GW1-2023-01136_Well Construction - GW1_20230126

Feb 1619 06:43p C(eatwater Welf Drtliing
828.622-7241 ' P.1
M I •q.�.V.t..
WE L 'Q gm--02 RECm M 11 For Internal Use On �
t• Gmtrse lnftta7,tatton: f
WRIr;,ZW
Namt 1 goat ern n
-A tR IL !
tr. 0.
ISOMER CASING
c wrl l cnttt>e,a ce<:isttt�,t t
2.wcdl corrtrnettan rerm[t g: MROW c170t e
rlstafla�tlia�&upym„nenpan�►r(�r711ccoa>ylssrorisvm�m+r��,r r..
3.1rYbl lGe(etaedt tvdl ane):
tVaMrS.pp(X Wes,
Ajrk' �,,,...,....LLLLNtuniaipaUPuhiic 0 c Ton �.
0ootritx W(gcmwcootbrgsww asidentfatwatersupply(single) n: fw re.
tnduts"Conuaercia! Reskmisi W.%tr 3nppler(shmd)
let anon 9910Mz
Ivan-v►nterS�IpptpudL ` ir. A. `' •
onitorirtg Rtxoroary ca. - t!.
fa'iterhat�c �prormdweksltcmcdiatian ft. &
qutfcr•Storage and RCcnvcty OsaunityBaf 1 .3AE AYSLPAl7(
AquffaTat Q$=myaw Dtayrow IL p.
EXParimenta)Ted=lgw �Sultsidatce Control !t. tr.
Geotitemml(Closed Lap) �7txsa ppl LOG(Numb dak
GetNhetmal Ii ReamaT Other andct#21 Banana) tzac►x 'no
u. 1 a s 'Kt
a.mate Wdgt)C"Pmw.- well uw
_ Sm.Wei ILaa mm. _ 7©1L r IL
I/1' i ���GLII �iUU (son � s'o � .6�,u�.:...�V E LT
racitt�s%'(Ix�xtlame . Fiea�yttlMt(ifapp�leable) n, rr. ;.
0(�V m �-
RlttC POPE WA
Phmd idaati$cntion No.(PIN}
5b.LVNtude and 109*Mde in degmuladmitellsecerdsordedmi dcgrec
ttt'Natl rfeLt,ene retAangttantttaterq •
6. _ �� - I-L-7
1t{are)t6etrell(tfttrrraneua or �7emperae�r sigrtnf r ' laratwetlCoatrtw. '��
7•IN INS a r"zjj•l0✓a4 C� B,u sf/flJlag tkAP,fa+Am 1 AM�rhYf�r/fy Mat!At wd1(I�iMl(N�R�pJ�If�/1aCA�lb agOb/dgtce
1j'ddriea tagttdt: Dyes or•�1% puiU1Z14�.Ca21:.Q/WfffMA.1K.dC•07C..i170D3PeNCoeeslmetenSYm�oh�amfdrarrr
n A 1 A1J aurknnwn wall aaaverxtmal�o.mrntoa4nu7 Tcdn At rttunrr o1 ma u+PY oJlkle trrdrl AaFbAeDPto►yd�rllnrhstvrll onttu
tworttln:onceajthtafane. i
&t?rC 7�Sits+�ts�toradalltlattalyaegdttttdls:
4 ewrak yr or t.Used tmjp C-,M mi Wm having the.We full Ines use die back of ibis page id ptevide additional ttrn0 Site deWh ttr ttYil
dn7letl�ctten.only t GW.t is ateded.t'tl QVA TOTAL MEMBER orwclls lion details.You tnaYAM Mich addlttotrat--- paean ift►tteresarl►,
. ,� 511[7t►d17?wti tti'S7'reve-ti.� '�
3'agtvrcll depfA Ifalow artdllitdltco: L�'�� � �'
Fnrirrli�lcxrBeltaMlegYA,ifaM,.q Ah=$rj m1dsQ�1QDg ,) 1dr wN wdb: 9lbtlfit tAis tbtm within 30 days of cvatplivloa of welt
IO.Stalk w�level bdorr �� rnnafitclion to the fo!!a► ,
lfxnrrrlarellai�rira �' (�) Dfvitinnot'Vhitee•t;,`�"8"`e�' /� etatu'eesr.laiitrtnotbn Ptoeratsisy U
t1.ltotebotedttttatetpt; �� 1617 Mal ft"keCgRtcr t kNC2T6W-t617 tt[t,
'1Z Won eD71 pp . 1 L'i(fL+�/ 1Af►.Fne 1■iecHow►Yttte= tit adtflti I to�tdin8 tGC fODOt(4/60 addtoss fn?An
V a mw.�able,qir shove,else admit one oopyoP this form whWn 30 days of eg10etiM of wt11
twt6.etc l anstntc an to the falkwbg
EDkismc#m
'Pt�t v WZLG9 ONLY: // )kbloaa of Water tdtatturoes.Unt)ergroYad Iq(txtler,Caatrol t*regnm
�/o iG36Melt8eroiceCcarn;lptteFai.MCZ7TGi6
method 01 t C•f 7�tc wirer Snpply Yc i(iiaatten'6VK�- LI additlmt to the fists to
$'1C the addnss(es) AbGve� also subotit ottc icepy of ft foam v�itidra 30 hays of
—_- C mpletimt of tvdl raosflM&A fD the comity froattlt Of Ule May
wwa centmeted
berm GW.I
North(SmlfmlDapnnmynD 4FlSnvlri}itt�tnl�wlity.Divisrnn oP Water Resouteet