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HomeMy WebLinkAboutGW1-2023-01116_Well Construction - GW1_20230126 I ' >r Potm txhhe UaedA►reinaleormloppte"cIIs, For latsmel U"ONLY. I.WdiCbn#=W InglfMaIton: Josh Plemmons •ro WenCoMradlMNeab. !f R I l 4137-A 0 fL Ne well Conop Iti4�60e Nambar ClearHr Ur Well Drllling Inc, l Q MATIM1 'AL camp ay Name VG 2.We"CatgAfpeftn(,ervits, C 21 I DD gcn6 alA "040appfc Mae ft yt ffF—IftRv-CORWY.RaftV-k-eerc) R. A. a. 3.wdi awe(elAC*WA me): II. a ta. 13Gwt u"W(Nead p g, ,) RtmidattWi Water�'PPtY(sblgle) e. ta: a 1 ORceldmnid WaM SUANY(shoted) f tt watt wtt Wattw,wdl: IL o �. aMmitD&R Alt OLIIF a Ilk IAgmfer RmltjM XlQWMdMM Romed",. 13Agnft Stotege end Reoovwq CUblinity llatdw 1)AgaiRrTest IL IL QStamwa[ar l)taiage l7SxpeoimenW TeehnalW C]$nbaidalCe Control It C0900M I(Ckud Loop) ❑Theca uoeotheeoal oa Rt'sme 130dwLaMM=ftA2I Rean:tt: C IL m n 4.°'%wdl(i)csteiuetet: ILIL � S ww L,.a,IletG TNM Q .a �hyaial A cuy,attd e.2Sp � /UC Cnml„ t�.,eel tae,ttlf fta.(plw} DWQIBoG . Orto deReeee/mtnax�.ece�aa.r aeeh.,aedreen: 6.to(ere)the � orc-22.4�7 ardeed wan CetltMxor 1 � Dtte wer(a): Mtaatwtt �r t?tettttptoty 04afiv►Id.fe„n I A"-A.V-PO d o tlie'W&VA)ww 000M1 couftww Af aeooa ne ?.Iaddaurepatreoan welh RYeo or ift1SANCACW.0190or1SAW ACO2C.010D Wen Cotltnom&a5ftdrdW&Ma IJ'Aldatie�epatr,A1)aer eaaa+mcuon+�! l�nnatmnmrdarpfaGrllranaAmrojlk� ��IAIa>�basheefprorldedMtlktNllfJPlstf?r. +rpolr awdp tltJ n�+�q�ynoronaFe%octo,J'Aiy,jbra. Yi 4tM illljeatA Qr AdiitlAtl>al wdl dedl{iR tti N atwed �; Ymt aw use the beak of ft 1p M!pmW&addMNM well dtll deWis at wll J1op� „ ,op +.etJsolvav,AdyrAe.�.,�ea fuesoemoR,n„r�,,, ealmm"on-dentils.Yootmy0oamltehAddttitt Wpflgesifitt MW. SUBMMAL IN9TIJV7WKS 1 Pa,Mwopk 101b ft0fifIdq.*pit." iR) 2eta.Far AN Watot SWWt Cilia faun wilhia 30 days of eaten of well (�rlp►N 3Q2A!►'aad2�lo0+) CGLw=dan to the follatving: IL Stale vinter kvd bdw ftr a nteg: 1Dt►ldon of Water 1 l Beat Me abaaecra , + f/ ( ) 1617 '.Ma®S!!ta lEr!!wC"I•` dlaettxeo- � ' � ( ) 24L ttor tntaeftu w' to addhian tti'eeedmg the farm to the addnm in 24a � 12.Wag ooa �mod: above,aiaa submit a Copy of Ws fbtnt within 30 days of completion of well Cie.aoaey rotary.trablq dheetptmb,eta} conatmetlon tothefbllawing: to trtdoe.f WA Mott salmon Cat wd Proaratq E:W0"RVVATR7R7V �'tJni4laU Set�toe the (es)am. also lmbnit owe copy or dds foml WMft 30 d4%of Amoontt eomplgion of Wdl eottmtioo to the r �haRh dapatun mt of tht:cml FmmayN.t . wl:tae canntlacted. I �Y 1VnAh Cecoflrra pepwmgetKorBnvtmnmentmid NatwatlZcaeonxa—Dfvtetan of Watergruiiry RavleodJan.2013