GW1--04878_Well Construction - GW1_20230728

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Feb 1519 O5:48p CleatwaterWaii Drilling i
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2.Well Comoriteiton Penult it: - ft. In.
List all applicable urrllrnnrtramlattptbtla!!s(Lo.(11C,Campy,Stale,Y.aianrci C14) B.«. In•
3 Will Um(ekt+ett evil me)! _ '
'Water Sop*Weft:
17 - emA%I* jrot'It1 trums= i►Oilti L
•Agricultural Rnatuipl/Pubilo R to IL �•A Ovontimail gicating(Cotllrng apply) I:Wantia1 WatorSuppIy(Angle) ft. .
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A indutttiallCotmateminl rjResidemlal Water Suppiy(shored) pdaur . n tmttzv
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al Monitoring f R vmy� -- 1
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%Aquifer D(rroundwatcrRetnedietlan 19 - 1 1 r • •VB P° ,..1„...-.. •
4/AquiferStoraanldRoomy °Salinity Banter , . a` 11111111111irt0.I ;?,[11111siln11 , Eric": •a .1,y_.•
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01111 Experimental 7sdmotogy tthAidcnra control O. p' ,
11 Geothermal(CiosedLoop) abaci i , ` ;}` LOC{ ,,.. 1:-,,..,I'`f i`'. 1. ► eoma
AI C1wlbtmltaF man alingc,Rs>ms), Qther(exPinin amoral Renuuics) to ..0 a. c-n,L1 41 `k-
Cat Y� ► -,�?
4,Date Well(s)C mpleted: 1 Welt II" 'ID p. I (A
5a.Well'lsandnnMCI `4`,O rt 42A �'1 , U I -
►et r -�5 d an. k 0 10/0�11111E.' I -
tracili!ylOccer nc . 1:ieilily NM EfsPpikahle) Il• O. • rn c'°s=/1-'
too ad* ie.NlOLVS -i l 1O G fv. ' i` = E" VE°
and
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blrcar,City, zip „fit.tfiMARtti4 -
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City krhrool kcndJ a Ono No.(MN) lokr���n d
Sb.1.1dtudlattttdd1on01 daiadcgr tin imrtes/semadsordecimaldrgrc= �
Ruin field,nee Ittfonuin s inclent3 Bonnet
6�+ 51` y--11 N g9. 33. C .4q1 , to - tZ- Z3
>»t the w dt(s) Pluanent or �rllamporary Si reoofQ�+tttia,iWeilCaseamtm Data
6.letur
77��a 1Ni upntng this-farm 1 bffrellacarmy shot alit went(}I tb t cwrmudd h1 ncani 1m cr
i.i1,this a repair to an calving wen DYcs or No teat 15A.CACQ C4i00 rISA,YCACdMC.O2I1O iCuradn °rrshurdhrthromtgma
/JW1"1"rcpatr..0au rnownmileoastruuronbOrmmton��dt�rAfrothenroatrgrab. MA}l alibi eneon11mR7rt+E1;pNrtidtathelvdttalna.
rrooir note?oNrutnna 1 Sex+taaerAal/ffi take thlstanu. 23.Site altsgeltmoradditlDllal soli ds :
8.ForGeopt'obe/DPTorClosed-bMpGeotborniilWebshavingthesame you tpayrerastineimettll!'i11a4paIDttoprovide!adtAton>+1 wdl)shradelarltraevent
amstnietint,onlp I C1W►I ill needed 1'nditarto TOTAL NUMBER ar„sns ti>o9ltUrlinn adds. Yott;soy also a111ah ttddltlo l pages iFnt:t esaaty.
drilled _ 4.r'� Slitttnjr7TAT.I?Sflt[t O(�B
P. atgt wen dumbpawWeed SgrlitCC. `� n (R 2ibb For_lt W.f1_ ttta/bum within 0 days or compialon or won
Far multiple wells list crat r/dtttiinfifehmtf amply-M1 igrant1:61110 otnsttmtioal10EN1111I0lRng:
Io.Stolle wmerlevel Wow IDpofeal►htg: (IL) BrIvill00
0t:WSarrie IonF ractions Malt,
,R*Wgit7f 9
IL Bon**lio ter: - 1 Q. 1 ° (lo.) 21h.1r ewlerxen Wank Io addition to uondiogtthe town tot o Mamas in 2Au
m /}�(} *ova,oho ettbmit one cepyof this form within I iI dais of com➢teeltaa of wd1
AZ Well mastrttelltln method: ' v�U"' - ' mostmetiunto thefullowinir
ti o.ow,mom,tq k dined pluah,AoJ
Richton alWlter Resources,Umdetglitud injeeftau C.i i1 rod Peosrom.
FOR WATER Wpm/ tllad
ONLY: /�1 1t 3S 1NallSe Service Center,RAW blC 2?Iiisb
Oa-YtetdOm) NAM of 24e,Fos Water gossip,*will:s imtt Wein: la 4ddition it:s tuding1ht form to
i/- the adds (es) :live,also submit.aye copy of)thlst Sim wilttn 30 define of
t3b.IAtslofeciimt ape p Dh C,�� np Ammon. \V O lcompletion of well comumetlon to the colony health debaNaent of the aMtn4°
vdwte comttaeted.
Pam QW-1 1JordalanolumlbpmtmeM delimdrorrmnaMlQtmtibr-rx„amuDr Water ltclbema. Reelted2-22-2016
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Well Drifter Safititent C.tdl
�bemby certifythat the above mien/iced well was grouted in appearanc:eIn accordance with
all County Welt
Rei lAcci,c‘ouor
wit Drilla%
Cerdfkates : - - two Grouted:
Constr ed= Grout
Total ►: 'AO S m;Casing Tye p"C Thido
Casing Deptb:
Diameter Le\
Drive Shoe: .
GPM 5