WI0100242_Regional Office Physical File Scan Up To 9/23/2022

(4) MaPs nibs! be swicd of Mherwye Mom& hAkwe oij_
Alcopecifi': Jimp t,Iwwimg tbc, f);, Ole Iollowinn:
• Nopmed iqjcfi(mA * Septic and 1ssoclait.6 spnuy irrigatio-n
.ifcs, drain ffii'l hl�'. or rF,-piiir arvas
Sur , (,nv water hudic_; & Ming m MIMI sourcvs of gmundwmer
Plans and
Am symni.
TYt'ES AND CONCENTRATJONS O'F Awwrivi"s — 1,i,,,! ;lily odditiVc-, ;ihdl WiH tv tied and tli6-
concoaRavion? (lily addiiivcs, tjjz:t ttic Depinineni of 11c;I[ill �jij: j fluillan Division ol'I'Volic HQ21th
d,efcrminvs. lannan. hualth Quill lac A list of appit"Ved ildditives Can be lu'und
onfille-al Lit All o:luxadiditfive.,; poor kiusc.
Ivan—, 1 �n
— ---------
WELL DRILLER INNFORNIATIONN fifknomuln)
VY'61: Drilling G)nmwtor's Nunle: L A tilt
INC Dliffing I razilor Ccnitcwion No.:
Compaily Nzimo: t
(is Slate: /W' Zip Code:
_,Ljtouoty:'' jw,I
FNIA II.Address: _4L
sf c 1.
USAT PUNNIP
(;Owtpany Nar, )wr-__. 14—
Lowwan, J OAK AN
Of cidaw
77—
City: e7
Oi , 11uC*VLieNo..,

.. .- #..,.
.$: $i §.. 6 3' -i t{'�;,t `> E'gP''4 .A .iQ:,}, { tZi 7l eis of:11£." t �.r ;1 T i,-
-
C Jlit. St:Sti.Fi C 3llt' 2'+�c?...s.�'Lt# szjiiny Irrly. i'??f.'_ ,.4K,='ta
lr3 t4t46: 4 ijt4lt%I1C; i(#AE IL'(S dti3PltF CS?1Y41l1SLtto 411
. s,
Js t l� 3 Ptit rttcltti I(3 t "It #�$CA CO? lc DiTector i)t tht: [Xvi�;titiri { rNV—au: Qttality r2,tat : dtlt SS
t'tiFlarilG.('. ttYlllr tipjJ2fC dtt. S4=C f Ci3ll �ilrrCtlf331,tJP (i�t C",ikitJ21`+t�it(�KiT(I ()r�)iii#t{�
t=1 } t2St i) ihfs> t; (l(j t ili tir c tt are CN ltiumatl lteaittl, �tnc . �t Olk zir ,he .rurtdt%: tcr: ad,
on.true.0011 ov 4?lmotion. itt aoi� Jt4* Lk_tttt ttS£ ?tliR#�i}Pt�,� lJ StCt'(Gt:lr ! -- 11 !t�?�E, tL of tiit
.
ptc�pc f1 t rlllbirtTvtibi9-,ptclti U E'. LC�lktt��QF t tik',f i3iOtLG13t)A ( rjif{ Pclltitf t IN1, ' .. -
�IT} lISPlilIILC tc`((tii t �tttitlt{# 1c C{iltt }colt StlkJ112titiil {S) hFS i2()tlttC aEI1l7i1 tt� s hpe ite e zi1wition p. Uz ,iL{]E7S'Si..
tls„ t FzCt'ct_lf6L7rAt i2ml7o t �3W:�.a,tGia?? 11j7It"tom°{Slti'i
Ut<Jtl lligg'? $'ciolon, is to, hold V ilP.bL° t}i 12 t1LP3C3Il:''3 tiitt{Fl rya t#
:i,02 - 012tlfe):r,(�, `r —1 l�mattili(s !s°[�+il�ltts:-`., .
