GW1-2022-07118_Well Construction - GW1_20220729

- 828-622-7241 P.t
i Fib 1519 05AP G1esrwnterWNelj Drilling
n tGW 1�.. For lnlcmalUse lily=
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1.Well ntractnr information:
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tVrll f:anrrtsta sfamr --••-• �
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VC Well Cnatraelot(txtlfiealian Numin1 pM
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2.wIeu Capatrutaion pertnil#: �UU/ (t
49110 , n
3,weil litc(tbeelt well list): ^IT. N A 6a6 u
IL
water Supply well: n-
n.MimielpallPubile 0
Agricultural ri 1n•
(tewilcrenal(l'iesting/Cooting SltpplY) Residential Water Supply(cingic) tt•
(tesidential Water Supply(sharat) -"8 O11T A
InArtStriallCrnnmeralal
irrl mion
.Yet V1 nttr filwla Well.,
Mnoito ' Recovery •_ -- R•
-injection ft.
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AqulferReell"Q r3oroundwaterRelncdiali(0) -n S N trg�PA Yw�tdTMt77tOn
S sdinity Barrier at�a[
aqui&TStorflaF1m41�cCovery �^ tt- #' --••---`—'
$mrmvvatcr Droinago
N iftrTcst
L"xperimenta)Technology 13Sultsidence Contr0l
bU, LA p81 , cite ire.
Geothermal(Closed Loop) ORA,," �-• /_
Geothermal(Head ling Return)
Othrx(e Xplain under#21 Remarks) it. ra J T
ft, a %
a.111aftUNAI(s)Cottepleted:VK im.3_..- L weltIDY H O IL — - --_— ----
So.Well Loeallom a, R' ie
Facility[Oa(if MPlfcxhlr.)
;,ilti`tlt•:f)�erNmrte ^ (��
(1LJ)r . YLJ n !e
>• slcni hddroax,City,and Zip .1<t, AR R
C�euty
pnaroi Identillcation No.(p[N)
Ilion Proa0(3 Ut>til
Fb.i.tttittrde apt]lmlp,Atadr in degreeslmfnnteslseconds nr Accimnl drgraes: A-,l,Cer fie inn: OG
((®vell field,one laftnit in aatRcfent)
gG N
!li of(krtif+at Ddel I Canttnemr
ti.1e(atx)Me WA(a) Permnuent or Dret+t(►orl ry Jhru thr wdl(,9 xar iSrerr.)rxAevrpeclnd At awarAJN.rcr
I,?v rJplllrt$rNk,;brm,I hR�vcaJilj+
Xca or IVo uil11JSA.^iC.A['a7.C.?lOOnrISArYCACO?f.'.IIX/DWrffCrmtnaa�+59eadardaanrlthm+r
i.Its anti A repair to Rn existing wrA: E a+P.Y++frirts r4worl has!bftm Prep to the well nw er.
lrrhlrsor�atr.•/Illmeeknuwniu,,rAaoeslrtualnnirl/i+rmaJlun +dr nMlha+mn+renj'rAu
rr.;ralr tinder n It rcmr;1kT wzlfmt Or to till.,bark of thisfom,. 1L ate d all"M or addit"l Well dEl4IL9:
11ou MAY use late lmetc or this pe([te to provide addilionul well y t1e1011s or+veil
R.Far Gmpratu/f1VT or(9acaetl4-m►p
t;eolAernaal Wells having the same cttpglnJclitxt tlrtailS, you tray also',altwh additional paW if noeessaty.
t*wfinrotion,only I OW-1 is needed. ruge;Va TOTAL NUMBER af"I's �to �■e'rwt ih�1RUl' AQ�>�
Vh9 9utntirt t1[id form wiurin 30 dasi or completion of welt
�l.lrotgt well deplu inlow land surfAcr:
!%nr nrulrlpfr^tvlJ.a liar nPdrtptlte;jr/lgarrnr(au+n�tM-3tFll4a'and ilrlrlJaa') enn9lrt[Cticm 10 the tb1lOW��
10.StpGe tvaterltwt A bctew tap of cnaing: (rr.) D(vialoa oftaster Kett►ente Rol mtttlatt -1760-161 wait,
i entertier!ixrrlgneclMtoe"•'Y AIFA7M■n ervieeGcntertIAstl�®h,lVCa7k99-i619
(in.) 2i/b, In addition to Handing the ur, of the VAm"completltm nftw 1
ii.iMrdtotedlameter, oPthinftmn within 3t1 dllys
nlrnve,oleo subma one aopY
12.Well exmetnlellon method: -------,-,-- et►n 'jinn to the fatiowing;
(i=.null_,mtmq.=able,ttiroa path,etc,) I Division ofWater Btalplt ceIVUndergroand Injection CoRwal Program,
POP WATER RL PPI�V /WEi.I.R ONLY: 1 r,36 M0N Sarvloe Ceemtr,RAtLao.NC 2.70;WI636
f Metltnd of lest. 21c.I ar Wele r�unD7v&ioieeflon wAM> . In addition to sending the lblm to
13a.yield IRpp►) the: addm.j.%(e�"° RISo Sabina Oita cope of It>Es fomt widths 30 days nr
Amormt: completion
of.v6[ ce ns ctton to the county health deptttlteenl of the county
13b.1)Isinfection type: �..-- whare cotmmucMd.
I+mn)GW-t North C:nmlinn rMpnnmonr.nr'li,wlmnmr:ptnl t.)uaNty^>Xviston of water Rrvatnas Ilr!uitaA2,22 Iol t5