit one copy of this fora:a withal 30 days W
---- Vie• _-- Amoara.:,--_ O Z-- Oafilokkion of ml!cos mmiml to tits Witty lia9di r#trtt wiffitm of the c013ac!
e:hem constructed.
Fatni DW"i Ntxtla Caivlina ruifurma rtY of rsoviioat:.az a:a OunI'ty-Divialan of WSW Reamam 17rw.i"9 M nn.