GW1-2023-02097_Well Construction - GW1_20230307

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erntal rf.. ! Return) gig Uhler a odor#21[taroks] miter it,, t o . • i_.,, ••�' � slams awn%
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Camay Pareel Idemitleadiper No.(PIN),.
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8.For GeOProbeiBPT or Closed-Loop Geothermal Was havi d,o ' Side ttis an or addldMlaf K!p desalts:
oamin,ctlan,e►nt r I OW.I is i►3 mane
you mey usa tlK bock of Ibis page to provide ndd&iomU well alto detnilt or well
dditsd: Ndeeded rt�t u TOTAL NUMBER of wells cwlstneciftm details. You nay also altavb additional pigec if necessary.
9.treat it ltaMri9 AL IpiS dill("poNs
depth below land>s1117kea: e 5 _[1!1
P'armulyolkwaif&I .rt�..,-v-zA•-•,.m ta>c^J. ir�1Daj Wowing:
1f119!'Dlrb within days of c�oonp)elioa of well
1R t3latFe water level belatr top Ocular (0 D .. cDasiroctiwt totes olto►ffig;.
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a8.me"•� Division of Winer R�itlreth.lafDnaaMe►n Prgaepi����
ri.DDdeehareryatutcr: 1617 Mill Savvier Center,Raleigh.NC17499-1617
1Z WEfl (ra.) 24b.ltlrrialcction W1I4k In audition to sending the form to Ma
(ia. ��rtion methods cons aide submit llo wing .this!blot+�r11sa addlta�in?.�D
to
"U wa+y able,dirga push,e - CINFst[ItChma to the following Sys of maple/Ion of well
won WATER s1:t'YL•v WELLS ONLY:
(ri Water Reaaureea.Ihrdergmmnd Nation Como/Prog am,
IX Yield(gpad) 1686 Mail Smoke Caum•;Raid,.NC2769946M
•_. Method often: 24G For Water Sunnily @IeFaeft.n iw:ar.. ._ ,.,..--