i"ctt3U12 slrtapczn It t {13t?c�Xa£' 61 i c
ttv} Iil+-I! parfile t5tllp r 2 cafe pi-ci rlship. b a ggei!c,r4prtner ctr tii pr 1pr utn,_ rti p £I� lyy ,
{c) lilt t llctFrji( tJ?ahiv ur Sl atc� �tctt"Ci, iTP Citt1C'2 ptlltl4 ;�L'21C}'Cltht P_ pniti`zt.ltCGt1Ei{ L, . `
cli l t P vt f Rt�tngr,pu 9tI �N C C, t �k 31 t� Cl
� o ic►`r it C1tt2C1 1 tJti dt2ttI0E1 C'( ..i(? 3Ct tall &li t� tJt t#tt'`,1r7iJtlt�i;� (�(�C(lniCtl#xE 1{sit, �lt`alt q�, , is ,
5llt2lttlttLKt= lYlttl tttt Ilt)tl dt.11ltill tttd2 Ci,e$ftjt �ttCltll ii tti� j1CiS(�it FyTi 2lt� Them signa_tulY
eEdItGUft:311[talt ti and dated-:t theppllt alit.
:dLdE�)}''i:Etl!tty tttlttCYi Jt(!1Zd1'!S' if'dtit l�Jtd1 j 11(tI'trJLt1 StJd1t71%}(l3ldttE{,rT11L� (d1TtllfitflsiY;tt;11 lliG':'1R%t1i1J1CF11f11
i4d IlI1d1 "1dI i1th4TaC26dfl('111 Cttdd,a fdlfitcltllltttlr J� 1C,'1c11 , dtfCl 1�1Cd{,- d`iI1tCI rJ11 mr, t1lt�tf/dl.:'tsj 13tC1t ttidjd}tt ltCdfi
t
1B72Jf1E'C�lUdiat t{��aC}1iSt�*�Glii ff1(diJlttl CtlttE rYt�clYiitt111Utt .'f ist�F(`r*L'd%ICti llle' lJflllt?Ildti}t.t.Y lJiJt , itCCtiYfi({? 1t21f( 4
{ [7t%dj?IL'ft . J Ctttl (trIIII L° Ift;( !It(1 E..ttpC' id3addl F{,fitll Tt'1?tl�tik:fi;" 117{ Itt�tdl � t%Ft"t7dtSSlafid{dl} tl� tti!S (F1Jc� !tuff fY-ou )lei]
fCtt,:Sit�JllllttltF3; C(fi e�tdtiJitifilltldl igIr t 0,4,-,tllStif#{i."O ZYIiG'.' lditiJ7itt?iF„i2��ddtY:t7)iyf t ('#j7�t1t(t73�Gj (I�tC2lFilrtsdl
fii,F#tt c C fP{tdl li 4�11 F211C t1�{ fi?tilt t�'tsf f!)I12,t21ftth 1 t'Zi$ t#f f tlf-tlfYt!(P Ft ttjdy fit6 l !r# 'i PL,:}w ��f�3i�llfSS
tiinsiat. itf YP9£ict1t WOO l�lp£si znt .
i'rtbi or C}ie "slit .'tirme
5. nmhrrco# Aut60&64 Ageutt 3fat
J (i
,
x
e
j
Y

C... _4g'fit."t"4Ftd-={ t€4}� �txaasj sfa�,a isrsEtt�c+s,afzf�t,i1 s.+b.lz ka,t,ii.si����;.ts�ta> ,tit:
TlhcUiviiol e+i' St' ztc.'t t}Yta1;t}' i c t.tfp€il OilfkV 4ervill" A Ael, diei . t.iti.a isJa t?ii ',asJscYi`sgta sefi d' ivi€n
ppV
+�s(zevil#iy I c r».n.�i i?fi
1
AVashinnton W'g 1aizr}i'offict
' 090 i , : Higim-py.70
tl�a4i tt n i�za rc tittzii
»`Y itaa gtot . s t'2 7$89
1':✓dc htaiYc (�#24;i c' +tlF)
i`mep . pnel
` i�a}ette���tie�2e�i�anal t��fai�e
1�+°tedmn�tnn ]ficg��ana[ t}ffce"
? 4 #me Strect. S,tzitc 71-4
i 27 C�zrcii z�td d3rta e i�etenstt?rz.
.
