GW1-2022-09884_Well Construction - GW1_20221028

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rx!T1xMwt1an,only 1 C.zW 1 is needed. l'lidiggq T0TAl.NL1MBI;R nr-cells crosmzetron tirtaits. Vott may also nttreh additional pAgcs if Dd¢ess M
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9.Tnrat spat!dapNA An1aw rmid Rurlgces,r._�� (tttl ate. cr+r n WAh: Suhmk ticLa farm wiihin 30 dR%,a of comfrlrbon of~veil
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!1-i4sirchniediritaarcr: y' (in•} 2441 For Ifllerrion Wc11s: In addition to dxnding ttte totes 14 4 d
' ttltn40r abn suhmil one copy of this form t mhl 30 dayc of complte lon of well
1'7 Wet;coMmallnrs mnthnd: construRtion to the following;
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1 tise addresc(es) abova, o1.4n sWlmit one copy of this farm wllhin 30 hays Of
rib.Disinfeenan typo: - ---- Amotmh. completion of Nvr81 00DA trxlr?n to fhb-primly hoaith ckRaftnial of the camn4•
Where commmcted,
Irarnt C:w-1 14omt CnmllrmAapnnmenr of t?m it inmrnni Q+,alhy-0M.-m a of Wow Rnsmmes RwrneA?.22-2Rt 6
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