GW1--04962_Well Construction - GW1_20240816

828-622-7241 p.1
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b1r1 rill np/oliate a well rnnrrraaikn p ortlt(Lrr.t1 C CtmnfY,Stair,Varlrrncs,err)
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S.1rYMl the(cheek well tine): ---_.-.— -:, 'I0 -r., ,I];;.a�afieiT:ti:r:L
WaterhM pt7 Wets: - _ „`.. R rn -.
I Agricukttrnt (tmiafpnl/plibtlo () i* Ma3 _
RI Oo*1icrinat(licatingICoolingSupply) Mulfdarlinl Watrrr S4+ppdv(dngtrs) -"'
X;tutus IriallCnmmeraiai 7)Residentlei Water Supply(shared) _ii.st:.. �� _1`y - 1'' y^ i: STSK{i+F7
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al Aquifer 1lrxisatgc p(ironndwatcr liamrdi tuna f, .- „ r 4.;LP...... c.. q e
•Aquu1 r SigragG and Recovery nvzty �Saliniry hairier `
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S Lxperimeatal TeehtiMnRy DSillisidenno Control R. . -
t�•^••t►m�r 1' 0 I -K '!"--..+•ram..-1 .
it Gtsogsrsmal(Closed Loop) C."Y' t M t-r.t E�R ..... ..1- - - -,�._. ,•-. -_._
,i�CieotAr-nnai NootinwK'ooling_Rooim) , DOeler•(re71p1in undor#?1 Rcm,aks) ) It, ML; A �-- Y'-4.t► w 3 �+ welt Ina__ _ _ ..a _ i>t. are t1 s...
Batt d1(R)Completed ft t C -J Le. _ . _.
An.Well li.cn:ittion, f 9b, TiR
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calm)/ paw teMndffmetem No.(1414) _ _--- _
.rib.Latitude nnit Innhiltadt indcgrecclntimltcsfsecondsordcclmnt degrees; --- --- _
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A.Nam)Mt wdf(s)0Perrmutnt or OiTempnrary yj, (� lsm�'1, ,pmiicd w acenrdanrr
,tip,AiKno ff moo(true,I hereby wt lam A,r rw.11 woo a glrplfbhtR Mr!con Barre
i.itt Ibis a repair m an existing writ: Ellis of faNn udrl,1S.!tir,ir nX'.#104)or 1SA VCAC.J!]c•,621 Viid irtt/nreiiru
fl ht,•lv:,rryrrrir,.t 11 iii i kilown VILA,aonWriie Wn ipOrvnnIna and arpfanr ri,r,.tent,-...rim. aim..afdefz meted A rht t proodwiln ihi will mistier.
vale*iWAerA2/nupnfi+AVOW)t1rnn11lrbarkefllds,torn+ -a.Site damiNarIm or ødd$ttlli*l Welt del
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Tots may uao Ilse auk of di•,is pawl in provide additiogal well site details or well
R.For Geo:wane/0 Tor Cleated-1.0ap Getahermal Wells having the cltc t Ginn ctrsaitc. YOU May also IOW)additional papa If necessarytxntaiiictinri,only I OW4 is needed. litdiaate TOTAL NUMBER of +ally
drilled:. A t=i tl�m a Ricid k
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9.Total wort doptii balm,hod surface: `�f' -J -- -(t) us. err A11 Weis: 9tihntit thin bbim within 30 days of completion of wrtl
I:ilrmulOplc wear litrali deploy'efefervorAmorodo-3(FILWArDe,:i@MP) COnAilICAUNISOMeMII0Vring:
1 ti.Statue water level beiow tap of casing:_____.-C ILL-- (P•) Dlvidon oftiVater Resource.s.lt►fbrmatton Procesaisig l)Olt,
I/'uvrrrn•tu,'af dr above cstrMp,tad"•`
1617 Mal Sankt Center,Raleigh, 4CX1499-lfil1
II.Borehole diameter: U/ I (In.) h,.For^ lo_�=aallillan in lion to sending the lbetn b the nddtate in 24o
rlltove,ana submit one copy of Ulla futon within 3i1 days of con plttiort of wMl
t2 Well auntreedtta laatlnd: r U+ f.- . . *nstVuction to the folhxvitltr
ri a.Mos',ring.wnsa,dira:t push,Qa.1
__ __ _ Division of Water Breanrnes.llmicrgrotind ildirtton Crowed Prripram.
NM WATER iilePP[.V%Vi t.Ld ONLY:: ( _ 1(,36 Man Strata Ce:aier,Raleigh,Sr 2709"1636
Ica.Yield ) I 2•ra. t;nrWoter Sandy 8c 1 lw•- : In addition to sending the Ibim to
iilnmi.T_ Metal ar cent _.._�_�_ n � ss(cs) above, Mao submit one copy of thin them o.hhln 30 days ill
I3b.I)I.Nnfectiem type: Amount, a,aiptatton of well coresttnction to the comity health department of the enmity
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Font/CM,-t North Comlinn Dcpnrnnnnt of i•:,wlrnrm„ntnl Quarity-INtiatnn a Water Ramatrreas Recited 2-22-20t

WA Delft SolliNermet Csainadein
Owner M e!^c: .s - New weft
rhereby oee r1t the t+eb+noed we'ion glowed fa apperouace 9asoconlancewith
aB County'We des.
wed;Mier.. -t.— A 1,l1Jn
Gam: 3 Drift.c a: - :ay
canetnecdan: Quit
Ibtornectin LOQs*Type4N
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Casing Depth: 3
Mouser LP ► -
Drive Shot
Gat 4