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GW1-2021-04047_Well Construction - GW1_20210823
} Fc;t� 151905,,43p Clearwater WellDTOVIn9 cs�wT•n�['+[1Ril IG1At^p.} ,.�ttr lntetnol UsG h'= WE�1G CONSTRi<T�'l<'L•.•• � — —.._�-- t.writ nttwrtnr lnlbrmntion: w r Its 7r s at o' ra tVril(:nnnaellx a _.._ P. . S. g11ya t vr..W�rtQl t:anmrtrtot m?atlfletNion t•,4rt�nUn' A �;1 ' ^�/''� I in. ?.%Yell ConRtrmelion Permit fi!: �. A i.f.orrll an/d/txrt,ir.mail Mlit'tnutlnn fadtnt/!.r(Lin=.7JR:,C.onnry,♦T ai,Yarlane,R cr,) +— it. I Vvetl liar.(eh"It weft ane)r 1m� �YAtcrSepplpWcii: '� all Agricultural �lNGmiclpai/Puhila () R Geochetmnt(1•leatillwCO0110R 3uppW} esidelmiai WtttcrSnppiy(single) R t" �. p�RCSI dential WAier511ppbu(shltrod) indrxamrinliCnmmGralni fi.s T 11an M • Ird Won ON islnn tiS'nter iupplvVlell: ft� �4aniloting ©Reialvefy r1n injection el: AgWfcritechlar(tc �ClronndwntCrRemtctli9linn !9 PA U tat Agnifcr Storage And tteenvcry �^t�gftlinity Ranier �_— AquitcrTM �}Smnm etcr Drainui R. sr^'�7Subsideitc+:r;ntttlntLac ry lsxperilnentat Tenhnnit►gy e.r _ Geothermal(Closed Loop) �'I'rnect np L GcnIhcr nal(RCRdn Cnali Retiltn 17t11er eJc lain under il7.f ttcrnallts) ' tt, -is tr, 1 4� 11L rank VC, 4,Dam.W*gpq Cmnpletelk )i well llTtl . 31,_r____ %•Lt Su.Well i<nrntlnne ft.q ��� Zv \khIFL i adlitytRwnm vamp �a�71Y lim Ct MMIPnAlr.) n' 1' icn1Address,City,and7.rp - �t n>zMARI n\'i 4 J 'CA. County Yntcelldcmiflention No.(KNI tih.11,0111de nod SonRltude in degrMIMimltestsecands or decimal flegrem. Of%va11(wlld,m1e InOong(nnuAiaiatd) { (icAtiont r;.b(Are..)the weil(A) Permanent or DTrmpnrary tl�ata ((k++lficd ell cntaor PRIM Ily"4MA$pa iRna,!hNMAVtxtflfp NM 0a4,epn"nff W Br ntmM"-- :,ittttirnrrpalrtonncxg No itlpgwrii: Xrs Aa Nd/lf/1AAYAr;O."r.qJlKlnr15.4W.ACO2r.O"0Wr.UComrmcn)?-'WMlanlsmrd1hm.r l tl lr i-)fr inir.fig m,rAm m+on l emon,aHnn iprPrmallorr nd rj lnht doe nnn,rr n(thc rn y nflhlt rr rtNd h✓ hl�'+7 ni�rfGix f l�7he W. ntsvlrr. r:avir tnadar�t)/rcmnnFrsarNm urdatlm dark nf/bfrfarna. k3.9tte dMX"M or*ddlO=M waWl daWlt R.Far GenpmhcllrP I or Qolaed-l.nnp GaAlbernml Wcila having rite Mr You rag use the bock of this•pflge to provido additional well Bile detalis or—.11 DOnatmctitm,nnh 1 GW-1 is needed. IhdicRlo TOTAL NUMBER of wclic rnnstrtrctin n dt70iis. Ynn mey Al�o!ntt�h Addillttrrel pAgtws if ne0e83Rty. drilled _ in '1:T-11n1 well mteptil below land surlltce: 40 _ j1E:i x,,,� prn ,s<II ws119: Submit tlltd fhrm tvintin 311 days of eotnplelion of well ht+r mulnpfr H•rH.e tilt All dnpllts:frllQ2rant(turOmJrlc-1(>lr l!/8'nnd�ii 100� gon9lipe(ian In the i81lMThW. ln.8tatlr,WAtnP Iev1:1 belGVr .top of rAS111 g^ la:� ____��(ft.) Division or Water Rmtimxea.lnttarmatitm lRoemsrmg Unit, l%rarar6nrrl h ntam2 cnrMR•nee"• 1617141a1118ervlee Ceater,WleigkMe:1709-1617 li_Rerrhnledianrercr; y�' /(In.) � e! 2dh.Rnr✓<8WgM WAF L1 addition to Binding ft form lq th0 aftr 6 it)Z40 13,%Yell e+►nf Mallon mt:thnd• ��Ll�ll.l "Bove,AW."plait one eopy Of this form+o►ll&30 tilt"Of 1otnplation of weir 0° "�41".rofirp,atMc,ditm et etc,) -�T '" -- cnnsNuolinn to the fbilnwing: p11tU, --— --— 9lublon of Winer Ruilitrux.Underground bjeetloa d:ownd Pragram. tNfR WATER St:l X W>�1(9 ONLY- 1631i NOR Ser0ce Cf nimtr,Ratelp,14C 270)91636 l tn.Yield(Ram) 5 "Othoa of teak 2't� _ _ xdc For Water 311nmy (hf& WO40 Milk In mddiMtut to sttmling the ilum to t11e oddra0cs) above, also submit'ahe roP9 af'Wo farm WMIn 30 dnp nC ran.nts+eretnnn tyke: a%nao►mt: ramptetlon Of mxl atttsmxtion to the ca)lmty hoailh dtpaltlircnt of fate VWnty varrara caAsmttaad, i i+nrmGw-r NMhCanmllnn ngmom.�ftin.•— �P htfmltcnMllj,mllty-7?ivia,MtnNNatel'Repatifcce '� Revreal2��-xald