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HomeMy WebLinkAboutGW1-2022-06022_Well Construction - GW1_20220621 E ® wELL C0UCTIO. BLC JN. $I�1gi YIAS lTf�SYVdY>a 8 -Dwigm cf waftE d. TOP OF CASING IS�e._Fi Abow LmW Blame¢ ,ice ra. PA : I; � + : v, aira3enee1�AAi�►CZC.Oiia Weil (ftrfwMual) WELD f N a.f � e. 'D �TtiOD OF Tear / i.• �o a VIM Contras Name £ Eo�+i: SiREEI'ADDRE•SS a6 �. / � ww-�R a1✓st �= Frsm , I/y To J Fum T® nj 6_. el ?J& n Ti® Ffm T® Cry TGtiRt Safe MO cocle Emus To Fmm To rl t �SC-t- gJL7- V��. - 7 CASMG: Dam i�; sia� Area wade- Fhum nmtntres awELLUUMMMMON: Fmm TQ�R% FL. SrrEWELL®*ff ) e��P����1-b3Y F` '—�—�T® 77 FLO j�ez� Est; wEI.L corls�ucrlQN PE RUM F, T®___FL omiEsr ASSCCtATED FERMTr;ucf-r ) & GROIM. DePM Wou McUtatij 3.WELL USE tChe&A a Pa* 0 '%"g*0FfibWM p In R' lU � Fmm Q To�_Flt. 1-Dr�jcn _ puer� DATE DRU LED From To Ft Tom COWL y : 00 AMI3 PZ 9. SCREEN: Deplta D tt r SW--,MB Macaw 4.Wt^I.'L LOCATEON: FMrqT® �- k- CTFY-- G-N b d a. r, COUNTY 1� 0 o !l,t ��41 From T® � 6n. k- 5�0 � C fil O . --2 7pa2 Foam To —FL iat. (SUM t+mtitle.lbs. A Ut tetra-.P&met.TJgCO" IG.SANWGRAVEL PACK, TOE P LAND SETT NG: Depth Size 13 swe®valley 10 FIA XRddge® Outer Erom T (Gb0 3caPPMPdata b0x) Mq be in dew, Femme Tll FL LAM UDE �e (o , 92 5-1 Mimaw 5=0mb�r =Fr>ar� T FL LOtdGiYUDE �D r D D D I� 7/t) • an a darmal fo�.t _ Latiweflongftudeso UPS 13 Topoganpblem 1iFrom 14YGTO n Descdption (bci3 o n ofvaeB must ae shaim e a USGS amP and p - S Pe ze C&c s aved to gift fexm tTrza'usf aQ GPS) '-- 7 0 ..ScL,,eQ, fir o ffi F.FAQ€13i'Y-rethartauseareatrxa�ai�a0xiv�Aisior�- . FACUAT U)ga la) - _ r7. MEErADMESSyl I I AI I A I UD MyerTbwn Sty 27pCode - �;:,�-'tea o CONTACT PERSON C�sse-nUr Lev- (,jeeP— �r�c�`r�7er:rlrF ��'�GljoiIr td"AnMG ADDRES s� o .tl /S l �9 c M a y n d , r,- f7 e- a 2,0.17 12.Rom: CUy&Tmm State Zo Cade C 33 `17 - 5 0 / - Pma codb- Phum nt nber 6.iI5III.L0f=i'AILS: toot csffrFyTMrTNSWa.Lwas�ttaAr�AHMWM 15Atar. MV1t8.!_ t.UGitQ'taSTDAtV[aMMTACGPrCFTMS 2. TOTAL DEPTH: RECOM 1 TOTtse IL DOES WELL REPLACE EMFM WELL? YES® Noe z 2-ZZ r- WATER LEVEL Bekw Ta(a of CagTQ: 6 FT- SIGNATU jRE F C eF®VWELL CONTRACY()R DATE PRINTED NAMI='OF P UN�+_ONSlliUCll5 G IHE EELL Submd#w ar4pnd 3D go D!Y!$ion ofWWatwQuaWv#dhba 30 day. AUn:ftdbwmA@onMgL, FUM GYM 16117 Ids Smmlw lamer—ROtlelgh,NC ZM99-1617 Phone silo.(WIS)733-MG ex#W& Re;►12M