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HomeMy WebLinkAboutGW1-2022-08268_Well Construction - GW1_20220526 YELL CONSTRUCTION RECO . 'Th e.r ssa7a:Use ONLY. e!b sac be tasE IN tt�te fu srtdQ*-IV, I.WIC CNtrlrrr aCual;aur.. wea f", ,x A / A 1 fL, rJ �^ rrr:meal-T ce.e,e:_ a �b i �S'''' O` G 'yl ---� ttiflNtNu I:ue,l;q �' �,)<�'APD'M:/ h+�!�+S Y.. _ : e• ft . L iuL►ntaYa� - 'd` iZtkGL r s. _ CAfM 1< —1 I.Wdl Ga U r r lYalat. Ire.ew.J'artatN r:� fr. n. 116 Orr urlgptlrvt�lt rrti oalnwCnioorsrr.rr O.e Cwwrr.Sl.�•./o.s«nv.Ne,J � __ J.Wall1)at(clY 1 �t •.h taus�P•r7 W-I : 17• �, OYN[8G �1 L1l it. h E is nOrnthwnW(Nawry)ftltep 3WplY) Rcsderod't'./tc,9t I I. h. t M► 1 ttC1Y(sick*) 1 1 OLrrdw4uaUCwulavSal JkGeldent)al WA!tl Supply(aw") ;]lrti Itln NN-Wasor&AP. .-wev) _V h_ _ Cl h Phfaa: Oh{onhor ...._.._ OR.cuvary tar ..M1. _ OAgLdfcrRacharSe pt3ra,l�twccrRem.dutiunLJLL YSLr He ' —"—J ii OAetli&r Steryp.and F -Vmcry uS WtY Burin QAgWkrTat p:sA R K 1 xmwaler Urainap 0I'xper:ee.dsl TuMvn,iocY OSt.br tsnce Coldrot ~ A Ofk9OWMIl(Clasod Uix p) U'raca ru ai '' ►t/. it st OOsotlte[rtts!Q{altnyCuulEtm Atuattl O(iRter(ca lain lutiJQ 1121 Namarks) h h I t.Psi.W.W$)c--Ptet.d: `/4:2a w-t1!1►,e ()" 3 '` � S o , G SL Well 1parlon- �� '' to -5 O �✓rH Lca��i�Ls R. u� 1t rr. RecWylt]rn Nw Fee-it iq•1DY:if rp%wblr) - >�6 3 cla h,�_ P ytuet Addreel,CaY.Md Zip -... ..L.! Gt c�,x'•- h I ft. AY 9 Eat Ce.,ry Tvee::,teut+Go.ise*to(IJNr ,;;y,? �i e,4� ' Sb Lslif•ds dt►d Iwa�ihdc is deerecUe�etsafweor4t or(kc)ttaei dwess: wc7 .ra t}w-.t r - ([.eU&K ooe 1KAM is sumckla) 2UL Carl all**: W s) 5� 6- �Q efCvad4e�J e,tr.,e,a,e�tae D.to C A(on)the%V1gt)! ONN'teaatasl or O anpersry riyrertr cam'Aw".I Irrshy uef*1Aer fik SIWA l 110;vase uwrr srr/rn`oonta ue 7.Is 1W I rt J ti1M!JI IlC tC OJ^..010o w f J.t f,r:4C'OX,'tfh7p>/e!!C.rnffrNW.TAss.rr,sb w1 uv a Pair N as asi.tiag well: laVas .r Cp.'Vo ey,.•o/Au xooN tar setn/rerrrrarl H flls Me11 orwr. j//IfI a i Mom!►.Jy'I oet Ilntnr rep ou+�rwtirow;rybrwi,n.re,i er�.rok rAe,;o.,.r q!w �v/r vrYr/Jl,vworL rac�w er.w tM Mast gr,nL�nn. 211.Sits dlrgram Or Stlighossl vrtit details: You may u►r Vie back of this b`aiR as provide sddltiorwl WveU Site detsils or wcu 1.Ntrtlba of tedb coestrrekd: c.+natruc!:on ddarls. You araY also attadf Iddlt M- al Noy tf w.f s" pw,e,Jrrftls areclon or ee.•wy,taps srdL GM_3'r,11r tdv tewae�.varrwasw,you ebl Mir,~`f--' ill -CI'AL INS-n-c"ONS F Msn b W ptb bebw sd sasfIte'. � tftj 14L per All Well; Submit th:s bunt vrttitict SC dare of t:mplatijn of wc:' FOP JftMMula�r nhY wr off�'' V "rM(f19^�• :�'�'°^�1�1�') comt:l:clion!o the fdlawinC 10.Statde wour laysl beta«top of calitls: cot IR) D,vb:o■of Water Qutillty,inforses tion Processt (;air. 1/..V,Ir.v1 is aloe swi 'z'°` icl'r M.r 6errics('.uw,Raf*b,NC 274Jf9-lfl7 II.Due"diameter: �.. _._ .. is.) -•t!ti Zr LJLM' rLXcl&: In sdditmn to atndtng x!O'M to t!te addrats u,:as L2.Woo ettestratflae tme.__. ,� f '�`e A. Iv' fit' .ent. of ...)r. • v r..w .' dsyt of e�ttple�ion of wdt (i e.aoerr,nasty.eeW.,dr ti 1M1; ) — 1 fit-- c nr rc:. •p A ro lowhv �--— trvitk a!W.. silly, -'.egvr... tcctioe Cam grid lrograat, FM WATER YUPPLY WLLLS ONI..V: � / 163E Mail Sstvice Cower,IRsldigh,Ne 27410-1616 13s.YMd(ipla) _ Mn:,ad of ual; L_ol.,y "e.F•r Wgi!r dyen!r d11�t.&gmm In adiitioet to&Willa tbt rwm to the tlddrau(M) above, also submit ant copy of this roan within 30 dsrs of IJU DW&kcdoa type:C � a I"i h& Amonut ?O 2 cot*Plation of well eonstrWion to the wtNy laugh depa nont c f'he:owty wltare coc struclad. n Gt'/.! ►:►'l�Cw:rc f tWonr.•.:.rr.t Ndsa Itwwa.,• r, i, s