Loading...
HomeMy WebLinkAboutGW1-2023-00532_Well Construction - GW1_20230104 - i . �VRML CONSTRIICITONIRECOBD ¢` NOT&c mlmaD of Fmvilmmm2 ad Netmal Resources-DivMcm of WsterQWRY WELL CONTRAcrmcSRnme-4TION#_ 7.WELL CONTRACt4 M d.TOP OF GASING IS_ F r Above Lsnd SutEaas w c�m �� :i1: SAI `Top afeaft av;a larmbt d allrtay balar Ialyd srcface maY ( ft eina=;ddMj6q'vv15AK=2C.01i8. -714 L, 4 �YfELD(gplO$_ IMiOD OF°LEST i r�il7�r wen Casaador Cbmpany Name Atom R-c.� 3TREETADmmssS` n'lctn rtt� I� 9. WATERZCUM(&%&)- _L d 4 iJ d ri g. j'I L a70�7 Faun V TO Fmm To M6rTown Slate zp Code tm:n Z To 1� FM -To YJ-7- Y�� RMR To Fom To AMR code-Phone number' 7 CASING: Depth D' 1hid IWe�Ia iklalal� ZINELLMCRMATION:- . - $iiE WE1l.m From c To—Ft. (o�g Sb�a r PJzs& VW-M CONSiRUGTION PERMR l,J r'De8 Ream To Ft OMiMASSOCIAT®PERMETopappUmbie) Fmm - To Ft 3-WELL USE 9%e&Appftabla Box)Mmft arep MwkjpagPubid 8' swur. GOP& i Mahniall nWMad IB afte On"-(BSiuw) pl„�e Fmm 8 To aO . FL- 16rT1aa /au�se DATE DRUM ✓b eZ(o - L ?i From-From To i FL e K 'MMCOMPLETED Z/ PO- Ppe 9.SCREEN: Depth Diameter Slotaw Malarial 4.WELL LOCATION: /� CITY-—M-d,S 9-. COUN Y/l,9z. am R To ur {rr. Fmm m To Fm To FL (5lreellimrtra,Nth,Oaror�q,Subd�sion,t.,otNn,PAoel2AOede) TOPOGRAPHIC/LAND SEMN(k 10-SANDl6RAdEL PACK 0 810pe 0 Valley 0 Flat)eRkIp 0 other Dep& Ske Mateaial Id1°'a 10 � FMM-TQ FL LATITUDE ° 0-a. : D/q) From To ft LONGITUDE�D�`/e ,�-(r, ` inadmPmaltittmat From To 1 FL I.atialdellOngimde cola+ �T,PS 0 Togaglaphie map 11.DRRJJMG LOG ( ofx�e8►nrrstbesGor�norrsUSGStapo;aapand From To FomrationDesmiptian - affedledtoWekmrindrrswgGPS) �' 0 - S • e� cQ C/e�� S.FAcnrnr_tamecm�armeb�m.nasem®,.e.swmrea. -g� 0� � - _ srP ra FACUMlDfQf NAME OF FACIUTY STREEPADDRESS I - CityorTown , Slate - 270cade CONTACTPERSON U r c«�.roc K Zu l..o l'ot S MARWGADDt2ESS •Z 7 7 ,Z ci u r� (2tyorToam Stair DO ILRENUMM IAC✓`caf� Area coda-Phone number GJ ar vit'/ 17`p ,04 z 6.WELLDETAB.S-. lo0M3Ir UwlFrTw► "Mw8LVlAS aNaxORDuecawr H a.TOTALDEPT� �D� 1SANDAC2C.WE LC0l rQtSTM�ItO&AEDTHATACWVCF MS, _ ! IPROVID®r�iHEW@!-OwrBtf "; , ta.DOES WELL REPLACE El SMM WELL? YESO NO 'a 7-Z r~WATERLeJM&I wTcpofCwWwn _FT. SfGNAlURE0FfflMUFlMVJE,3.LCXWMCTM DATE (US&-vffAba eTOpcfCasmg) PRIN EDAMEMPERMN(ONSIRUCIWG THE WaL 1 1 .SBlfY ( DjV{5l0110f W8 r Q(Gft WOit.38 dW& AWL- 60jt R1gL, Form+IAIIF-1b ugh,NC Z=9.161T Plwne No.(919)733-7016 wd 6GL ; FaM O i i i