I a�tt¢ i ilt ablC:' a,glat?.}` v
ti[mztagtilri.C# if}5
TWOPdzc i G (SJaii
7 62 d
FwV.j9Jgj 4 O0
%ax(,9101
Ioa°e Vi31e}8e;taritii" #fi3re
"lb
4'gists`tt}n-Sgt�ctz. a tt� a1't,}ti't
ast tx azrer;. vc zYzze:, e- 301
i�+5 i€us;{aYnnzz" tr tki
Idt7ocestrRie,?x '19l t °-
�'G'at�i�saz=�<aSs rsa� "v� � lG.7 '��'i
'L* PpAPP g7fi b +7 1 i?`)
,P czrz (00?7i-; 000
„f rtx3fi t,F=fttl,
773
Silfl':TCtOA:�
r
,i HiL1 dY. l 7704 '6 8_ ,
L(3DtYNiGaitil iCt�r#aYYGIit kaa ulztGit tlYe }tiJtt3Cai1:•1LQ1� {;i%;t)tt .t6ai i?L ik3t tc#� 1:tti? c1 4fiYt2Fat4 dattd2. .
i�FlP#i1i � G�7Lte% kbizia d O7Yla3Yt;�it iatt a bt�iYlS
iLc ddYi Y YG�kttaii�altalc.

UTH
ERW UILDING. lN,a
2732'H g ivuaY 75.! BtaunW!lie,'"i N 37617 • 42,3-323-32f38 • ,Far4-2 323 a21;6 r i oll Free Fax 80t) 84.1 2518:
.o=+aist +T. �:-... .�[< *..� ,v ,...v;>, :..... .+-..vn....... � '�"?f+L ^`.^�(J•=•r+.•mve[v9V.r.:^"*
,
S �
' s
n
+.vc
,.«. }. r} Y• .r5h.,.
e
,
t
'.a
,<.,4�p•;.ez s,,.. s fy � G t.-<rr Y<„ z k,.s�r Mr yrc,....aw.s;u.r+s�..-,`,....�......e+•......,. . 4�
.. .y >• ei i.µc. ._�� ....tr+r. p, 5 =L �r t`a . x ,. �.., . 4.as. } epn. . ! ....ya..i: •.4
•` .. .} ..a
` vr.� ve. f � v+.av-, «,titer. ik. ,Sr.:ww.v K v. t .lw�w we ..'r N { :::':�.�xrt _ f `i"^".`•'k; 'et+x`� :
w+ta�v.....�.s. r .e.✓ r. r. �3 .t d +.�'.. cn.n ,.s ���st; /.T.,o-+,+ .�w:.,mT`,K, wit k...h."n`. .'3:,.
� t � 'mow-..`� �, ; � � s;•?.
xa �V v. J,,vrs \ Syrr � m.. s rt*.r,. ) {. Tnx�rw vv, }.:m.n 't.;.T. ..Kf �'\�-\•..
n+n ,vr +u:-..cA^ay.. } 4...R p�f wth z .<.+�-n 'w;.ry 4.W .,:�w Tv..wK+t ,t+az .w .xX+mr..a •
G i ? G # t.
.v +G aTrxyw.x w+tae.Gxy al,4 .r{h..xS ,:tF-. � +5.��'z h.>,�✓% r.,n ..y vtii[ w vi. F � wnv'fw: ".x M Wr.Mn
.. 't d ....j <}.y m ,.}.. .z:j.- st v }..a: .y .. j.s�x j � f>{.. ..•�Ly. .
. +} M 's i. 7 m+ � of `K.X-� ; •�7 1 Z rr,'e� +e.'?' �....i'i�c. t f9 ur>+t.+�fv..w d'h»A}:r{r svw.S.im :
t £ v < >. .� %; "F 3-- •5` r fr ., e: n 5 � .F t r v €� -
`r � -
G, f
.w x�`iav n ,A ; �'r ,wwi+y>�r�+e{yi.+ v .�S .'+F�>., q:. .vf'�..x�M+i•Gyw . s:.nwtikvrd� w* L+d p ,tx .ma.. }r nK.G .�r :.w-Tr,.m+, wrws y r
4
{ t ta`' '"' ` �?� r � "' ,. �QiY��''?'d��lPt^•.SITSMG
w
t
Y Y
� �i