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HomeMy WebLinkAboutGW1-2021-02439_Well Construction - GW1_20210620 wax, (eif+;srla4�is��3n1y: — ; II.Wed Col 46-aaWy Mov anAcha: WO Contractor Name ----— - KC e'daR Coatrzctu C atlfa•wmi 11,Fumba Cumming Davaiapments, Inc. ..........: +1 & '�_ 3 n IL 1 .188 G.sty � �.sett�olasee egseio L�e�oat ll: y(„t'�'z 1� E LN E0 _ e+tatto"rl�n ft.r.a:......r:..s r...._.0........- °t'rr�rr� R4A'S�4�4 _1 .u.r .....!_,�._ in. a.CJell use f ch :L-,rt sil evep 31tI== �iuitu!ic' aUW61ic ua. �, a�a [JIGeodlern!sl(Fieatingteaoling Supply) ORasidwitial WaaW Supply(single) - !_+7a-1m > n 'R .. . ._ a� 20 A [AW C �ifl4 Pour edonWev: J ?ecovePy L I feP Rlto a,3 1--I GPouucit"latt %egze iaios: 1 Aquifer StoPage sued tcovcy �SalialitQi�at:iec 9�gAi`J�i:IAM 1PAQ5X ci�talloslli "" �•�,;}.�yv;:�, ;�,i �3tOPi51!°JafiiP d-3rtiintlt$e; �(���g n�, nx° � � `"� aase+taril T tistolo,3y Fasubsid -im c-ontwi 1- ac,doom(Closed Loop) �, ` - IV Go ocher"(HeatinS/Coolina Aexurra) C�lath!z(e"plcatn uaadcr tS21� ii2Ps¢ss .1t 9c Wdl(s)COU0e8e6: Z��Z C"✓eB1 IICtit ) - (J .a 5n.Well I1.028doug Feoihtylt)evraer Nam® Fsof r 1DM(if appfitrable) � it f ' Fisysicaai Aar,City.and ����` 8f34� 50�8'7 .��l,�L�C�y\�� rl.0 nI Ip... Corte x �,,•�s„ fl t'aresi Yd,in.Hfiaipon Na(PiN) �fi>a]Lafilinde lied IoiWWde is d l!yalva�E�le exa��3o aw a ccha rt dgt+eea: (if wall field,one Wftlg ig sufHcioaat) 22.Cclydfleadaw 6°1�r:lalm)ter.weat(a){�s�itb¢ ma©eras or LI'l'eMPOVarry Sig Heal all Conta�eetaa DW gaalrag thGv forma,!herahy cenh)J that the ucuft)P'M(nett)OxNj"xw IN accaardmat,a I°lls Cuaia a r�'Iufli6'g0 a!rl�IIiUirtiaf�er¢lI: UVM or &JO iiith 15A N('/f°02t'.0100 ar d 5!r1(:Af'0?(.'.0100 Plell Coastvrrcaian Slaaaak%6 mud thrat a ljthts Is a vulmir,fill-d lrnmm iwril conslrmcima 11trarnaatlora mad exl l[a1:a Ma noturs oflhs eopY of thiv)twrYd hav freer;piaMacd ro rl e r ed orrner. rip alr ureter n2i nnrfar>v sr�clin7 or on the hoer oflhis jar r a. 23.slit,dlogamm av O&Hdo.d Tic'il deteAs.. I)for Geoprrobeffi °mv°CGiaged-La3p Goa iierwa➢weld,Ito You r use the be&of tide !tl!a�tilt.°9fif fd8 v_ pqpt0 p(Ovltae addltlelial Jell site detasis or e^✓v11 rr,rsrs ^'u'®kaU le W d.T fig /1 dap s If6 se!rrl,(a: �qa° E®A,L Wft gubsrait thiis real; e"Jithin 30 days of completion of Eiail d•'ov rnulllpJe wef/.v livt all n'oa9las jP'ad{(j'ers;ral(exaarryle-3(oj�2ll0'mrd 3®(00) _ C4trlEtPa!oii0n to the followingrl®.es9ade watw bVel Ulww cup d en2ing.. fit, n 1 acalor devil is atovs cash,*we°, (-`) BEerhiM ofi C✓Mw E",- a9rrseo,ilQPor�aBSo�II'cos�i®g II)saiCr, 1619 CJIItlid S`e!r�ri�d`nntRP.�1':�91Pi,4�i.rd4``3?4ia?t"_9 a°� 241L Itur InjUdgr IVAft In addition to sgnding the ToF7ai to Vyle`.LIlTIP83S•:sa 21a H?-WeR mftd: Ptave,silo submit one copy of this fomi 1r4thiu 30 ' (i.e.Nw.rotmy.Oak di,isat pareh,do.) ---`~--- - ©onsnt!etion to the followina� "y'0 CS1Si1f3iC�n70n Of eJG3t FM WATM 9I11P LY WS LH.Iq®DV- �dc tploan eaB C"✓nfl¢�C�¢�nt�ec�4 iL'u Igieefia• [�o�a , p fl b 'T QEiCD�f. 1;6 oL16ed'C�ado ` !E)ngLai 1 ) ;'P ..atr g� g_. r.. n. �.iER.. aa.n- v...IJ _ �u>> �a n6¢e?3om z MTN � 5aac arlraPses(ES)`abuve, al3o s!absnit � capq of this�ihem 30 doors of !. _ Awe=:�(��Z � tYiri?Ii�:SCla!Of arc cl so tstrts t.Mr #d1 Zoe coiaiatjr lie attic depeetlelmt of do OtIW1,Y eytm cottstsucRed. ana t3W 1 Nosaia Caraallnrr a3 y_�gmrnit of Tsuviean,sx ^3 QL_Ihy-Division ot`PJalor•a off._G a...a.... ., • ..