GW1-2023-01129_Well Construction - GW1_20230126

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FerenrinpletaelloJtuaudgxlkrt(a�u(�p►e-3�•a�rdz JR) ZUt.iRe� Submit this fdmr;wilhilt 30 dtiys of miqftm of well
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11.BeattlNe ) y+b,Fo, 101aft MW io eddidmi to seud'mg the farm to the eddnm in 24a
12.Was casumelba method: above.also submit a copy of this ftn®t;within 30 dogs of caotpltd m of vtell
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FOR WA'f ER 8t1fIPLV WMLS ONLY: 1�6 MUt i lae Coat icr,Mlefsb,AiC 16 1tfY6
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n � !1n �n n ttltc addtrss(es).abotir, also enbmit one copy of this farm tpif k 30 d %of
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T Hereby cextfy that the above iced weIl was grouted in appfflMce its aocox+dOM a with
all CounLy W41 xvles, '
well sex: 0 — T
Construction:
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Total�pth: TYI�
Casing Type:
Casing Nptb:!
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