GW1--07278_Well Construction - GW1_20231109

I
828.622 724i Pi
Feb 1519 05:43p Clearwater Well Drilling
•'NVELL GOIMtl3TRUCT[0 0 fGW4 rnrintcmntvao n y:
1.WL4l Gtntraelar lnforolntton: m..- i 1
. ,DSb Ql n I(Yl ...
wen enamor Nrunr
J['weticnMreaArckcitaaetlAAN,nn6er '^^ � �[tC�9 6lra` ' ig", ' f`'i t o raw.
1 lam._ v 4/ t-JP
Company*Nome t6INN= Oft dom1qi
A,WCH CnnBirYeflOn Permit IYt • 2 v *^ no DU NA I-
[s. fe. '
Uri an a haatOnwallcanonfmtoppintasam Illy��pAtn1(p��a 414E4 Varian";et41
5!WM MC Wilt wed Well '.— 7.'PILL,:
WAgteraSt[xoappVWen; M •.,�
,n ligea eNh bti►i.
oUti U R '
cc memal(hteatiug(ContingSuppty cadential WelerSSppiy(single) '- to
In igraio llCommetai,d ��-+jtiisfdentEat V9attrRupply(shined) ,A p i t tI A*
pentor
Non-Miler
- �-.-- j „ 0 tt,'Can /" /j
Nnrt 1!`aferSupp�v►►ell: 1 t4 �
Monitoring - i
lIBRetke lacil: it. tr.
Aquiferiteeltogg $OtoundwnterRemedietion MO►1M11D Ma rimttwct'atetert�rtton
pitaStomga and Recnttory DSnfmityt3etda Pr I
AgoifcrTeet �Starm+vateiDrail>n� „,,, U.D. D, i
thlperiaua,tAt Technology oSltbalilemw Control �...- •
Geothctmai(Closed Loop) • U ;;`v u: 3;`` .<<..: •ra�y�
Cwtktxmat(lidfltinaatinBRsrhtm)Madter(01P11411undar#21 Rcmattes) 1t / 201 %' •
Com
plete
will Luatttnn. '(" •(Y)0 `tf;(l'_Q/J .,.,424V Al2 frtt.• aRvOsOMlkatt-.• • #.4,/ .A IF ./s 4•
~- ., ', ` _
li,
ItmilityAl erthem • rao'li[yKM(ifoetpttceble) it: i NOV 1� 9
I Abbott,2 rrrt3r err 1. n�/ I�;_ 2023
P il erce- tp 1�+c t i io.,wt4S ..:= .: = em s,
e•ma - - �� PeleeltdoaifimltonNo.(Pft� r (
li SI).Lalituda non tonglenttrindegreestodnutes►semndsordecimal degree.% L. �-
(fined Bead,one tefllennin,Atilieleit7 12.C.ertt r•!dont
/ !,
N VV GZ/ i,
,,__,(( Spat'.of coitgadVic0 onnoter Data
6./e[thte)the>rdt(i)ypFcrmaamt or` mnA i
'\\ lvdf ' $ .f�+++.I heactravt��t�rei an watt) lk+a►a�J eotfn�ed H ocvatrmttrr
i.la Ms a repair In nnaligi WPM MOO or o wilt IS,AiMCAC O2C.4100orllA,YP.AC aNC.) WI Crnalnotinn Stainlarde peel Mtn n
I tbkIN tr; ranfm?l=Awnt a wnotrr d+: ti") afire:raoal Aga ttenpiottiedinrhe,Hh!tti owner.
1 rall<+p.M1 oueknnwn,uttlwaas+ro��,:nal
► oiruarlerGnreemslasctgaAaroaticM>ekaf1Llsfarrt. 1.3.$11e Bap=or odditiondicolldefeat
8.itorG¢opmhrll/PCorQosetl-LnnPC,eaOt ma1WciMhnvingihcs,unc YoumaYuse lie tackottlltspesp Mitch
ipagewl wfllcessery. or wed
wren,ctian,anly l 3W-1 is needed. htdieato TOTAL NUMBER ormits
cimottuctinnc(ttails. Yore soy also tdatAh add' t pages If nocPesaty.
dnituti:......,.. �. O) t
Taeat Wen uaptp MOW tang serinece tQf �ht,For An-`tea , submit this fire within I dam of completion or well
For muliiplcwearlimandaplGaifc fennu apm-3Cf� orencsJeina1 omstructinntotbefollooln6: '
111.StadeWaterleveibdra top orensit'W . 7 - (RI Mi¢ril eSake Resc Morin a a7 Processing nit,
lfNyttarle ,llsaho>barnstng foe°."� ..1 I 14 thetttkdtaas In 249
11.ftan btaedinmgeer: i 6 (in.) 7ith,I■,,,���w 1 to edditii n to,�ndi the folios
aH0114 two soma eme copyoP this Nit within flays of cowman of well
12.\Nell mnefnc1 nille8�d: -ro-baikit o►nstmetinntothefalloodot +f
tie.maw,aunty.cable,IGMtMb,etn,T _ Algjyip»ofWeterRratntraeseUaOrl�ronnd gjee0ant7na�nlPlro�ram.
aatiWATERSEPPLNWELL ONLY:
l Iy[t3611tAA8arvtoe�et er,>tbttdgkiVC�'AP1S-163b
i 24e.j sol�� �iga in .•,,. in sanding the flow to
13s.Yield IBIS], a Dtadtotl of tt9t: the uddaFss(es)abnan,adz submit olte copy this tium wllitlo 30 days of
13A.11tsinrectttia ty Ammo mpmltonit� lUACton to the county •alth daDnflmMt of the county
•whore
VonoON1--1 Mort/enclumDeuunantaftirodotenummlQmligr. ivistnnotRfen4itoPmsao I ReviKd2-222010
i
1

•
INA PAW Se*Aro*CotModal
SAilr)ade/K [bine V
/460
Pen*
thereby certitibtite ebovenierenced well was gloated apPeaninC011 somidanatwith
ail countyWell.roles.
PlernalOOS
wen Doer
Construction: Grout
Total De to 4225- een4bAJ-
Caskg-TYPE p 1/116
Deptbt2E.----
Diameter: Zo'
Height
,—
DGPMO
ive
•
i •