GW1-2023-02068_Well Construction - GW1_20230307

Feb 1519 06, 3p Clearwater Well DdIng
82"22--r 241 ` p 1
�� CI'ION RECURU fGW 11 Fur-lnlemel Use Only:
I.WN 'C,nttxetRr InfarrRA
14WATO ZONES
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M
a1Cwe11Gtn1raelorCattiA�atin,►titm6c CA X 4irtttstbatted a
Cott ry�c e.�-ti,�e�i pnl ta`r�q O
ft. M
cwmlturxcutw
16.txm CARMt>i: tAaarat
�.weft Coystsnetiott thteratit#: �, � I nn n
f tstmll r)p�(e u carer�rserrlan p s(i a UiG SuuG c�arc J $. IL tn•
-.'Nell Ilse(eb:ett well on): MA
WateSApp�Weth t�
-VI
rel MtQtiaipAVPu6ilc 0 0 a. is.
1tN $@�trlthr) jRwideotialWawrSupply(sittgte) � a. 11F.
(ndustttet�ttiai Restdetuial water Supply(shared)
lni otion T c rt
tVort-VlnterSttpplgµell:
Monitoli Rcwuny
n a Well:
ir. tr.
quifer Reril a ©Qroundwatcr[tcrttrdietinn 1.9.1MMA.YRL PACK
AquMrstorago and Reawc y Salinity B=d=
AoferTast �rljroll A- :i(Wn
i xperimetttet Tes nelov C)Sulsidenw Control it.
(ieotherrnal(Ciesrd Loop) �7famaar z0 RIt1.
C,ernAmt>Ft1 itcilao} under t421[temarlis] AeDx TO
d.tAare W�ge1 Caoplated: -�Well wy
fr. ~0
t'a�'OxnerNane . � FM•rldyf[)ii(irl:applieable) n' � i ,.-, ,- ._
Iasi 11,.�4:aad2ta M AL r p��
Nil 9p
Memel to Mitkadan 140.(PA4
Sb.t•sttlWdc lion t0DJOIR&in dep w9j uimueftewtdt er 4adual degreros: I ng r<a'w: ;'r
VPVAH lt'K ma letflpp�fYwulitala,n
�+ l 1 :.t2.Ce Boni
6.1a(anr}tbe+rNt(ejt�lxteaoent or [1'Pemparer7 stannt of traawcllcartraara puc
13v aymrag tLIS,(ornR!Altrhv aanfp rAnt de wW4 xw(Na4 enwmMa h�Adltnr
?.1HlbisatcptirtDAncldl8tgwelk Yet oe No wl1bISA.4CCO2(..8i0Dori5AYrrC07CAMWdNCnrt..*nSYm,rlv&owl dwjr
Ifd,lsisn ,irJHvwk"1,"w4t.m+w►ruNrne,lfasswllonm,rl�r�r�tlain the,�rmrMiha wMinrthlar�mrrlAasbleRpJvltrderlJnrlMtw,(letttrr
+ jt'wtderANramm lawatornntl�bariuJtAlsfma,
�.Site+tlppam Dr Atldltionttivaff de4lta:
8.Fnr GloproMe/DPT or®t�d�Ltlnp Geatltet troth Wlltabavtag the sntne I du may use the be&of Ihk pegs to pwWdo adWiotlel well 1e dowh ew wail onDsintctinn,only 1 GW.i 1e needed Facuti TOTAL[NUMBER of yells constnaetinn details. You tnayel6b!dt&ch Addidwtai pagC6 ifttottw¢ty,
ddl{ed�-
;tLIQM17'1'At 1NB'1'Ril[:'fiOlNfi
-'alas[~sell*PikDe1tMv had SiUfita: -70
I�rnwNtple�vrtls4pal dr�rJartfr imn re arapk+a(g?soa m,e:�t01 AW 24a.lsor aH welb: 9uMnit tltls fomf ittiltdn 30 daYs of co07etlae of well
�n/� rnnstrpction tome roucKving:. .
It3ttr(k�++ehrievd 6ltotr top oJlt:sirtg: 1.t'6 Division orwater Rewttrree.l'n%rntatIM p
JJ'xwA!rla�JlBrrlvirecwsktg run�•�� r�oeeas Udf,
1617 Mdi Smite Center,<be1e19h.NtCiift-rag1617
I i.ibnchWedtatittew (ln.)
�y p� 24b.f 1 SW etla: iD nddltlon'to finding the foam 10 lttp[[digs in 218
It Well amwileHC4lu ftd:-- �(.[�lrl above,Mw submit one wpyof this form wltldn 30 daps of eoteplet�of watl
tt C.war,,orary.Ca*(%d pelt,etc) "�l""—' ctmshuetiott ro the foSit►wdtt�
E7PONWATC, Rt.'PP!v Wg�DNIY: Ulvision OrWAtcr titeanrtst.UndR7g alold Tq adon CURW tr gWXM.
rt} iKethod arum Zits NDr V)'�er Canals&f -an'l AIP Iandddlon toanditIbe tarot[t0
oq type. the��Ccs) AbDVQ obl)submit one Copy of 96 fiotrtt within 30 days of
.Amatnb_�, !Mpretion of wail coosunc ion to the ewmty hw t depp umm of the tautly
where amstrrchA
Fenn C+W.! AfoAhaunnnp nrt mantof[Envhoel}timtNQrwtlty.Aiviu,a,oPtVatcrttmm�+c� Revued322-2t♦t6