GW1-2022-03445_Well Construction - GW1_20220311

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ust all nl y=limbla well Mnstmetion parmna(l a Cmwy,Shwe,volvanrn,ch.J —
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ft.
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lacPcrhnental T('chnnl + [3Suttsldena,
GeMbermai(ClasetlLmp) ®ltaca ftfirlu rot>G tidlal+ tYiKett+ BRA-_.
ficaltlusnal tFlcatisepJGaotlnR PMM} Other(expldin under t121 Remark::' re.
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Well I antlan:
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t�acilBi;(sxmcrTtmnt: . facilitirit)il(ifppplicalslr.) n• ,_ _--
flt,xirnl Adrtrex4,i hy,vi v 9� ---- -
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Comity 11=1 Wnati6crtimt No.(PINE -
fih.94ttilude and tongihtde in deRrorslptimftceiseeandsardeelmnt rlefircca; - !+ .i'
O a rill field.(tile n0ang is Fnniafr11f) p l '1t.4:e Ilnn: I •�'�
Chum)file wd!(9y 1*ermanCnt or Ormporary r oturr:tv CertlfsedwellCmstmCIO fJnfo
.t=.rtlminR rd N."aim. hM—O cxdlfjt(lull lire 11Y,'il(c)mar(lec►�J rr,trarn//ur!!tr aecvtrdmrcr
�rh l.sA.v(-nr_'02.0.=Hull nr J tq=vrdr 02C.0000 Well C.'r nafmrnr+n 8htndnrd.mid rhos
YIli1hi>n:llals it psllMaknnnrtlr to an �A11 slptcitng well., �fo=nialrnetn spinnl On'awnA''�(7hc rt+!llrttff$(sterns+lhnobe�ermiNdaAfi.t!>tivcrinwnrr.
r{mtr raider rJt rc0lpfrcr atcfr4M nYnn f/n!hnr•k nfrlltaJimu.
73 Sttel diARMm or ttddltlntntt vvdl tlttllBifA:
A.For Gmprnheli►1''1•or CJntcd-1 oap Gcotherumll WeRn having the some. VOU ntrty 11Sl:tttc ba61t of ibis pop to provida addili-mil well.tits demlla fir w011
mns1n111nn.onl?:I GWI is nrcdcd. 1'ndlnntd*MTAI.NUMBER of- rlis rnnstntdion tfaxilc. Yogi may ntto attach ndditianat pagss ifneceaRnry.
drilled:---•_......____._ -_�._.. �
?t A'mat well depm Ifilmv land surface:,,. CD _{h,l q,M,Y9r.AV-W-O: SuMtit this form zviAfin 3Q days of camplrlinn of��zll
1 i r rurdaptc xvA,r i:it»l;rf meh�•jAljlernnt f��+r+111+ Mt+and°CrRjalF7 con ion to the following:
Rn.Ptntit:wgerrltvrl hetnw top n1 cnaFng. _ „.�,._, ,..M.) Mvigou OfWarer RexuW•txa,W)rmptlQ0 rrocewinF,Utitl,
(!'Ny+t=s•lawl is ahnru cywnu the,•.,.• 1ltlT ik ll&Fyiec1cetnter,P41dgbt lqe 2700 1 I�
ii.BafTehnledinmet¢f-. Vy I tn�(ILn j zits,�^Ifticcttnn Weliat Gf adf itidn to pnding tfl¢fwm to i is nddrM in 241
i� Well ta>,ttnictlan medloif: 1 l/fi� 11bnve,also s foray
ubmit one copy of ihiq within 30"of c=Platltm of Writ
constiuclinn to the followinx
(=c,nngcr�rptnsy.wbk,direR OInh,Cte,l ',
- — - tMWsion ofWtner 13em irce,%Undclgraund 1gid:tioa C oRtMl PMram,
rOR WATFR SI.P"_V WFLL$ONLY: 1(136 iNRil 4MIM('enttn•,itI Mghr NC'29tSt*16U
I3a.Virld(gpm} AZ¢thnd of tesk � = F 2tc,far ylrote�Boosts&IpipeHon VltNt4- in Mmilion to ssminit the RM to
the nildrt:ss(cs) above= also Millmit'one COPY of ibis fofm WfiblD 30 dnys of
13h.1/lsinkefion type_ ,r AMntmr. wMpiction of well cc nWjucftft tD the connly hwdth depintmenl of the soling,
� ` � rtlttsrt cc)nsltncted, �
i=nm+C71A=-1 lok=silt(,o7nrinnt)cpnnmentoft:tnirtiarnrrertlQaaltt..,r)i�ismnoPWamtRamna Ii REo196A7x�-1!d16