GW1--02073_Well Construction - GW1_20240405

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WET.4,COpISTRVCTION RECORD(GW-11 I'm latinTaWie Only: . .
2.Well Contractorinformatiosx
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ff. TO DiG IMAM= 1 31110041:53 BIATEIUAL inl ,
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2.Well Construsfaou Pwit* NI 7(G. FROM 10 BUXOM T IliticliPii= likATEMAL _
UStallOPPOAVe101iCalagiatall/Matt lie Oig 61143%Safi-iiiit44Cie aS4 t!' tt. I'! :
3.Well ITse(checkwell use): a. it. Fa.,j'
Water Soppy Welb , I,—•,;.”-.. ;',.,t'.. ____,.:1•_,. ___....,-,..„...v.:7,....:::-.. _„;•- •-:-• ,
Agneoltural 40.. a.
. Jranartirmen TO ja., stow. - -----.--, sox mntles, _ nalgrAL
GOothcnual ClicafilleCoorteaSuPIAY). 63141"213""wResielasdal WatarSupply(single) It. —to. 0.4,
ladUnlial/COMAWicild , DRairkethil WWI.SI*Mad) lila:MOM,A.':,-k,,;'.:. :'.t...-•' ....:::.',,.. ' '. _.., . ...:".; 7:777'".7.....".77--. ,
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Nen;Water St Welb ft,
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Mccitoring EIRsconty rt. 14
injection UM .
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ASISODRFAVELPACIC(Maiallicabley.-^: .,--:.‘:.t.Aqw
' Stmage awl Rccoray DSaRnityBanier _Emu 'to swum: , iitieursioncr snoop —
Apar Test OStormwaterDsainage is, A.
EVerillaaafti Technology riSabsiikagoCoottol
Gmhantai(casa LOCIP) nrracer 4613flilLtiktatiMillaebliddielialii
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GfOilltfind(ireaftfeCOOrMg Reft3110 r10017(93ifix 1 lindfi#21 Rangli* ' . 24.5 it
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fl.Date Well(s)Completed: , W4:111D* _ _ c-6 ft. 6 b re• $ iç4
cp
1 ft
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SLocartotn j;0 it q n- h5 rovi ,01,14..
OS l'• 3SS IL el PlAi•vte,
Facility/Pws.ar Mir roe*flit!Ofspprxdak) ft. A fl:77 "Th ..--'9 1 ( "-,;,.-.•‘
. 7 25i A 69 ) 2 ft. .
PiOsiest Address,City...snarls tt. a.
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COURty ftseelltutificasisaL Ns,(MN) Infc..r_ir:;-:-'*:•71 7,),---<:•,-:::,-,,,. .,,_,, ,
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6h.Latitude and longkodeindegrseshoinotestscotods ordecinad&gins:
<M3aalfwfd.sae hark%is asfacienl) . 22'
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O ilgratuie of
6.Igate)thewell(s)Plennanont or resoporary i
fiy avows:Ns fontWortrby mg,that es WON was(was)consThiged its occarelomw
7.Is this a repair to an extstIngisdh Dyes or 0§No with 1.54 Wile MC.0100 cr 15,1NCIC OW:WOO WW1 Co on Mandan*exchhat a
'Mists amp*:Jillatrknownwell cosimalossitionnarianiuxtaxitkdatha wore ofths a;PY elks I=raps ban Pivvida to Ow Wd f artter•
mar;Warn' St Ion or ott the boateshls form
23.WM rliaTramormhtilional welldetaLs:
You may use the back atlas' pago to*wide widiticoal well site details or well
L For Geoprebe/DFT or Closed-Loop Geothermal Wellshavingthessme constucsandetans.you=yaw_ .__,..„,___. ..._eccsmy.
construction,°Idyl GW-I is nosdotl.IntlicateltrfALNUMBERafwells Bmica mullIN1/2415a8eSlin
MU: VW! .A1-111sWrima. ;
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9.Told well depth bdow badmen= 35 (ft) 24o,fog'All%Mtn Submit this form'within 30 days of completion of well
Formultiplewells list oil*yew Miami:(exotpre-.*200'4442g100) Waltriltlictatothe following: 1
I
19.Static wateriesd*low top ofeasbV g.° • (10 Disiskin of Wader Remotes,lloronnationProwessing Unit,
;urger kvel is aborts cadhp sac-+i LA 1417 IStran StxdroOnater;Rdeles,NC27699-1617
11,Borthok diameter: GP- / (104 24,InjujOsaOk: la addition is sending the fans to this address in 24a
above,abo submit cos copy of this fuses within 30 dap of completion of well
12.Wellconstructonmelhorls 4.41/t7 alfttli constionflon to dwfollowinv 1
0.0.ear;mazy.sable„dream!),a.) 1 '
EgsssiunnfWattnitesowtots,litatlagtoond Injection Control Program.
FORWATER SUPPLY WElLCSONLY: i636bfolSeniceCentar;RNC27699.1636
eitesft_ A - L 144' -2.3r.re,MtgantaggtadgalottLar,djs it odation to ePadilt the kern lo
° •Mee" — -- ---- -- - - itto mums**Jaw;idso submit coo,copy oaf this two within 30 days of
oonnietion of mil oonsitudion to the coualy heft&penman of the county
13b.Weinfeetiou types Chkri#1 , .Asnotosh • 141acconsmazd.
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