_Well Construction - GW1_20230327 (87)

Feb 161906;43p Clearwater Wall Drilling 1 I 013;6w41 '1 p,,(VW(WEx x,C 'l(QN RFt(:OB �?�'�1
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•e.For For cti beMPTor Co p Geothermal Wells haying the snare You may use Ow hack of Ibis page to provide
riddled: M y GW i is reeled.GuGceto TOTAL NUMBER of wellscOrl9fita(in11 details. You ins t acb adtgtiidditieuel well site aehl7t ar well
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Formylynrrweos0,1e emotes p m f pie,+3�Xmo-and.400.ry � ') r'1� 1�►`MI Welke Sllhnlit tht9 fettnf within 30
strws to Static .tevsl bebotr trap or easing: stroction to Ittc litIld r/SE of eompil ap of well
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Wall cat act Hesse methods i(�t-� )4 A above,also submit ono In addition to sending ibc faID to the addles In 24a
8c,rotary. turd QtuL,eac.? _T, w �" copy of Mb form within 30 days aF completion of well
12. construction to the following:
FOR WATER. PAf.1
'WELLS ONLY:
Division of Water Renames.Undergirutad Tn Jrstiot Control grogram.
I3a.Yiefd([umt) nA teas map servtaxccaar,Wel a►NC276 4636
WWI of tt tl/4 2 For Water surety&Wootton Wells: (n
t36.brstaPetatnn cite ad uddidal GO Solt
°— Amowt: tlt qcs)above,.also submit one oeplr of this form i0 dayfirems
if
conviction
constrrc t constmaion In the comity health dt p or of
Ferns GW.I countye
North Caution Demon. toftimiroAtnaoW Quality•pivisinnofWART Reomtm