GW1-2022-08694_Well Construction - GW1_20220518

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3.1Y41 tits(elica wdl list):
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Wiltar finpPly Well: 1t. IL -----�
kricultural �MiltliclpnllPublle I} ILtn.
acotlicmmi(1'ieatingicoal,linsupply) Residandn►1'Vai4r Supply(cin$14) tt•
(ndustrtat/C,Altnmetolal Rasidential water Supply(ahorml) g OUT L
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Nnn 11 netr Supply wool: Ir fa
Mnoltorin ROOMY fl- ............. __..r__-...
in action
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Aquifer St.Irgls lard RCQ(IV iy Ds'dillity Tiatrior fl
+ AtpritcrTrst �3mrmWaterDraipago .._ bn �"
L>nlerimental Teahnnlagy 13subsiderice Control --
Gcpihrtittal(Clawed Lw.,p) OTellon {i
(7eathatinnl Hatuin afinR R�tunli dill.(e- lilx tp nululldnr{l21 [tcmnrks) R.
Well 113i1 It'.
a.nA1t�wAs111e1 e�mtorcd: .__r.-- rA. �• 1C_ —_—
Su.VIrcULnr:etMn:
�12�1 -•lull-- --�----
_ Facility tnrr(iftenPllnel1ln) lull~ s.
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ti.1e(arA)Me watl(t� l'r t mattant clr �ITrmpararY err c»1rA►itl�llY 1 Nf ACWrtAQ!ter.
fv Yl!{RIaJS rNls(n nr,!hetrhv rvtil flrut Nrrt� 1J tiv+c(F �o�.Yluxrktrdx mul thnr.r
Xes or �No will?),IA vmc 2C-_ M or JSrs .weft Owner.
r. cmtrrrn.
7.1t1 flit-,a rcpalr'ta all eX101R9,WO' I X cnpa•+frlrly rect'")Ago7r�h P►a►' iollx wail mvNq'.
lr'ddrsoryrufr.,Allaurkrrawn,wrllnonxrnmrroni ++-mallum ui prniatherurun'dr?fthn adbArMor001111amlwAilldMIN111ltt
r+;wnrr render ali ramarkt.r'�,'c11An VP na 1ifl:harknjlAlr,(am. 7?.Bit a tro vide addlWallol well Site details err wr ll
1101 may usr.flea Weak of tb!&J dlt Pro Ifnmrslary.
8-Far Geuprobe/ff1PT or 000ed-l"P GembermAl Wcltn baving the soliMe r lltl9tN�ian tlrtails. Yall May AIBh 11lldCb additional p@Q�
IVR.91illatian,Only I GWwt is deeded. llttliama T(YPAi.NUMBER of-vrlic I
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for submit this altn wiutin 30 days of completion of ivelf
9.Talsit'wdl depth NOW land ourJA a:
At r yudllp7r xrltc li\l nPe dtp/lAc jrltt9ar,rnr{l enmpfi-3e�+lSt1(►and air llRf7 Owing:
cnnst► ml
kJoa
119
16ATorwaloarRmurccm1Wl m TOC317fi94- j ttll,
M.Stacie water lkvkl below Np of casing: - lull'---`-
In addition to rendieeg the>bne f om�d� n n
li.lktrchnledlrnneMr: lJ al?�Ya,a �eopyofthin form wilbin 3p days cotnFledlRm of vrall
12,WO cnnetmallon mntked; �✓ GtAlisWCtion to the fallowing
(f V..mrdcr,rerlle)',sable,QirfA:t p11911,via,) Alvilion orVl our Btemrrcesi,UzidCtgrouild 1tije:tl0n C:oatfa)PMram,
1 rim Map Service.Cewtar,RR1e1411,NC 2709462s
j1,M WnTFi�t c.'prt v vvEu s O NLV:
1� ..r . a.rntav&faittoHon�WSuE: In addition to sAmdiog the tltmt m
Methnrl of test: fill:,�e'ss(_- _ �---
13a,YialdtftJ►n1l '_.T� the AAdrGss(cs) nbavo; also Euhrnit one copy Of thig farm withbt 3R days nF
Arrtaemt; winptction at'Weil ct,nsirucfim too-the county 1lealth dapatUnetlt of tilt:ttetlnty
"b,Aisinrnattarttype:,.,,�.,,�..... vrtiereoonnnmemd.
limn CW-I NOW,tivnlinn1!?apnnmontnPttn+Ircinmr:osIlQuntltg-Aivislnnai'ii/otarhadrn+icaa RRultbl� �ZRI