GW1--04904_Well Construction - GW1_20240816

828-622-7241 p.t
I eta 1519 05;43p Clearwater Well DrlllIng
WE L Gw-xl 1;orinletr►ai tJso y�
1. C,nnVAttor Infor Won
:
pe
Well r77.m,n�a,,�rnnN�nt it- _ _-,
` LTCUL-71A ir. —
e11 Cnnhapar['atlttaalton Mother , o., 4;t1 ' C.: I '. Ibr __._r u tAt
ekt �/ ire. ;11>6'
t.'naipnay'ivnrna (J:X - C� tZ!'1 R' 11L—r-:.. .:- •7 ..�
,r r1m: i alto
x_tVnll l:eaatrtwllan Faith#: u• ft. ff. ft.
i.in M4 npplfcoMct wall cmtonuolooRoma(to.WC,Crtttnfy,$14k,pdrlanvo,eta)
1", n,, f t tnti
S.Well 11st:celledtt well me): 7.' ::;i riNAS>t tAL
Wtitert+up r Well: — - __ 3� 74'l:�t:-all�u)ri rtltt
Agriaukarel BillitMoleitioliPubilo () o• —4
Geothermal(tiaatitlg/Co011og BupptY) ElPittelideciffil WaIOr S,tpply(single) """ ft.
tndusirial/Comtnorcinl DRcsident'ral Waur Supply(shared) Eit :_' rr a Amato
Non-Water ter Supply Wall!! _ -- it, )`, (_ t M.�/", 6-•------
ti Monitors 1 EReriovery _ _ ___ tr. rt. 1 —•
Injection rt. R- _a
E'Aquiler lteeh a Groundwater Raw:distiun try,, L P:..a. �;. :. .
la CCJrt ?t�E)twn
l�Aquifer Stori o imrt k rarwerS' Salinity Barrier re �"T•5'•:T.T.t" Aa'•'
*Aquittr Tt-ct QSmtntwntcr Drainage
>1N Lxperimearol xrr;hnoirtgy OSuBilidenee Controi �,� ,
11♦Geothermal(Cloned Loop) 1'rncct `-,Li I.M+l��. _ i ` .-s4. r ".-'+i '�,:rl. .�,... - --�:_•_ '.
,JI Gaol ermal Heikki.' ceding Roam) . OOZher(exploin under tat RemiaksZ I''� to Y=ft. 1z, (xr`
a.Rate Well(6)Completed: '7 l4 y Well IDit _� 4
go Wc1I Loottioa: 16iI/ n- d ;: 'L- - (114 ,,,,/ ..p- 7_,/,:..)--, ,/1_.A...r
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F. unerNama . ,l F lAytPI (ifaripllarime) " '
- — (---
Physi 1 ,.cht and lap
(f`unry ��// r lr 7• ?araolki,,Hiti ionNo.(P1N) — /i -rry�q; �,ik '
fill,I.Atinrde ells iongittideindegre�estminitteresecondsordreitnn1 degrees -- �— - /
61400 field,cum tsdlnnµ in tuiiletsnt) "..Cern rot
< LD rr54; �o N c '� c"5 - L _w ` —f 7-ax-,2y
p ae za$na'ueor -flied eft Drau
A•Ifilikrt)Mr well(s varcrment or EllTampnrnry
'7'C- lry.ra t 4W r wM t:+rm.I hanrhv twig,slut the IKON ins Onto)i:onM^x7dA ro ocunrierer
i.to this a rlp1lr In an coating went E3Yrs or riNn r,d'b 1S.fs'41..'AC't N:.0'00 or)SA,YCAC V:"MO Walt Coninte0f lr Staadersh teal rhal.r
JJ1h :r:ar.1,ale.Mlma known wJ?.onun,cwoolnl7r,wx+ltaa'rni,ic.rJob'lh•n,,,,,,..(iho ly,pp ofilOp mord kir'kilt?proW011rninnwt!flrwwta'.
rrnolr taller A 21 rwanrhx w:1Mn or on tht:Apt*of thf r,font? Xi s or toltettonol well dirndls:
1'•m may Ilse the back of this pep tot provide addltiO%tel well site detallt or volt
ft.Far Geni)mtra!Jl)PT or Qtriaed-I finp Geir14ar1AAt WC1M having the same rnnotruehon drink 1100 MAY alto finch Mal pones pages(If avaranty.
wr"fructinn,nniv I GW,1 is needed, indicate TOTAL NUMBER rlfwens
drilled;,,.__.,., ..., ... j r
ailibk
?.?d nt wain eepet b iN afmvland snrae: /r i' , ) 411.t 24*, For A LW tr
SUM*thin l iron within 30 days of completion of wet?
lr.lemul elf*wrN.r air ail depihrif4►arentrexanph,-.10,01enuri;;WW1 cypnviTUCiHnI oW totbcibll *Ig.
tn.Static water levelbetow top of twang:: . IC/ _(ft_) Divialon 1617 Mal Service ec Resources.
loilwatidloo Cater Rsletgb,CXT4Qntiog Lion,
11*Nwor toot is oboe t ominp,toe"•!" /
I i.Ronehole diameter: . ' (In.) •xlb.�+or 1oiscligp w&II In addition to gentling the foals so Moe warms to 24n
.f� *rove,Man suht»it one copy of thin felon wok)3(1 Aldo!of compicoi of well
12 With motlroetlm muflp� ���I< , ,arnatrurtiosr ro the fallowing;
tin,mom-,tom,.atbin,dis•m:t pull,t'ta.)
>aivision of Witter Resources,Uttiteegrioau4 tgFtxtftm Coatroil Program.
11DR4 WATER RtPPt.V WELLS ONLY:. 1 11,36 Morn Service Cea'oar,Ratetglt,txiC 21' 94636
7 j//C, t lc.For W9llor 3uttetu itf�tklt3lt Ito addition to wading loot formtol3tt.l(ttldtg(1Ai) MietherlorteQa — rite nddreSS(cs) above, niso submit,ate: copy of 11110 fins witltln 30 days nr
Lab.I)lxinreenon tyl _ ,Ainpum r at
t, ptatitm at well con..tlnation to the county health deltanrnant of the County
- -�, wham cmtaltonred,
1+nn„OW-i t4ordr L`nmiintDaWnnrnont.of Etwirc;am,tntnl C)st2h -rNVix,nn nr Wow Ranwuctu Rooked 2-222o,M1

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