GW1-2021-03602_Well Construction - GW1_20210823

82M22-7241 p•1
Feb 1519 05:43p ClealweterWell Drifting
WFLL CQNTS UCTION RFCORR(GyV 1) !i(�1 or Jn%Mnl Uao nty:
I•We)1 Contr for rinat n: !-�•ae info io
tt}i.Oq 'ro
well Conwwot hfnmt:
�tC Well CttananerCati6celion Numbs'
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ft..
/.'omnrrnyNnma j�. � ttt�atat
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In. stA
2. l Constrnalion Permit d:
i.191 all Offl!roof-waif 001MV 0110n JID1R&(LA ViC,C.nm+(},.41415 lrarlam c,rta)
3.?Yt41 file.(check wd)111C): 7 rA►.
water sappily well. to In.
Asriculntral �MoritaipnUPublic () R• �-
(fe"crmal(HeatinwConthngsuppiy) MtwidentialWniar Supply(singic) R. tc. tn.
IndwirielfCotmneratai f3RCsidenrial Water Supply(shared) - >tir< L Da
(rt1 ration M ct.
NOR-waxer Supply Well: t++
Alonitoring ©Retstnrory --
lnaaet(on
Aquifer lteciimpe QCirotmdureter Remodiatien 19 NB1.PA
�rwc n stcttwa
Aqui f�r Stornpe lind Recovery f3sanity Bliwter x
AquiferTr_ei �Sit>tmtwaterIhaipol� n`
fl. n.
L"xperimenral Tcctnmingy Fjsubsidcneo Control LOC
Gcothtamnl(Closed Loop) �Tra��,
,m) Od ml21 -ksCasWennni ladn fn Ra 8 p
•t.Bare%1%11(s)Completed; well IDtf
.riu Wa1/1 Ln¢nt�Mfn: //�el
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t�:xility:Onaet Nsrtnc//. /� ��acility iDi1(iFnPPlicable) y �' R � � �
fitysiwttAddran,City,andrp AR S =;r,` • c>r+`
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C.unty Patr al tdantireaticn No.(PIN) -'-�----
5b.i.atitude nrx)(on�iltpde indt:greralmimrteslsecandsm'dlximnt tTrgraar --
(ii woll frcld,rag b0onµfo s stdrretcnt) j ..2.Cardlum aw.
nl'ary : gnar�c ef'CkrttficdCVdlCaatrnator Data
A.Is(ttre)the wetl(s) Pmnsoent or !Temp
1y.rrinr7r,f�r,X.e turn,/hrrrl!veaetr/fjr-,Act!bc rw-►(x}xrtr{ivem)ear rSronrf in imd tit 7er
.hthtsnrepalraraaercirtiugwall: �Xos or I�JPia xrrrrlS.t:r'r:',rr'o2t;.#Wo''ISAN(.ACMC.'.H1rN►R'dlCnnurmarar+Saar mrd,hm,r
n,P �x,AY nflldr rr cnrrtirar7.eet pf0tl�dlntAewr'Jl nwrra.
tfrldaiv:>,�,alr..pMmuknawntwJf.'wislnretroa:rrfnnnur,r amlc+pluintbrzuarurcr!fiAu
-.-Jr render 421 ramankr s=f14 l Aron ncc SaRr"or addltiaeml ttrd!dl1Yil9t
1'ott pray ctso the bnek oT tliis page to Pmvlda additiotm)well site dMl1`1 err well
R.floc C;enpmhrlilPT or Qrrtad-L.anp Geotderrnal Wcit>r having tits snare �yAy�eticsri crrtails. Yeir tn�y tales ttltsch addi(iane)pages(f neae�arY.
tx>ttafntetion,00iv 1 GW 1 is heeded, i'itdieato TOTAL NUMBER of+vcns
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9.Tatat we11 depot below fond sntiaec;„ � " � rR•l �8A �l Submit ibis firm-ylthin 30 days of comAlation of well
Yrrmuhlerr.wNlrlElrnridaprhtiftld9amar(erax,pta-3(1111(t aAd 1n07 arnaltmionto the tolloyft:
in.static wnterleva below top of msiag: -- (ft.) Division ofVYater ReMW t%Ifffbrmatltm Processilg I)^
YK"(01,lr1rellsalvtnscming.roc"•"" 1617MdScr*VCnatetgPAIdlib,MC27699-1617
1 i_Roteho)rdlalttt trr: W / (In.) zsd.Far Ini eti y W19: to addition;to$=tong*c forrn to ft nddm in 249
rdrove,also submit one copy of thin lttrnt wllhin 30 days of Compledon of wdl
Iz.Well enstraclontntrtkod. � Qrndntcjion M111efallewinir
(i e,oogm.MtV-cable,direct Intsb,etc.)
1?Ivislott oTWster 6rtltattt0,Uadcrgrottnd lgjaetloa Cnntty)Program"
IiOR W___A1_FTR RtPPt v WI&LLfi ONla1f: - - -- 1Ci36 WAR Swdct ctwca,RAIdo.f4c"Mg,163b
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13a.Yield(Rpm)�. Mclitad of test:T_L_- 2-le•t1'Wptcr gnrfQty&�rti�SWR t0i41tn: 1n uddidon in scmd6>g flit tbrm m
the ttddr+r5s(cs) :tbnvq also submmt omc copy of this thmt within 30 days nF
1]!isinrcct(pn tYP� _— AnlouaG completion of wall cor ttmction to the comrly health riebRlimtnt of the enmity_ whore corwrnGed.
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