HomeMy WebLinkAboutGW1-2022-09598_Well Construction - GW1_20221021 s=Vltttt Vnitt
r � PON , Ql _OUI For Uwie
1.Van Ca"buftrbhrn dm,.
on Poolb
Wdlcont IMName
2' 1 I rt, 2.60 ar
�:wiesi La�tcmr ta:casicnaon i�ivatti� 9.� - -— ---
MOM
1 (� �,
--.- o
fit6la409G70OtPd'aQ071d"Q(I'ON(J mb(LA INCH('OW[ I aft h4mco.Wei ft, I a I k�
I WA UN(dVAWA nse)t A n �
uuiClpalf@wsblic �,: g;:
t;Eta:tinglCoolleg St►�t1y} WantSWIY(stt&) I IL ILCommaatal �Ol Whom Sup*(O�
mTo
NaD-Water Bnp*Wells O aw 0- CfAkol
4. tl.
WdIf
Aaui&rROCIM a I {"�flmrmdaraterRemerlietitm �' _—._.._...
AVArSWMVacidRecovery DSaunityS '8 wt=wa�r rwc: u
Ted ac�iar
cotamwater fka it, it.
1Tecbnatagy 0Snbmawcoslitai R. &
t3aoA 11(Cloted U ff) Brae er 20. 1t
ts41E> 1, Itedan Outer tttttler#�i Resnatrke 'c"
` 50
4.D a-3-ate Ww (ej Completalw Well IDIM p t) $ sq,
WWI Mid'MCMons.
V� OL &
lM Faallf�rl0wsarNemo FAW* ( gWcsbh+) flt f
ftsiailAAhWs,Cav,=d4
to .,
COptlty pWtaClldi$CatIQSAIo:� }
.H.adta8e and act to tirgreeslctsbaafesltsetiwstic or doaim.d gees:
(ffrndl fla,i,sea 1�Ulat>a is sufBlo 2:L,Caditcad n:
lv w
6.L(Is*ties W�(a)�Pe�nettt or DTenrpor c dW tt M —, UM
7.It6k ate to*a well: 13ya or o wuh l$A NCA f2C.0100 ar JM AI CAC D.TC.wtlne Fe Coectrseatw Wawkx&sad&W a
.(f 4h Is rqd; Wathwxcr reeg aonso b tam aad e>q*M the nx mr f the �FY gfthtr rsrcosrthea beat provMed to rile wrtlflweer.
,f.neJ.au./„ii]J.r.serlm.srnNnw�nq,Aa J�nknhfi[a
73: ti f or.adWaaal r p)a dc?(s31 m
L For GeoprobelM or p Geothermal W4b hewing tbQ um You may use the back of this pt so to pavlde additional well site dattills of vmn
condtnatim aady l GW l is needed. ln&Me TOTAL'N't>l M of wells Constructim details. You mlty ab o Mach wtdtlfdoal pe m ifaeoaaaty.
9.TOM wdl deptb below turd tmrk m A) 24ss.For An WeRas Submit 96 tbtm:tvl*W 30 days of oempletim of well
r�,r mui�rte wrlri 1UtaAdepN>t y dQ t rexo,natc-sr�1o0 ac�1 Coaeaaa ou to the Now1w.
19.Bartlewtar la d blowtep of crams Z° ( ) Dlvltttost of Water Resmuch bform kdon ft=atdug Un%
Vwear L-W o abm woft we 14" 1617 Mdl Sevin GenterT_Rdef!A�NC"6994617
?+tb.XUAWAVUVA& 1a MM"to Naft the firm to fife edbu in Va.
13.WeII ems aramnd: l r t'p�a r ebov%also submit am ow of this than wttbb 30 dw of compWan of Watt
i��'•�Y,��dkcct path,��.r `— """"—' eottsttacsloo tattm fnllow�p:
M—WAFER SMMY WRM ONLY Dbftn of wow RMWfxs,Uitdat9=0 Ltietaiolt Control Ft%"M%
106 Md saw"Cm►t 4Il MARC 27"1606
XU Al
Mewl.Yttld taPmD Matltoa astpts v 6V� �,
atsaltlon to.ma;ng die�sas to
r !! the 4ddtWCG)'above. alto snhedt am clam of thin firm within 30 4m of.
""'°°''a - ;ID• __ ` _ .coarsgleiiau of web avttttrt CfM tothe cour'it r.7tealtil depnsttnent of rye c