GW1--03463_Well Construction - GW1_20230518

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Feb 1519 0S:43p Clearwater Well Drilling 828-622-7241 p.'t
.HELL CONSTRUCTION RECORD IGW 1 .
For Internal Use Orly:
1. tContrattor n ation:
,‹A 14e0C'OAAS ti.WA'.4' 7,UNF8 i I
Well rotaraclutNotat mom TO D a:!. 1•L.. I
i. ft.
AL.L3..::.4,
it.
WCVPeIrGlntngerCettiActituotlumtsa S. CASINGtia ' )
r
�. D Sl. �� 1n. f[__,
x.Well 16.INN!• . OR'JHftIG • ,;
2.W B Co>lstrnei�n Penult TO _c f tau*. ,,•I
icaleaeiIcanstaalonpannar(.e.INC mnq, Ymtimrgett Inn
3.Well use(Oak well usf):
�srrpay Well: ILI
wsc
�►gllwldual �MunfafpaYPub!!c . Tw fi DIAMmfl carom rxrlctavtran xaxrt. M.•
Cteothennal Pleating/Cool*Supply) ,`,1( • •Identlal Water Supply(single) i) ( f__
.
ew tt.
lnduslria! l A • r 1 Water Supply(shared)
a" 'Lit./
litigation
- \ it
irirA4� BM f 19MA`L171Amr1ar4Lr IlioAroDi1NT
Nmu VI'amr Supply Well
t. -1111 • A '_J &
I
Monitors Memoryn. I
njecttaa Wl: —
ft. :t. I
Aquifer Rechiage ClOr undwotarItentcdialiun
gniferStoryge lad Recovery °Salinity Bonier f9 S.INJIJGN ) PACK h7A i aMilACbtilfG atiillon
AquifrrTctt 011tanmvaterDrainage n. rt.
GtperimeitaITeelniology cPSubaidencoControl O. ft.
Geothermal(Closed Loop) f Treeet RIMING I, I:
•
.
tieotGerinaltHa�ing/Cooiin Rcnzml ' Otderfexplain andor#2)Rcm arls) most no ti!,ei,!.� ,i_ .V rrontue:iw itrt ,
( I �, 3
' it. (1.1) O. ill 1
a_flute Wedge)Completed:4-IS-la Well IDp 4 D k. i(,f,(n( tL ' U
Jtu ;tlsMuatfame . s l0ct / . "W w""'vr .
Facility MI(ifglplic ble) IL It • I
P I Addicts,Cl4►and9Tp n. n. �, ' �; ._. ..
•� \ 'ta r b 4 1.
t��L�� �F D ,.�- ARroC cc .
County Parcel Idoatilltnit n t.to.(PIN) tV*ILTO .
Sb�.LatitudeandMagltgdeIndegleeeterim►tertsemndsordecimaldegrees: ti,;-l1�;i'r cxW ' r�I�rtii
Orwell field.one Innen;le latrt) - `
t .. don: / (�+�i i Y:f'.�7.Z
1 _Lift
a.1et )Meweu at
(Stermiaent or EffPelnorary SifnoluteofCletr Wall Well Cuntiaetor iI r
:a3
aft
?.to tide a mail-to an misting By aloft s1aA farm,I hardy ovt.that me ndlf Inv 6orv)rwewuacred matt* ahee
7.l e U ng well: nits or No wil;11A tiC.AC 02C.PiOP or 14A Nl-AC O7C_.02oP Wdi nnstrnak ar SYmrdart(C and chats
• rJlNemtk:nenwedl.xmumufinGAnnaannmu=plaindknanmeemu GllonilMLrrrrowll+aeMePmuldmdIntha well allam
Mob'under t?1 nrsarb naiad art*Il►c flack ofiblxjorm.
&For 231.Site diagram or additional Well detatb:
Geoprohr/ilpTor aeaeddslai►Geothernal Wells having the name Wu may use the back of Ibis page to pmvide additional well alto details or well
eananncllammoly I GW t la needed. Indiana]TOTAL NUMBER arwclts co t tructfdil details. Yatr may also attach additional pages Ifneemeary.
drilled:-
RMI7TAT.INORTICIYON A
9.Total MO depth l)etaw Bind Odle: U
Atnurimp/cwe&liteallduiblutld!$'e m,.r�.�A- casac+'o„a"Nuoo7 - conafinx.. (ail cons ricPA.N WOE 9Submitnit d►ia Than within 30 days of completiontlon of mil
imt tome filltlming:.
of e
top in.Static rrntl�l�t Mowemir*: -
Ifentar/awlIsohmcrosf,merap� l • (Ir) Division of Water aeraunee 1d mt��
II_ItorM0lNdrastxer: Li) �� Ib17WM Saralee Outternittaleigb,RCMP 161 Preen:lig7
-
IIn.) M.liar salesmen welts: In addition to sending this farm io the address In 24n
12.WeIE construction method; '� shave also submit one(IL cum meaty a,�/l a copy of this form within 30 days of completion of well
cable.enact push,cm) r cunairnction to the iatlawiag:
• •• Divielon or Water Reoannoe%Underground If Jectlon Contra)Progran,
b�DR WATER SUPPLY Wt+t s R ONLY:
a(�� 1636 Mail Service Canter,AltatdgL.Pic 2'JB9A�s636
lb.Yield(gall 4 D WSW of test: (LI q arc Iron Water a Infection u In addition le
tab.uratuatrctlon type: Amo1mU rbc uddmsa(cs) above,also submit nabwaling Urn Pays to
completion of.veil copyty Im this fount wain theh countyot of
ire oonetmote d. •
consfssxtlon m the comity health daRatllnCni of
Porn GW.I Nadi(hrolfats i1e lothoonGoftinvrrilhjyuttonl quality-Division of Water thencrea maul ed2 22.2ar6

WAN !NNW S.lf.Giw ut Certificates
owner4rTY)_6(_ \--\cOMQVANewwek
Addresta
Perirdh 7.2.4WLO2ta1
1hereby ozadttbat the above woad well vast pouted in appearance In : ••► :• with
all County Well rules. igra
wen DxfU 9)t)c eetCLOWS S"
Certificate* 1,1 A : 9- 1 - 3
Q,sintrtirn: Cyr
Toth 505 1pe:
Caen • v� Thickness: i ru {ci .
Diameter:
Weight/M
Drive Shoe:
GPM...a. ---