_Well Construction - GW1_20230327 (3)

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23,.Site diagram.or additional dtdonde:
8.For o eopro ly I GW t Mc p Geothermal Wells baring the sumo 1'eu may use the bock of this page to provide*dame;anti As detail or well
mu GYMneeded. redieato TOTAL NUMBBERofwcirs Cochinddeils. Yeftmapake/Mach additional Pages ifnoce of
9.Atm wwl detail MOW lams sulfites" l J PhrarlNpfc wens tip eserlrtAvtf ►enl(wt� 360jo(!`eud29JO0h II)
2i1a liar Alt Weib: Sri this form within 30 days of cumgieUom of well W.Stalin cnnattwclitm tame fditxxtog:.water level a+'el below top of ashes
Iii)Stgt710 k 7t rQv,rr el Be toe •�f (1t) Division of Water Retiaurees,Information
Proceeriao i i.AonebMe dltitaeQer. 1617 MR Service Center,Retelgb.NC17 9-161-1617 toes.
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l2,Well curet ?Ab For Irdecridyr Webs: to addition to sanding the foom to die add=in 7An
•(t o.au method: above,ebto submit one copy of lib form Wain 30 days of compietion of well
•1Dl1y path,etas - construction to the following:
FOR WATER WPM
UrEi J q ONLY: n
• Division of Water Rramirattf,Uadergroand igjeettoa Cairo)PrograQ
n _� :t� insiu s� ,� ,�iceCcr, .rrtal,.tvC27sao.r '
130.Yield(apes}, 1 } of tear ? lrnr Water Sutra&A(j,rjcery Win RN In edamto sanding Ibe ilium to
13b.Dtsi Mc addritsKes) above,also submit.oac copy of this form widths 30 of
lifci sj Antonin: of well construction to the county health deennor nt of the unty
Mare eatetdrtcted.
r° i _L Nordl[�ml ins l)apnnmontoflimisiiiithhi�atalguaSl' laivistmtoPWawrResoufce Reviee/2-22-I016

Well MOW SolIfArimot C.,iMcrlion
anuAkeo a
New Welk,
Pem aav
Ihereby t the above referenced well was grouted in appearance in aoandaltce with
ail G unyWWll
Well Diem ex
Construction: try
Total Depth; 4915-
pve Thidnest 4.1[
Casing Depth: iO D 40
Nemo= 1! .