GW1-2022-06469_Well Construction - GW1_20220519

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lrou maY liar p►c Imck of tbi4pege tat pravldo additiom
R.Far Geopralie/Alf'Tar Qagnd-lamp GedberMAi W011s having ttic Motif' cnngtrur�ian details• Ynit Mily Aieo attat:h additional palpes if TIMMM Y•
iatnatnicdan,anly I G,W-t is needed. I'ildimm TOTAL NUMBER pi+vr-11 I
T� f+ stthmit thfa amt within 90 Basra of catnpleAOn of well
�.9ratgl•well*FM Dow 1011d 8Nr•McR. _AIM IM 14R.�4t:.Qi44
fear mrdiiprr wtgr IlX,rrri d tpthv ijrA eranr{2•ra+nrpin-3 e()?/JO'and conattticttnn to(he ib)loWftlg:
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*q Service Choler,lRojolli,XC370,10460
!fFi'nrrrfm�tl ff rrirmu c(tf1n�,tree^ ; Lt addition to rendiltg tlia th"to The tlddMa in 248
l 1.itanehnledlatnetere ftn•3 �h" "� �
subinii anG copy of thin form within 30 dtiys of ltompletifm of Well
athOVd,nlso
l2.N1+r11 Conttrnellan MRINO l; --. ctina oration to the following
On.Filiaer,mt•,ent+k,oiract(meii,iKa,1
_ oa Division at'T1'atrcT Rrao:,ttrtes,IJndctgltiund tljectlan CoArrol Program,
MKtWA'PFRfit.t�(K1fW>ri.LSS1Nl1f: 1C,36rAAM wvteeCr;ntatr,l0ltlaigli.WC2709.1636
13q.Yirt4(Rpm) NOW Fir te4t: _ __._-T __ ,21c.Rnr 1'!0ur�1 Rasol+r&i®Imtla��ig: In udctitlon to srsndl4g t}tc for Fir
to
tilt: addMSS(c3) a6ftve_also subtttit.Ones copy of lhltr faun within.40 d '
t+n.lAkinfection type: Atnaimtz J Crmpletion at'�nctl cansttuc6on tw the cgintty health ticpntlnient of the county
_.._---- •wFrere conatnicrae.
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