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HomeMy WebLinkAboutGW1-2022-08701_Well Construction - GW1_20220518 (2) -- --------------- 622-72A''l P,i I erh 16 19 06;43p GlgaiwalerWglf 1�rillbila G'w 'For 7nlclnnl Uso Only; WitT T rnTMl4mTti t.W,e}ll'�►ntraeter lnlbrtnnNon: �•--'---' NS6 __,_._....---.T well(:nntracla hrame -2� �� lb 1. a lit; u� .,.,C Weil CnnttaAnrCatereealinn Nnmt,e* Z, T db. /� L ,{s;irolt ft.C. u ..1.� BR 1 9liR Cnmprmv'Tremn To dn. ?.Weil eCnnbtrbotion PRr1nH#: Qynects, --ft. in. i.lrt rtrt rriptrevrhru wall rnnxtrxarlon/xrmlers(lta lar, t!lC.,Cnnary,Sra Y ft --- 3.1Ytti C W Rte IrAEo �' liN Water SrtppiyWell-Ad f1, IL ricuiatral �{trlimieipallPubita (i Cietxftctrnal(I;Ieatiu@!L'oniing 4uppiy) �t2esidensie{WatCr Supply(singly) tevhtsrr1n11C,ommonolaT (tesidantint Vigor Supply(shor(9l) - OUT v Irrl atinn vnnW netr Supply Well.- Mtntlt4rin RcaAvary --�• fl, y R' „��. --""�...-"._.. In eotion : VR ACC ?' j TM ton Atitilf-ml Reeliat$e "'C1rar,ndwntarRemcdiatlnn n — Aquifer Stcrqc(pill RG WIFY �Snlinity l3nrrier :" n. �TM __----- AcptitcrTcst j3St0tmwbR~'Dralnngc ExperiE ntal Tcehunifigy uitaidcncc eontml 1, - Geothal Mused Lev.>11) �Ttt�et glher a twin under i121 Rcmnrks} w I zb ra nl Haetin oiing pcWn1} � �-x�------- ��Its• �f•• u f.tMtfi WMI(n}C"-miRptetRd:Lam-- -^-^welt 1)r1N I---- •o fc -- Sn.Well Laeennn.MD— T Ga¢i1lty IDY{ifrq,Pitna ) —'."- k. E',r^• r^'x - l�ocilihs'{h�„etNamc . ���� !►; c-'t a;' "� ,�--��'t�y —.._.• ft, . Physinni Adrlrasx,(I,x,an ?ip i Aft pnrcei idunlitfaaripn N ( ? •'^�""-�--- r-c} �'"``'' rvlt.1.nntudbantlletrtptlodtinrlegt�lminutectsocnndsordccimnldrgrccs: TU,� P,;�{{ �i��':;.'�•_,::':.':'��i.i �0�u rtitieati {^.a (ii wvslt Gel,h Ong 11tr1nnaia s1vindcat) o --L ------ ` 9lan +!of(kAffi L�A 4Jc11 t^anrrnatar !Nt act,a►Ar1!tcr. ti.In are, the welt b l'at mm�eat ar �ITrmt►bt at y 1 err croMNlbrA„ { ) (�, i,,ggn(Mj n rs firm,1 Nrrehv ruMl ,IGar!hrt,wdt()mtr tia Xcs or it-it, t r t vr.,rri n2f.-4!(N1 or JSd+Y(:IrC Ir7f.11ltrp Wri!C7mrfrrtrtinrt ytnirlarda mrr!rhm,r 7.11h flits a repair to All exirting Well: RU) ,r,> ofdrly rr!rnnl hotbAr4 pM►'rdnvf!n 1/x x+r11 mvNrr. rr'6h,is:r rr parr.,(l i aurtmawn war!4ronsrn,cNPn ir�n,marlin,dr,r r uptpirt Jbis nnmre nJ,hrttHA etltM or sddltlotml wdl dM1111 t flail dlta tlbdlls art wr.Il Jv-poir tin der A2f roma*--4,rfanfirORrtu:Aar�nflpis,rena, a3.�F d Van tiny„gc tlic tmck of lhiBpuRe frs Pmv{do SdditionfIl if Pnetbestary. R.For Geo rOhdltPT er arced-1..m1p Gedhortcfil Welly having the 50111e cnnatruciierrt tlrtails. YOU MAY also Mt1dCh additional paw mmin,erlon,only I C-rW-t irnecded. 1lttliaptaTQ'PAI id11M8ERtfP+vr.11a 1 drilled:__........ �I.1Potatt'vyali{dtpth 110tew land 6uthlca: V _� � •! 21ot.FMA I submit thig�artn williiR 30 days of anmpletlon of tee{f fi,rnrurNprrwalltli�lnfir�tpgtcjd((tanmrtlrr+mpF`-3(hl?Illlandc�illRn'} Cfln9liltClin11 101 i]C)IllltlW 1IJni1 FJOR 14.RtnGe tvMerlev41 ba"tatt top of caning:,_.... —.a-.---.^--____ ---(it.) DIV1617ol1hRSeKvicec s1Reltdab. e rWAlw po " fi7 ' 1re'n(er 8rral IS rriv,ru cm7nA lyre","t Li addition t»eenditig tha ftM to�E olimel 111240 12.%retinledimmeter: ( �anYrti gleo guhtnit one:copy of thin form w{tbin 30 days Of aomAl OHM Of Well 112.Wei;conetnictinn mulbod! - et►nsmmion to the following (i r.ougcr,min .&ta)c,plrNtp,ith,ate,) Dlolllan OrWater Rre11111Tec,Undc%Mund 1111Jer:tlon Control"ram' - T GM Moll Serviee co"Mr,ltRtelgl,,NC 2709406 tatM WATF.RSt.1PP1.V WELLS tr LY: 2ae,.,. a ""tV�roie0f30rt well!: in utlditlon M srmdit►g the aline to Ust.Virld(gpsfi) Meth+ntot test: - the itddlIPPS(CS) ~bola also Suhrstu one copy o£this font within 3() days nF ortot: completion 91''well construction im the urunty health depallmetil of the Monty t3h,1>Icinrnatipn ryPa: 'AM T------ where oonaMrcted. Irn,m CW-I Nnrlh�l�miinitt�at+nnmonr.�Fi:avlresnmrurnllhratitg-1�Ivis,nnoPWatarhnHoltrPag ��i �"���41G