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HomeMy WebLinkAboutGW1-2022-03369_Well Construction - GW1_20220314 . �2f3.622 72h1 - p''I F'ob 15 19 05:43p Cjea(yyal..0V Well Drilling WELL CQ]4i,�TRUC7!'ItDN REr�OiR31•tG'UN�A� Fnr mum n y: t.W. � a tirr In rm _ -�J..� ����l.d-�-�•�\�-:•'�• err: .,,,,.,�,._--_.-----�------_ tvell01nlrtcrorNow tt, �• _�. _____-..___-•_ rf1C'nntmttnii:egl{icnlinnNn►ntrf TO M1t VC _ l:n:nrymyNamr. �,� -••���� "'d' SqC �-lYrll fgslfkrnctinn P4rmi1 iJ: �( ��••�._�•--•----.•+--�--•,*:, '" ft. R. _-•-- Ltrr,.rl n}grrrvrhfu wc},t rnnrnnc,inl:pomilrr(/.c,tJ!(�CfmMY Sleitr.,tFawn�trn,,:1:.} ------- tr. -- 5.AyM(iir,(check won ffiser W stet•8nppty well. tlniaip0llPuhlle U Illtricuihtlrtt ' ip - 0eaihennel(Meant WCmling Supply) rSidenflai Wlttcr Supply(stngtrk hatucfrimicammpralai 13Rcsidemiar wmer suppl.,(snatdtj a U7C - T— L Mont On*TA Remary {e wi-flan ell: �Mnireeltcetfargc Q(irmffldwnkerRcme�atinn ••�9 �� _..-- 7 IJOJIw_-- fAguirerStOrAt}e MA parnpf7S C)SOunity Qnnricr -- Si- Aquil2rTcst --~- Lxlmrlolental� hltt►inip+ �ISUActdcnc. Controt ft. ---•-- UCOlhermel(04.4ad Limp) iraeca r<: N.�.Ir.!_--• fienl[termailHaatinQ/CaottnR Itetustt! �t7iher(ax�lain under 1l?.1 Rcmpr.eri, ""-"—WI ."'in.Wctt 1<-,orf►tlon: �� C..i..� ��`� _...•_._--•-. --•- IR .. l tnaty Pntml watmration No,(PIN) �-�-- tra n rr-4-•�z�grf- _._. �b.RnHhtdcnndrnnpltudeindRnrawmimwec/secnndsordecimntrtrRrgrq sirtry/t/�il field. "d.Ong fnftmir RnIhA cnno v :73 Certifieatinn: 7 /) r;.J om)the weil(sj 6mnnmmt or DT"Verm, 6ipaR .nf(xtiffimt diCnntrntgor > e ;.iq gliv x rc air to nn emiatingvrctt. 4;u gmmf}IINv�.,m 1 hrnfw ranrr ,thnt rJ,r a+11(xj»,r/(.fits)rnnam�a1 aurtrAmrm D eyes or NQ traft}.SA Al 4CAt^ f-A100 or M.V AC'Q2C.B)flAWiffJt.'rrrstmrtlmr StafMamfc mid ilia,a (j'rlitr ix;>rRY,7A:rill i)0rm0Rp0 a r-vp?0 in the namfe flee 4eRlr nt igfr rrrtmt hneAeCm tmlIll"fa rAr ivK10"mr. ,'1pafr rq»rrr V r ii mnrtn srzrfon nrnn7la har7.njf$1 /hm. x•t,Sita d6*XMm er sdd MMd VAd1 I/no OMprnnf Itf1 K ttflteeffdAlnp GenthormR!WcRn hmtnrti,hc snmr 1'mt siny uco the Uncle of thin page to pmvideaddili-mi well site doultk nr wall �TnrtTMnuimf,anlpIGW-t1,umded, fittlicirte TOTAL JVUMBERnrwrlis con9tn��ionclrlrila. YaefAaynitoalMhf+dditionniJfMsiftiecme+ry. 4 JI'°ro+t wMl Acpth irolmr land suracO:Or., Ott i 2�q. �`nr nil Wrt�; Srthmit thta fbrm tirltAin?p flays or et►mpininn�r wr.H 1�rmrdliEJctrrN.aliunifdrjrlicclfAj(lcrrtM(aran�Mn-d(DrIIN+'a�yle(o�tOA� consmictionto the IM1(N411 : ttl.$tatl a ww.r levy)bctaw tap o7caging: _,.__ • _ fafvifiina nt•WoUr Rama cm,hRihirmatign)i'ft)Cl�bg Uldl, 11'+f+•Ift'r fawl}r+�lmruemtn}k, :...i 1417 Audi%rvkc (!on ter,Retltgh,iMC2700-1ffil7 k i.Noirltnlydfamett r. (� (ln.) yth.pn,, hkelynn Wens: In addition to rending ft fofm to the oddrm in 24a f:T !Yell canttnlcllan method, alcove.Abo:submit one copy of this ibrm within 30 deya cO of nPhdion or well --.-- cnastrunsinn ro the fallntvin (i c.anra-,mittp-r.'�blc,QlrRc(plfsd,ttc,} � 3Yf1J WATNlt Sr.t'i'f 1r WF.1 LS Orlf.tf: •- _ 1"whion Ot{4Httt'RrdinlrClA"ltittletlgretlilA ilijll ti6f1 l oRlittt Program, D f trr3 "Alf9 ee ervt `t'_enmr,RIAteltt ,Jgc2'7#39#06 i:la,virid(gpmj 1 it7ethnd m ort@ u ZIG JrM Wjki'rR4oy XokM ie_{t,•tt AW. in addi"ce to qundirtg the gum to 111c nddress(es) nhat/ef; also sffUeb-one ropy of this fozm Dubbin 311 day. of k.Sn.JfkinlActlnn types eamptetion of wdl anr►ltmfafon m tho cmmt7 hw 1h tkp► MM of fhe txmaty whora txfitatritatad, 1'nn»CiiA'_I A4v+t,t'nnnifrin t7r hnmm�nr off:n.tainmrntAl t.naflly,mufman nt mw RtMnnirtt RaoitteA 2 22�a16 Well PrIIMor S ere"t Cif c*ftA Owner; d 1 hereby catify that the above refcmced well:-Ards gmuW m appearance in amwdaum with all colma r Wev rules -7 WWI DMer: � `�11 S Si ed Daft C nnstxucdon: TOW MVN-QW�- 1�a�nerer• �9' i!R Weight:/Ibtck: lietht, — Drive Shoe: i