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GW1-2022-03373_Well Construction - GW1_20220314
Feb 151905:43p Clearwater Well DrillIng 828-6227241 P•1 't1'IG FrCO tG�V-11 l±nr lnlcmai FJsc Only: f,Wrl!PAntractortntormadont 1�1 (Y --- U� WA TEN tnlrfiS -,-- J11C � �tn� rttak sn-. p turt'cors ,_,•,._... ... Mollva�rtv fS,AITr R C&%NG ma wdbs OR a imble Dnfifl r+u0frr M D7A MATERIAL Cnatpmy N vnc _ "tit CA83M OR 1i thprmt♦I c ton OL 2-Mlt Construction Permit a. �/11C _ 10 Rn rctcel `s MA•tss U^U 00 nit n/yrlim9ly sell cvrnxrntdlan permits(1.+-111r,Conaly,SMrc,i artmrrc,et: Tn- 3.lYrff 1 fie(chock wrJl use): Wate1.. A7yWeli: rt� ro ItgricuIttlrnl QMetDicipallPuhlic MGM e• m �- a A u4 soon Alm ntc less MA R A Geothermal(t•Teating/Conling 3uppty) g01idential Water Supply(cit>Ste) ft. tl. 1tti Industrial/Commeroial R`esidentialWalerSttpply(shared) Cut, l ^at10q N T MA RGL 1ra7ptdl D MOUM rinn I' AftrSupplyWrit. R. R / hianiloning j Raovery p. fa niretion Well: " G. tG Aquifer-Recharge q(Ironndwntcr RcmMint4m 19 SAM=ftg!E PA 1 hte rAqui ler Storage Md Kcr overt' Salinity Sorrier Tq} MATISM _t:ACEMEnT MLS1i4R — AquherTcn [3.SmllmvatcrDrainagr FL IL _ Experimental Tcchoolop Mlibcidence COMMI n. it. Geothermal(Closed Ump) D'V= Oftit.LOG 10C&AtathaddilleaddIeft Ifinzq] _ Geothermal ttf aolittRRcaom) ther(ex lain under#21 RtcMMl:sl FROYt TO eeler. 4fyae,anlrmrlu,eMd it. R d,ilaec tit'NI(s)Completed• Wclt li1'Jl d tL t4 5�11 T.nr:gtinn: � I?ailill"C3 llama Facility INJ(iif ytplicxbla) h. B. -AR 14 HP - �... �AferdqmyrjPI ,ip' ft, R. (:aun(y Parcal fdrntitiaaion to.(PIN) 'h.Latitude and tonAltude in dcgxWlminuteslsecondsordecimnl drgreec (ii well fide one IaNktnll is snflicicnt) p 31 t(` I lion: ti.)s(arc)the Well(c)fYBPcrmnncnt or ©ITrmpnrary ;i ntma fCenific+tv✓d! anitoetor t)me 7T�� FU sharing+utv;nrm,f hrtwhv crash:alma lhr oral(.)was firer:)miumvrnsl In arahrdance �-tK ttlti A[Cpgl[to qa Cltltdq�A2n: Oves OrNn x•rrJr I.SA Y�',tf•M.[:.9/ntl ar 13A Yl:dC a?C'.f/Zf+a{Yell Gansrrnnrnn Srnndardt runt+has s J'Uri,ir;>rcpDtr,.lJl onrkrvrntn urlJ a,>nxlhat/nn iltrprmolJPn rdcril"rb:Wit're r!(rhe e0A1,1{fjhft rre'led h4a Arm prorl"!trim tve"I muter. r,79/r tatder 01 J rrmorkc xcrttrn noon 1/ra ho:L nfrHh fnm�. 23.Site diaRnum or Rddltitmnt Welt de altst s.ror C'coVrQtPe 11PTor(9naed-lAnp GEMheemnl WeRa having the Sant* V011 Wray use the bed of this page to provide additional well slits delni)s or weil cxlnstn+ction,on)v I CM-1 is needed. I'ndicme TOTAL NUMBER of-rtis crmstruction(fctait— You may also attach additional paM ifnecessnrv, drillui:_i .....w.._... __�__..,.. �;�l���r•fij1i.41'RUGTtONS ).'Total well ne/depth&/; mr land sumitrrx (R.) 2,fn. for All Wert Submit thin f0rM witIlin 30 days of eomplrlion of well 1%rp nnr!!lplc xrA rlirr(+lid%r/hr ifd;,(/errn!(Doan+ele•.t(n�1?p'and 2(r�lnlJ� ctmshtiction to the follmVing: 10,Static WOW level below top of casing: M _�__(fr-) Division of Water Resources,hdhrmatign Proeessiai,Unit, //•Mml,•r•/ur,•J Jx.>h,1Y.'>Cm'Jn�,ux`•' M17 Mail Scrvlrc Center,Ratagh.NC276"-1lil7 ti.Borchotedinmecer• _�h(ia,y 2t1V.For rAIM11nn Wills; in addition to rending the form to the addresst in 24a t2.Well ramtrnetlon method- above,also submit one copy Of this form within 30 days of complrrrllarr of well (i c,sage rnt1s}.r dale,dirtxt pus)t,uc.l �----- c140n[ction to the follorAng: Lr , SUPP1 lr i,LS ONLY: Division of Water Resawt.%Undergtnnnd linjet:tion CoRtMI Program, I636 Man Servietfeunw,Rolelo,NC 27609.T636 ) Methad of(eal: 2•tc For U'ater Snook&fa➢eelion Ad►r In addition to sanding the ibrm!n tn►type_ the mldress(cs) abovo; a1So Submit Ioae copy of this form within 30 dot's of .-- ....— Amount: eamptetion of well mnsimc don to the Monty httalth department of the county Scher*constructed. t Vann ow-I C WorGram"naDepnnrnentofl:nirdnmcrralpuamy.nivi5tonof wow RoMin!" ' Revised 2 22-2n1 R