GW1-2022-09901_Well Construction - GW1_20221028

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Feb 151905.43p Cleatwatel'WellDrilling
titiEil i,CONSTRUCTION RECOW�„(_GW.-xl rnriniemnl Ilse nly;
1_3W]l Cmitraetm information:
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M7 Well CaramclotCenificotinnNtnnttcr 1. liER t'
Qy 4 Q�1 J��� 'may^ \n orie ua
M P!A ICE Tilt B83 M TEnULL
Gna>ltttnyTlvnr. 16.WN6R 1NROR7i11RIN 1ltotrrwl 400
?. .J._ MLrEfL I}1 11/lETntAL
.!Yell(:nmttraction Permit tt: tt, TO fc, PL1 In.
i.l r1 al1 appricahla teal!cnaMnrnrinn parmttr jl.+ SAC Callwy,Sra7s Yarranrv.clr 1
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5.Wr311hic fehech wdl uste): t7 N
N'nterSApp(yWell: � T� nA et 7tttc MIA uaut
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Agricultural �MuilicipaUPubtic q D• f+.
Gcorha=l(Reating(Conting Supply) gls
esldential WaterSupply(single) ft. tut, in.
1ndu4ttia1lC,otttmercial McntiatWatcrSupplv(shareci) 8 OIYC ssA L CREWtw M am& ouNr
T
iRi tieR ft. v�O t! �/� /
lYnn lyn1er Supply WPM: tl, oL t� cx
Monitoring Recovery
Inimhon Well. ft. R
AquircrRccbnrge QCrettndwnterRemediatinn 1S►g,�Ntt1GRAV8LFAC C
AquiferStomgo and Rcroven, E)Snlinity Bawler _Bnoat M IAL taNrt,AGCMRVinmioo
::l
AquhcrTeg �SmnnwatcrDrainagc �_
t Experimental TealutolcW OSubsidence Control D- it-
Geothrsnal(Closed Loop) 13Tra:er 26.DRILLIF L ■ti+ n � k rain uc.
To
Cicothennal(Hmtin Ifn9 ROM) Quit r(eltplain Wtder R21 Remarks) ir. 0 Q rt.
41 Date Wens)Completelk Z 2 - well IN
C� rntace blurtola
6 % � - = �
�.�+�Wrll T,ncatino: �`�a� .
---
n. �OCT 2
)rsetllM"'OentTHM (a . Facility IDOfrfart/p/UCAbl�e)
7� VGA • ...�.. r..r.v;:�. I:.��Xa nln flit
P t .'cal Addre."City, ttd Tap q1, AR
C,un ��� Faecal Idcntiticalion Nn.(1)
ill. Mint4e and lonpittlde in degrees!lninntesrsecnadsorticeimal drgrces; —� --
(if troll fl-OdbanclntlInngis9uiricknt) 0 r H12.-cc I tiny; '�
t.Isiarc)the wells)*ertnnnent -or ©tTcmpnrary ;•i mturr aff7+slttiwl Wd1 Cmtractar e
kp,erlatall,'Ihr3�nrnt,!11gWAV r.+nrJfj,dray rhr tw.11h)mws-Arias)u'rmsrnn rr rl 1n arcv,rAarrce
7.1ti 1ldxaexpairtnancxiydngwcll: �Ycs 6T NO ndlN lSA YrAL:a2t..?100nr:5ANC.ACO2C:.0.2110 tleensln+uk++rShotalanicamrrhma
!!rhlric;+rrpmrflrlm+rarnumioaReanxinwirmyinformarinnmuI plainlhenalurcgfthu •:npyafffiR reowlh&NlempRrid&finr/u weft mvtrr�:
awir ratdar h7.f rnmnrkc nrnmt armtlbr.hark afrh Of—n. diappmm or ptldidonal Well detilils:
R.for Gen rnheMPT or Otteed-l" Geothermal Wells having the same lrou may rts.e the lutck of this page to provide addMonai well silo dMita or tue:il
minsimrdion,only I OW-1 is Heeded. Indicate TOTAL NUMBER nNurlis constntction details. You may also attach addhumai pages if rgeessary,
drfilul:�_....-._._.^..�..--•--��.-.. ��� �1`,ra.'e"�'u_...rrr—."r'th'�i{'R>C)GT(UiVB
0-Tntat well depth trnlow toad sarince: ^(tt.l 21a.OX wH Weilst -CIAM t dtfa famr l0,111;0 30 Java of comltlrlion of*0
iraratnlaprrnrv&Ialydttprarjd)jfrrmr(trnoiprc-3Onod.1rtd2n@1001 congmrcliontothefOI[DVTM9:
ltl.Stntie Water level below top orraslogr 00 Division or Warer Resources,information Proeesaieg Unit:
?r*Mnhrrturtdrsfduewcminp,u,cr"•(J f 1617hUilSerliceCentar,1Aret9h,MC2176"-16l7
t 1-Boreholed1limetcr: v ��n•? 24h,jU% tRiectlnn W" Irr addition to txndfng 00 SorM 14 111114 0110fe y in 2401
alloy,also submit one copy of this Farm+vithin 30 days of eompleMO a of,veal
12.!Nett emnstntetlan method: �� — cnnsttuction to the following:
G a,nui r•,-lal.cable,Olrta:t posh,eta.}
Division ofVFxter Sealnlrcv,Une!lergmnnd it(jtstlun Cnatrnl Pcogrnm,
FXM WATER SCPi't:�NF,,(,LS ONLY: pel
i6M Mail Servim Center,hats O,NC 7,7b?4-1636
1.3a.Yield(gpm) (J Method of IesC 24c.]1 Watrr 4nnaiv&Faieetlen Wcllp In addition le sunding the 0um to
the addresses) nbnvq also submit one copy of this form Within 30 duty. or
Ob.Disinfection type: .a MDtInt2 completion of Nvail consuuction to the calmly twelth ricpsnmeni of the county
whore cansttueted.
Fornt GW-1 NorrL O mlinnncponment of ull iranment 1 gmilty-Diwstnn of Waal Rasm+rerx Renisats?2 2a16
I
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Well Driller self-smut Certincetion
Ojimocas
�„::�aS`px l� 1 Ct'.t,Cl� Nm Well.
T hereby MtTy
that the alb refemced well•v+►, grouted in appearance in accordance with
all Connty wen rules
.
Well Driller �-� } SiVed_ / — ---�`�
Catfiicatec
' aGro 7���-2�z
Construction: C�nonat:
q TYpe
Total Depift
Casing 7EVZ Thirlmess:
Casing Depth' /c)--v '
Diameter:
l3xive Shoe:
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