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GW1-2021-02552_Well Construction - GW1_20210620
Jan. 29. 2018 10:58AM Env. Neal t1i � N 5711 P. 1 wEL�coxsrxucrroxco )a Lqw usc ooty_ �.wen coamtcmr vt10 aaD inn PrCC on � �ti�JR ec S = --- -_ F=� -: . _ Well Cmftt6 Name saw TO DIS ON - B"A ���� NC W aretarCedmaniosNMIbw V. Chi n fi11 C`oN - - - 1YtM&S51aA(E -s c l- Gt/ rr e G' '° 3-03d t eVC-- 2.well Constracdornj'erf�tf: / r FILM TO Df u.taai.r. Up all apppmWe rill sb»rtrxaaapamrlu In a I11t~Cmony..%w4 YmtmuC cry 3.Weli llte(checkWell:rse): n a to WaterSapPtpl'YeD: I�grieutturah sc t►. It +a G-d-mal OMcglinPJCOnling Sulky) idential Water Supply(Saigle) II li is _lnduzbria ammereial OAasideatW Water Supply(dieted) 'aa lam A~ W!?dL7;7d17iTifb7$.._ KOn-WattrSupplyWelL R tt s� CA -Z 4d inl h Ma4tuidog [}Recavety tetlotk ell: — _ Aquifer Recttarp C)GmundwaWlkemedietion it Storags:andRmavesy OSalitay Bauier 'M :pd auTtttt Mt� - _AquifrrUss OStaramterDrmioage d 2 Facperimcow T-A-10gy QSul sidrnce CoMml tt Et, Geotbe iml(Closed loop) MTrtteer Geothermal(Ileotra Cooling Retw nodwLautldeflfLl REntetkY tun" TO 1L © 2 ft q 4.Date Well($)Compnettd: l�lwen J)w Sa.Well tis>a; ,�l7rpl ,f PscBitylt7Aarr Naau Paeitity M,Riwk") D / J t--W �Idmri&tvioaNa(PIN) Dl' J 5b,Latitude and LangLtadt In dtgreeslmiatetheconds or dedMAI,degrew. dd— (rvsatl ddd oaa tuliarrg u se6rereot) 22.C iiosl: f 6.Lt(arc)The wavo"IDt o= E:)TesDpmmy S of Wdl Cmaaaor D1to By tr�Ciag a4ls�bae Ilaraby urub Yro the rd�tray rrais)mmosrud rb arerdoan 7.It thin a repnlr to aD atathtg wd1; �Yrs or o rirh!1d 11KAC O2C.4100 ar llg hY lC 41C Al?O WtR S:oxcvuasar Sbasdanir®rd s4as a err, eo, n�►n .drops.r, r ,aramyraards»caaa7frr, wvs•MeMs.vasaearbaupws idto the v4lorimr. rr�arr viler F?I.e+mn6 itmao.o�on tM AOeFo,�ddt fares 23.Situ slragram or oddttioeet will drtsitl4: &For Geopr9belDPT or Clostd.l oop Geott erntal WallF having the some You mug use the bacL of*.w psrge to p av idc addiriowd weA site details or well eow nctioa,truly l GW l is Deeded.indkmta Tt7i'st,[,NUMRM of wdk cat>si>ttction details.You may also attach addition',gegcs if aecexsery. d1illad: SUBMITTAL IN57 I C1'IONS 9.Total well depth beLowhadsodsrea: �� ( ) 24a.Par all Wells: Submit this fora%Ihin 30 daps of completion of woll lro.M,aayk elftarmt a ,lid.-302M,Dad �►aa1 c iDntoth-raliowing 10,Static water level bdwtDpofeesinp: t , O (it) DtvWepofWatti-Resmrms.lifamallmPrccetftUnit, q terct tr about &sa++" W7 Main SCMO Centex,Re)tlgb,11C 27699-1617 IL BwtilAla diametdr. X (IL) 24b.For InitcttoR 1Yellr to addit*,to Rad6gl die form to the addroaa is 24a M Well eonstrnenan nrzethad: above also submit we copy of dds n»at wultm 30 days of comptttiou of well (l-OW.,a,ay,rabta,duns pus14 do.) rorutrtrerion tD the wring Dwsica ot'Wamr Resources,Umlargrouad Weerlea CAtroi Progmto. FQR WATER SUPPLY WZMS ONLY: 166 Mail Service Cemtei;,AsIdgli,NC 27699406 L 13a.Ysetd(Dw) r hfefhad ortest . t" For Water BuRDIy&Iakctton jkLp ht additio to sending the[am to J !s dye awes)abavo, also submit 3w.too of this team within 30 days of