GW1--05469_Well Construction - GW1_20230821

RILL CQNSIRL(t1O` 10.l.Vltt1!ti!' H eve arerlear use some,
II.WeiI tlethersterr eaf«.rtie.
1Me11 ft t� u u.i Blr
'�ial(�etrsaca wlte.e l T a � t� __sit
3441A • ...
Vy Irde tly ww•r(tiarAaRr wow - E!t)C.TER C6tt41Glb►
NW Poole Well and Pump Company ,
m i To
r,„/
r „ret+ t B`e'rFR e,s,„c QR elrltdltr�l --
T� i
s Nest e:..aearaae lleelil Ilkj92� ( —talW t. it
„r: ela rerMrrerawew../m*OatlCCwt�l )
7RRtlletwrct
S WA tit(deck yeti est�
17.SCREEN
L -
KWaterSappArlle!
FROMTO ni,.yrertfR stoma
lIn7t••-"ac !t/ re. 0 j fey ! c nt. 0)0 a ♦TO
zXteethereesk l J`*MAW Water WOO alrr Supply(sutgle) ft. fry ,n.
°Residential Water Supply(shared) Ill.GROt.Ialemssor
0'Wrl is>166.IX06 GPD FROM I TO WAIF[HAL I LAIntatCxteosf 10ET * a"F
IOW ales Sop We! D ft. a1 C ft LYek,
j.- a °Recovery fL ft
ft. ft.
C °Groundwater Rentcdtat Ion `
19.SAND/GRS VEL rAcx DI soplicankl
'S ,nrrtr'r$t<*r1a*tarr Rsosrn ❑Sal:logy Burner FROM TO MATERLO.
n .w, ❑Stomwater Drainage G ft 4Ot 1"f- +� 1. ,3 _ I �L� -..
Zi ell Teti h tology ❑Subsidence Control ft. ft I
%ueoi''erot.d 1Ctosed loop) ❑Tracer 20.DRILLING LOG(attach additional Ann if accessary)
FROM To Peso IPTIONe.ne.Warden..ewL..type.srsingskase.
f_�';,',r sa kliew:r lg.tooling Return) 0Other(explain under 112 1 itcmattO C J , a R. cep. Se,,,A
GT) —23 Well IN ,1 ft. &t ft. C_ t � .. r
..Ilalr Wtl}(s)Completed: '"�" 1 - 1 \E C L 1-
.�s- ft ad s-ft C ..kc t � /
�a.ltielB k ucalioaa: h. ft
1AEG 2 1 023
.� �.,,��, ft. fry
ilierb,iet}..rer\wri. Foamy IDA(efapphuble.1
ft ft.
hir Vd :ri I:),( y(1 . fw/l< <1L I i f f ft. fry t;lzA"
Nogg Adam CaT,and Lp WICAOG
21.REMARKS���►/ Used Hardened steel dove slice
piano Parcel Idunulieonon No.INN)
SI.Laililleit MI Illadrede ie degrees/minutes/seconds or decimal degrees:
o re-wet Mkt Rat tt le su D;ncnt) 22.Certifiesti
.al eb ti Pt\ 7(6.1+04372 W t(16-.2-
s.w..iuteof Ccndied Wrf}(,Yrenr lloe
u.}sfarcbUut well( ): C}'erawncnt or C'Tempurury (JOOWwng lint Jio,c/Aawelrantiffilllhaw x/m1•01.04Caleifalli'ilaleal'rOr4W.
zlogee'n2r loanu.tfixSCaiC r���+.area•.'..
'.la OW o repair tuan esistittg well: DYes or IRNu ,iron..-IC ft but ha.,rprad41tedraef.uurr
a,*4swr fill weIrwin aell coin 1 Cfu,rr r Jrrmn,c„r OWarytfarn rbe,wIu u/fh:
,r:.r ref noon uaueww,v ill*the 144A u(dw l,ou 2.1 Site dieeTem or additions/11ate>g details:
You may use the back of thisner to pro,.tan 4dianiad ateiainsin'--sat
i.kor f:tteptBM10rr or-) rued-Loop Geothermal Wells having the same (add'See Caves inReRemarksYou inn also�I:1'h atiilir teaell laret� s=tr.--
::,,Cta,�tr,.riot1MX)us Is netxded ltldtrate1arAL NUMBER uCwells
24.Stimuli-AL INSTRG.CICF'S
1.Tied etwill*pet bd.Ord atalete::
S (ft) Submit this4R'-1 tri•
ahin30 Joy,nP well completion per site fenemi
,,1d.•-lt39er e.d Sf�i lau)
r r...here emit.eetvedpte rd f
Z.6 24a. For All Was: 01t put fort to D,-s.at of Water Resources fDgia
�� .� lead trrapafcu.iog: (ft') (nformauonlnxessmg Unit t617 MSC.Rate ttPC27R94-B6I7
feuunanetesolbwt.ue bmot 2Jh For Injection Writs:Caw toDt4r2,tMlnpuarrd iryoettaw Coma(e1..
1dRueduir 8 lBt►F Pt opJtn,li,lI, tSt',R.tl.hgh lC2le3ti 16.16
1Z Wei tprrRaeIwr t+�Rotary 2.1e.For Water SulSelo and O*Lrur eeellillestinoi Roca Wei Cary to us
•:<eJewel,arum omit'r•eMe*' ) county en,uvntaefetalhealtttdepiauoeet ado dowdy.iaetstmeBid
dfOMWATER SUPPLY WELLS ONLY: 21d.Frtrtterr Walls Jetei e 1 R CgyInDWR,CLWi.
BLOW Poirot hnsur-nn,101 ;1tSl.
B 1St Vida tlp�l !a et test:
1 luahg n,a,,,u„N 1a Wn e.tn c tta+roda4_.r:.
y,rera7Y-1 Alrlbe�u,.akmu t r4i.u o.,.ur.,1 i iI,i..,uu,.u1.,
I