GW1-2022-09886_Well Construction - GW1_20221028

s2a•62z 72�4 p.1
r C(ealw�lorWell Drilling
Fol)1619 05.43p
�tFeo�1(G rnr lnternni ileaVON T
n ;
1.1+V��alnirneilSr n�ot'1t11atitlA: ! ----
SuclEinnf�cltxN�)nt: .... a,
:wrtleammnnrrgeti(ieMtontaomtwr 1^ �I� the TO
punyN;t.•ne AtA
� In.
?..%VdI Corkarnctinn Parmft th tt -
blst 1711 rty li,r,Na+MlLtnnruttMimtiwraJtJs(t<C
n•.
5.VIM 111p.(OWR wt:ll Uny, A
w A rSupP`Y1�NcI: •� to n, m• ��___
ARricsdctttnl Kit,
ajdanttalWatcrSttppiv(shored) a t)vir a to
`fan�'1'netr�luppl�*+1JL'ril; p„ !t ��
�4onilorio �RG4ttvary _._--._.--- � ""—• .__-_. _
gnite ,:ch
t)lorgc D(irmtOtlwntFriirmcAiarinn 14• R -• C
4nlinity tlnnrir r
t,[
nquifcrSrvraRFpndRrs:nvary �• tc_ N• --._—
AqultsrTrat �Smnnwatcr7xainn a ��
Su(�idene+ Control
l:t<perlmt:ntal�'�r3umto(Ry � & �,u,l__,
Geothermal(CUmd loop) O7'C= ? ��
(icnlraennnl fI{cntia ^^'t^D Return► 01her(altPlAiA under#?1 Rcmluks} tr, fR 1
4,1101r:W+01if)CIltmpletCrl:? well lot/ ii.
R ._
Welt 1lneattAft.
i�:tSi{py;C! t lfamr. . f;aiil$ytAd(+F�I,iirgLlr.� l4 - .^_
PMAed ; td?r, � lot I t�- Pnt+x,lhfcntitlentinnNo.(ft1Nt) �•--- - i3s1 i�r^^,;S;�:j URti
__ .�...r--�•-----•-•--------.-^„-'tip, � y
5h.iirttintdr.Ono WAllttdeindcgtc s(minntC519ecnnd4nr<treimnldcgecrq; :11.card t i � `7����
Orwell rreld,nnS"01P)t1sHivilMlrnt) i C / j n L
rAlpnrn+ry F.ipnntur of �16od�VdiCaMnutar AAIe
ti,It(atr)the wCli(,yPcrmananl or �►�' f r� vmrtat to nu,nM�rrcc
/\ r l l.;u v t rpfx fntm.J hmlrvcdfl ahm rhr nr./1 a mlr firer')+Tor
7.I,y this A repnir to an 4XHrtiAA vrclk F.rCXeK nr No Toll .5,4. df•R2f .1ltRAnr lSA Yf,tf OZC-'.t1?Rtl N'�+tl4crtxrn,mam5rnmutrr[a mnt,hm�t
►tal�L>►! a dtt nwrrtr.
{/'dd,•rac,ra7talr,,/11!m,rARln,rn,etlt+:,>urrro�•rmn bf>hrnurltnn mrrt r�,G,ln rbr r:ru„r.•nfnc�
�nny rf{1$fc m urrlNachrrrsl plo
n.;mir tuuirr A21 txMAr7wuzrintt nxAAlJue trArAajJJtls Pamt. 2 i"ilto tli>'!t t>Ir tirNltlrntul HrrlllldtiMiiSl
R.irnr Grnprtlbe(ifsl`1 to{3ttsCtl^1t lfnP Geotbacmnt�vcit+,having!hc cnmr. 1'nn mtrr u90 the leek o1 ay Rise tt l h adfite addillt+tatl wail:site Dry. 1 nt well
,xn:+twrrgnn,cmiy 1 C'i�Y-t isrtredetl. OtdinrttaTOT/�t.NCIMi3@R Dt'�+r.11�
cs)fl9trltctlpn Actails. Yott may also eltAah additlnnai patsy iFnrxaasnry.
......... ..--—... � r" ,.
{h Tntgt 1Ye1E1tkptls l/aitlw IBM SttrfaCa: Submit tl►Iv•0M tivintiq-SO d,qm of cotnplctlon of tell
t•,;r•nt�drrplcvrlgliA, 3d:prkcif�l(!a+«nr rAwillplu-dGivnR arA►.4 1A�? cnn9ifU inittothc fdtotCtng:
itl.Stntin tentericvgltlrlap ral,nFcasing:,_._�--._`(„�(j►�)z- _�. ._l�t_j Alv41617 M S,,A,,C A�j lglgh�PiK:7lT Hilt
{f u�drrim,�J Fx.'rh,tmerhntn ae:`• '1
l I.Aottahnfe dtataetCr: " (in.) �, t q 211+, QL!Q0 jV In a"tion to Vmdfng tha farm Ig lite Addfm ilt 24,
�(/� nhnvo.n)sn suhmtt ttttc eopyc+Ptiflts tam Wlihht 30 days of aampii01t of Well
1%Welirn»ttn►cllnnmethndt � �------ C+>gyttnotintftotitefilimvinir.
(if,nnRa,-,rotary,alitla,direct pati+,¢lc,)
ptvisionofV4nter6eetsttrrele,Undetrgrr►tind>igjet•tFonGnatra) rngrnm,
d� VYATCR 31:PM_1 vtrF�S QNONLY' ►//► -/'. - 2636 AfailServim-0!mlar,RA149k NC'291C -1636
►R
fr/ ?riC,t�l,�W9t1'r RonntY�iaieo��dj� In uddltloa to sanding the ll+m,to
1b.Field(poi)
the tsddress(as) a6ow..also SdhYnit ntte crfpy n£Ilti>: fetn7 svlthin 30 dnyQ nl'
t ih.Ulsinrectifm t e" t;ttiRonnt: c.-,ntptatrnn of roan lm,s"cdon m the cgnnty hoallh depOnment of the C1lnal1,
kQ ,�...-_•--.-�----•...^. �. �tetc apf�ttnated.
Irrntn GU+-I Nordt[.arntfMtSN.Tnnmentaf isn.9rriamntnlQaattty"nivt9tannPNtuOt ttaamrcav IlAal9tell?.21 xAl b
i