GW1-2023-02056_Well Construction - GW1_20230303

Ifinati1ALh ifturLGleerifirsDernmaentnr'Isenaccmuntquoit,"Phisrmral�awitnbsarrew �IIr�J ��'d111R
•
Feb/619 06;43p °teaiweter Well Drilling •
828-622-7241 1 p.i
GL Qwcrn��,r310NizECo Gyy iy .......,,....
For Intemef Use Only:
3 1Contraetnr Information:
•
----.. 4_____j_LAWCIG2.25_______________
...,,nraaetNa
iirtii7r Nee
me
f1.
YG wine..n�nttn �-eati o,t lhrtdkr NM
vje
CempaaYTisma f c�1- ( �ii t u`!:-aimkt I^_5:L� r'F�mar
2..w.n cant 3o sr. L -----.
mudtGcfMa 1(�1:(1fG Stale Yaltmirc moil -� "vim"� t .. .:.
1111111111111111111111
S.Writ BSc(check well rise): • uJ i in'
i Agricultural •
•
10 C1Catlraaml(iimtinglCopll rich:al/Public 4A f? _7n1r i ccen oral Rin lDBSupply) dmHal Waleisupply(single) R fi. io.
Ir H•,.iondditlat Water Supply Wand)
Non-Water R '� aikramow. cigtmrraf itortamm
r)alp •, ;,,_ 1 n� 0 Q,�l'l C knk\ ct
- •a " ; Recovery u.Recovery
111' 'Niter Recharge ®CroundwalerBmrodislirm rt.
r Aquiftt StpraBa and Reaivrly �SaRnitY BarrierIR sANIUGRgvs[.MCC Of;.,...;,_)
i Aquircerest aStanm aterDrainage111 A. a. v.,i:?T lw ,r aU:�
Tfterimental Udall* Sul aidencc Control
2 Gcothe n al(Closed Loop) cru« �-
Al airatl Remarks) am �4CMI Mi ' �1
•': Doti.,Return) II Deer •,..,1 in tntder i121
-7 �1 , ` ft. L-,1"�LZ rnithstarisau.la+lwastil
4.'Rate Wdl(a)Compteted:1 Z- a1-2 cli uni1) Ilk r�
S e111D don: z I L �. r
1e9.i ,
F. ac1 t`6 �3 n (� it
tltamo Fsaltlyi D N(ifgrplicab(c} ti INI
! 1_0 ti -_ ._._
'eel ridteat,C .1adZip
R it Emu
Ir ; r L •
Cop).
•
81.sostuAtuts
PALM fdamiflcuhl04ge, :.`
Sb.l.tttoldeaadlon O ln;c•,,,• ,. r•4: _•�,-•..:,
(fi 1 ri,one egrees/mimnteratcaads ardecimal degrees:
Q on is tu+mmotuat)
r T r ,I r A2fe How
v Oat �_S 33 oWrecPOa _ 12-gyp -2
Za.Nags)the sedge rift-mum or 'e �4r ay &Qnu ttfweaotraator:.1s this a t�m1e
Id�lrlsa t+ghairttthuleldrtiagw � or Bps�Mrle$11Na.forn,1hoorlirautominOoswelI ►n a1v s) lttf>Ttelado oc000dhrce
"gyp RN to balm anmi w0 MG with 1.14 ACdC 02C.6000 or 15•4 NCAC 02CNiSOWrdiCe.so iRv1M►SYmdq
�eiranalr An avat .esalAst An back m a"d` wn the arum nlUie u+PJ'Alfkta frrnrrlhAcbdA?p7pfRdiedlA7he Mil mnlo rds rmrf alas
8.1%or GeopratwpPTar Glared- .Site diagram or additional wel/4essib:
mnafithelihnL onlg I GW.1 is IAt�p Geothermal Welt*having the rruae Yee may use 1he back of Ihia page Co provide additional well situ
drilled?
r0 •OTALNUMBERarvclls construeliondaeiis. Yon mnayalso eftachadditi�pages 1f detail`g' 1
9•Taliwendelta Mew land man: I-1.0 S
Faraarloptewe wigMld¢p/ht!Warm(P.t/1loOk 3�j�`� 100r1
(�f TAIe. For AR Welk: Submit this fbtm within 20 days of completion of wall
Ill.Sig*water ievel below top of easing: conalRictiDtl to Ike lblh)iT1Ag:.
/powerkw/isokracmino mn - /rt1 ... ._ __

VW*illOmv eta**Oftippide ODOM iliawswide tit=Oa•al*UO$ ij ,radii
144141419
14k4iyi
40tOk
1-3.6M-70"r""`leacktici
ff' -"Ala ‘----&---"CTS11/6418111*0
"t) -"4411111.atitft
‘.-----1-17-7771M-4414" PYAL
Wag Uoltsmmirj
7.227-1="771-1161""Wath41"1---- I -.7-7?---cau guava
' Oltr."- pirO:77\ 67641411,141
1.0111 afttititibtrj
vansfil qv voftwomig pailiaguit Pouraigall 000114141rigagsweln
—"--.":61:QOLaZ 11 /1441
9 _ r6
• . •
•,•••••••••••Z•••..•••••.•
•
•
•
•