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HomeMy WebLinkAboutGW1-2021-01671_Well Construction - GW1_20210429 F-eb 1519 05;43p Clearwater Well Drilling 82M22-7241 P.1 "PbrInkmal Um Only. t.W ntraetar inf boa: 9 2a2� BONES tort)Conw mix Name t t+mort 2 tt%iol13QWRS for [° - ft. Ir. a NC Wefi Cnnm ate,cabs+: e,mm ba ?O1rfBR C tIYC Qu OR UlAnMiaLktdirt1YNMt rp Cmm�+myNvnc fi ,fy} ft fR 2.Well ConstrMftePamit#: `� .W � M CTO t�R a taarawte rat Y�►t: id�9a!!o!'h!ltwh/e+vc1laxurr+xr�/anpanvattxtxarHGCmrtep.StabYartamgctc.J Ee. k, ht. 3.IWO USE(thak[rd) Pam FSt"o alFp4y Well: TO RLO -MUD IVUAL uhural QMuniclnl/pbki gyp, &ra i(Heatingicooling Suppm eRidembf Water Supply(single)ri tICA mtnereial ltesidawat WaterSppply(shared) 1anter Supply�►oiisring Recovery dL•rItexhaW 130roundwaterR mcdlatitm r Sine Md RsCovcs} Sttiiaitp Earlier f9 3 L TV PA H L xatr mttcrrtem Aquifer Test �"mmtrvata r i)raittogg rL IL 1-:7, rimearal Tedmwom 13Subsidence 0DRtMl Gaothmmal(Closed loop) 'TOM Dktt.LlltlG LOC e4 Ciartttermai HotttiA i Ftetarm? that( in ttnrdor#21 Remarks) now It. lR. 11Attwet1(s)Completed; Well IDk lt• 2 LZLLC�L&) nnao,, Tft l a IbY'ttu»et t+Gnma . Fga7tly M(iforplicame) Pl 1"Addresr,City,an 2..ip R A at. ARIM County Pntael(dentiflmfttm No.(P1M 5b-Latitude cad hMi tode in dcgreeahtainates/seconds or dccimai degrees: (ii wait Seto,an ist9aan is awrrcdcnt) Bon; d.ls(xrc)thewdi(sjrarndAtuM or oiasarporary tiPotarenftkAtrraalttrdlCaatraaror pee Jy dpigg th1S,iarm.I h"Mv ttrtrrlfy Aw,the wiW(50%wy!were)4pnJrnwW 6f amor .d0 KY, 7.tathisxrcpalrtoa»existlrrgwr3t: �Xt:s ar�No addriS,[;ur_,1Co2C..8108rrr13R,YCrtC.41G'.!l14t1F'd/C.nazrrrmxta:rShrlarAtrr�trnntrlim�r 1,rtrdrisorrlredr.JlHalert�awnwadl.wnstrnrrranudiirmatlonmularlrtainthe amumgr)hu 40)pleafibbr4wMIJ1O8bl wPm1ftdlntheworlmmm 'Vair noder An lmwb=ama aran rite bad fiflkt farm. 2:i.Site dbgrun or addMuml wort dtntltis; 8-f'or Geoprobclli r or t9rmet-Loap Geoth.,. Wens having the saame You may use Cite hack of this page to provide add itiomti wdl atite tbtWb or well ax}nwntction,anh l GW-1 iq needed fndicM TOTAL MMSM arwcrls Wffitr%lbn drMils. You MAY also Attach additional pages if aw—war}. drilled,- ------- C MElLatr.>ttmurrt m 9.7roeat"ON depth below land su1'hiset,,.�,,_ ��? I &r AM W-AbAt! W-Ab Sttlrmlt Vs fomt within 38 days of oompitxian of cell MwMaImpreertlltllStalldagrlurjd�drnmkramp�d-3(n�pt!(y'vnpt�a�t(i� �" conwmimlDtilCfoitdK : 10.%tk Meter lev4l blew top ort m or. (ft.) DwIsion unit. !fxntrrfenrtllahrratxRatirgtale"." /�/ 1617MISa VktC1410,Rstetb.KC2709-i617 li.itatcdrotediamener: F O {in.) BE Wdl atrengn a: In aaldidon;to tiandi Ii.. .,,r ng type farm to ft Addtmb in 24a l2.W eli amaU mitam me+ltt[ralt alMwe,Mw submit ant cope of this farm uMMn 30 days of compled m of wen d,e,-IF,Mmy.table,dirm intsh,dc,) —-- c msttnction to the following: [1:3a.Ykjd(gpm)__ fit WA7'lti f+CpP1.Y W [LS tHVt,X: Division of Water$taAarrce4.Undcigroand ligfectloa Control Plratgram. I636 MOO service Cetrdr,Ralelo.NC 2709-1636 iNCtbartofreshFor WMer Sanely&kjWj g_Wt tt� In addt ca to sandotg fie fam Atthe addm9cs) above, also sullmtit one copy of thhn form within 30 daysof A.Disinfection type; Amount: a mpletion of well consuracdoo to the county health dep"flu ette of the county wimra cotttttraGed. Fmm GW-1 W"ht]snri" apmimoneofrin.kdnmandrt tanty-iwstnnoPWwafkamnttas RewW222-2em i