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GW1-2022-07200_Well Construction - GW1_20220804
WILL CONSTRucrIONREC ORD For Iricnial Use ONLY: This form can be used forlsingic or Mullipk John Eisenzzlan FROM TO I DESCRIPTION ft. ft.. ft. I 4439A NQ N%fell Contractor Cert ificat ion Min-lier CIS:OUTER -LINF R ;FROM DTAMETDIAMETER. :1 THMN IM 'I'M FAL SAEDACCO Inc Jt., C:oaapail}rank.. VAAING�Qk 16ANNERVIAAAING�019f HIN(Vt6dili-rms]ckwil-I �_:j TO FROM, DMMMR I THICKWSS. 1"MATERIAL' � li, tinstl��ti6i�petnit'C' 70001826 16 If.• 211 SCH-40 PVC Vo 0 3. cc; CI "k): -77, Water Sullpty Well:, FROM 140, 1HANIFTM I SLOTSIZZ I'1111MM I MATERIA1, 16, 'If.,1 ;�6 2- �.Old SCE-40 PVCOWni0paMblic. O&oiliemial(HeatingiCobling,Silppb) Olkesi&niial Water Snpjilti (Singld)" 13IUdUStfiaVCdlllllierCi.af Olkesid-fitial NW(er'Suppl)"(sharcd) IKGRQUY .FROM - -JO AIATERUL i EMPIACENTENTMEY1101)&AMOUST 0 Iiii6i ion 0 11 (11 Portland and Pour Non-Avlater SuppLYAV011: ORcco%-cty nject l; ,Ion Well; .,. QAgnrfcrRCcfhtrge A93ANDIGMVEL PACKJ_ i itc Wc&'-0iO'fl-- lif aiiiTHICAble THOM .- 10 AWN'TM fit%lxrFHtAL FAIPIA 1'- pAquilcr Slorig�-.4A Rcco%��ry osAnItYkIM-61", Sand .; ..'i�F 14 ft., 30 #2 bAqn.iferT�st .0EXPciiinenial i1c0niology bQ10thennaf(Closed Loop)* 'bTracer -.FROM TO [MESURIPtION(color.bndnqw.W11nock 61w.g4rn Ve.dc.), MolhCiiniil(HentingiCoolfife Mull)) ooilicr.iexpWo tu&r OL116na 0 fi, 30 ft.- 'San3y clay d." 7-14-22 jb#GW-25 A U 6 0 ondell Environmental Custodial Trust racili ' %vocrNartic, Fich �il):ibg�ifipp� Alq -Oan-p-=pwin MAV800 g(ink 3926 Glenwood-Drive, Charlotte, NC, 28208. ft.: ft'. P)Ijiiriit Addims,SL:city,a6d,zip", '4 , Mecklenburg 06510128 Bentonite seal from 11-141 h1wel 401firf'-djon go:(PW) - 5b'.J>ati't6d&atiNI i4n�6&-ioficgrii;�Mlnut,cvwconds;ON,decimalI cglvcs:. 22.1ertification:- 7/24/2022 A9 6.1s.(Are)tbe.'wd!(q:_mPerniattent �'1Jr_.0TcnNponry. JV sivfbi;�rhij jnj .iz, 127s 74 o.e;cj 4xinitosicted in 4%V irknee fit j, details: You ma ,use avei a"m, f i-i sp:age`to pio%ibt,ddiflom i ivel.site dciails`oi bell 8.Numbeird Onstructd: C6li(4Ctl0il&latl� -Yowfili ai�oiitaellzdditioiiii pagesl ne cessary. For iitWfflpje ne (I 26 ToWivelldcp tliel �24a, Por All �Yclh:"SRbnDI 11iis ffinrt. 10.$tat!C umter.16d, top of casino- hivislon o )dater Result ,ij Infutrinat it If imier level is rbowie_ea'sfot -.167,A,11Scffi`e i -Ici iNic-27490-1617.- 11-Borehole flianfctgi^8.25- 10ml to illla'addrim�uf 24b.For jl�lj�jlgg W&i'ONI V- In addition founding(fie 7 a.copy,of this f6f.to,witid.ii:.30":days.-of:ci)iiipl,etloii.of'.j%vll: 12, Yell ctlnctntctiorr method: HSA .011-Wonot lValer Resourm,so U it ro t derg, ilt it; F0A8%1ATER-Sb-PVoLYN8'ELa.0NLV.': 1636'Mail Sen-ic"e&nter,1bWgli.'3N'C`1769M634' -14C.Far WiWrSupply-& njckfioUWClh: 1314t;Violl _Mcillo,ll test: b1nit .of tlii� 116 1 or--.AlS:0'Sll ofia copy rm,*il fiif linfuncut .0ic-conn wl�4c, %%-cIl'cori,;jnp6flofi to flic'countil'icitith ac .4 ty '131i. l"Net Amount:. coiislrncied. a &DA Cofolin:i DepaAment of Endronniertz wid N-biaW Resources-Divis oil oi W.let ResoLroes Revised,'August 1.1