HomeMy WebLinkAboutGW1-2021-02439_Well Construction - GW1_20210521 S..
WELL ;QMMUCTION RECORD
Time hm"A to used twos"ft mWittlemg, for leta-W Use OXLV�
I.WIN Comilrous:r
or-e-- r r r-5
we'1-mawsor W&M4A.
- �2-79ft AI t 6toM
7,
W Well cowee.-Cddlut;ft N
19 1-.a
A/ ifi,L=-
9'(0 �- 9 6
P40 Olk h
2.Won cossermao.PWSWI 0: 71Y—
-M
3.Will!Use(clatek te.11
A. CU
!-.I= IMAMrtKA goof uta
GAArfaahucal ft I is
MiDowwW" (Howwoftleat sw*) iA
t. cial water IULVIY(5i ft. 11
wa!el Supply(d0j") -H Gko
almmailmn I I T9
120 99 O-C-A-CeA-
IL I.
ORecovary 'L-1 IL
Ohtotthor
...............
Ugetum Wall: IL 11
DAquift Rachargs I
00fOu7*A4tcr Romedustion 1110,FANDC-011AVRL FACIK(if Itimmiti
0A4Ld*F Sturap au:lt�.-vmcvy usalwly Bwicr ..r9
DAquiiicrl-em ? r;,Pkwmwvd.er Dranegi; [!T
Tee)Y.6.9a 03%.W-:lance Control 1k
M(kath—al(Clasod uAl") 07ram LA&D=(G-Ort—flM h&J46".bbettill if #*V)'.
ClOtothormsti(H4@tlnWCqdM Rmm, Mew(CUP1111ill t;c%J- i2l k4marks) all" tk ft ew
4.f4ft WOW11)(3m-ploso: WX,!U0d IL
list.well 14tafta- R, r IL
aroplf4p j 15JL -5 to
F"4mYtL%VftV mm" I
9sa tolhp ,d, lD#VWP%.b1q)
R"vW A4MF%I,CloytitV 1% 011.
L4sgkv4g is of(k6j=&j get: 7
(itw011&K toe IKAOM is BuMcka) 3606!
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or CTtmpors"
fi--,I 01-41 �-N*AW LQ 11VUAV 1700.*61#j CaW'Wftd 1A&VVAWI.
1. JA",
vfM MCAC Or.014V-MA AK* #Jr.'VW
12 this a rt I
itsir to an exittias WON: oves or C5.No ov,o
'he nax,,*qf,4,
021, Lk IS.lilts didgraft or additlossl will daittift
You:usy use the butak of this psi u provide sMItWail well si,.#4"Is or well
* A d"ll You May also Weak s0fti6ml r42at If W.sia,%ry
owl FLIM11AL INSTIAMOMS
t.T#AW WOU depth bdow land sorfeco! O jftT 34L Per All Well ; Submit.th:3 bunt witlit) U day;i of cumplatiin of vm:!
N I pwkpk,,*get oft dfVk crio*qou(imoviv- comIntdion lu the fdlo%,"nlr
w8garlaval Imsew top of t4wag; i ft) Division of Witter Quality.Tntermes lio It prucciglag Unit,
we 1617 Mad Service Couw,lk&§*b,,NC 274WI417
(is.) -.46 I Ida, a-weik: In*&iL Um to sending he fom to 00 Godrois IF"41
vVe h. 3 av''N', .eq. of I"10 ., days of omplitign of well
1.2.Woo coamrtertift e w V
"m to".two.&,-t POOL
-1re. Custrad ftogramt.
MR WATER(RIPPLY WZLLq ONI..V: 1636 mad Service commy,kallo4k NC 374119-1616
1
13s.Yield(spa) 16.4od 44 wil;6L.0 A t7 W N 24c,F-,e Mac*,Suaw,d js ist.et Merl.VA11 1p od fitim o to mble tile rwo to
tN
hft4U(4$) above. also submit one copy of this ram within V,days of
13h DislAcdost type:C L,:F r i h& Av"cuut: ff,-z 0 Z w?"P14110n Or well tonsintediun-a'0140 CAINVY htalfb dCparhnent Ct%At-w
Mwo C1x2lt%Wbd.
Nor'.k Can.;t..z Vqwjr;ive!.i•f
r-,
I J AY 2 1 2021
Informatihn Processing Unit
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