GW1-2021-04588_Well Construction - GW1_20210429

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ter Suppry NoRecovery to fa.nrlteeltatJ;e GrmmdwatcrRemcdia[iR
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Cmorhemtal(Closed Lop) DRUM LOG
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2,3.t3lte disRsttm as eddllloslalltmfldae111s:
S.Strr Geop ebeAMTor 0asi d-Lonp Geothartml Wells having the slime You may use live bade of this page to provide adc0lorml wall she dMlh ea•well
MMMIctim.cmty I GW l is imWed keliw*TOTAL NUMM oruclts u>rWlrurailatdd"N. You tttaY alBottlfa�h addi6ortalpages ffnneedary
drilled:
7ro"l-ol"M he(ow land ouracet �,...__,_,_VL) 241% Aw AN-Wells: 3uMUit This fbmt wilt 30 dap of completion or well
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18.9twie writer wo hdow tap of tamdon of Water Rewureea,ltofeemalion Uldt.
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1i.ilottdtoledNaurel�: A 0 { 3 (in.) 246.pw Isk6 en jawr to amdoo�;to tending ft f =to OW fiddrM in?Aa
above,obo submit one oopy of this fbnn w110dn 30 4fir of eongdtdan of wdl
12 Welt Matniellille»tellroat {�
ri c. hIA4aM>naviawn ft fatlowint
�',^Wiry'.,into,dre�t iltc6,etc.)
Rhdsion of Water ReamtrcM Uad gAt,and lineation CopiM PsWom,
FM WATRR ALIW V W8US ONLV: l f,34 Mo1F swdee Ccetnr,ltarerg►.NC 27fi •t636
13%.Ykld iRDRII � Mlethttlt of ttRl: _ A:te Ew Water_3owd&bfmftlk In m ton to wmdiog the Qom to
t Otsiptbatioq Amount' the niddrasc(es) above, else submit one copy of Oft form 901111 30 days of
catapktion of well conmeaioo to the enaniy health dmm..w of the connq•
where com"we,ed.
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