GW1-2023-02099_Well Construction - GW1_20230307

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Feb 15 19 OS:43p Clearwater Well Drilling 8287622 7241 ' p.1
FILL Cotr [I$TcTIUN RECO tfGVV! For Imam'Use .
OniTy:
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L,-Viii101RtlM rInformation:
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NES I
• Well Connadurliamo [ 1IV1! D
• t+teoq xn DECCO rttort
�31 �� O. j •
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VC Well Coetgp�CaN6cYinn Number
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'* 10,11 iJrl t i• I ix OOTEVASING 1f.. - „-,; ..ar�g1� ) araa��qq��pp��)
( rnr m Lte Ill ''r. eAMIAL
PeeY'Kane r t� + C �v
to fyjem rltilElt : ag �J-
2.d l Mwnrrllbs S 1 —12 Y l L iNAiER TO DLtdtTC[61t Tl1 S tieetkorr dew-instil i 11A1E1cpiAL t koble teelJ permits(t a t11G Corn*:Srar4 Yarkaoru er "' D. itt.
&Wei INC Peek well use):
n. et to.
WeRrSo0*T4Ile - "caw
❑AB r� MadaipaUPubltc =ohs- Ike nlAneer t stOTSW •sal awe —mantIen�,
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OleatiogfCooling Supply) CfResidential Water Supply(single) - tt. 0. lit.
Rhuindrial/Cotnineroini °Residential Water Supply(shared) 011T, '
t11Q(1- - , ;hum 70 rb7AR �, sanmaL'Idtmrs d rba& em
stti taF al:irrigation
( it Pp & efft ill M i kLA C
Moteitotite� ©RcsorS,
n%eci nn a --- a. trF
Tee °Groundwater&radiation a.. It.
AtyifiaSt�gC end Recovery °SalinhY t;errim LV11X.ps. PAc[C�itttgt irk) _
AquiflvTeSt °Sto m atetDrainage n a L --��" 'wP
Experimental Talmo)ttgy OSubside»co Control - ft, ft
Geothermal(Closnd Loop) ()Tract \ 2Q,pIIII LOG(Mlisa6
Grertlaamal(t{tali CooThi Return) fjOtber(ex flaln under 821 Ranerks) led if. 1 � to �.t .
a-Date Well(a) :2-3-2 7 Wall MYiK O R l IL ran,'r , c MJ/t
Sa.Well Lumina: es1 m 4Pk' AWGe
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Fid7h�Y([Di!( +4 i�Me)-}�/ h� tt:
WOW Address, .an• 0 - " • M 1 4 V Y R U 4-- :.- , _ ,•
Y i�, ram..... 1 n R. R I L..-r,":...�'I<,_._ W L..
Camay
IQ v • _2L R61MAR*W
Potosi Waatideation No.(PIN)
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so.Latitude n
(+7aet1 anaad�It�Itltdeiadegteetlmimttee/seaar:dsordedaialacgrec� t - -.,,;� :: F.;, r..-;
�22 t tetI angios l' n :i+':;.'3 f .i..
t.� S Fi l' it 22.Cerfifilm rCV .,.3uii
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h.,a[ate,tberreu �- �-- ' /l- Id -(I)''(8 �'IaaBatlf or �Ts°'l�r?' sleet of Certified WellCar6aotor
7.is Ms a repair as`cm �+q By at a.a,dts rm I!writs,cmttjy Mat tAr Dam ---�
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I s Msa►►pain oe n=henT roth n t'7frxy its orlongiNo with .tf:hr.tr:021:_WOO orPM NCAC.07C W eaatoir rdrand
nfyinatdetAzj Neale oreodrebarkO OW*foa9. again ttPpofU:tr rrxrlko�K protKdfadlntha wrllmwtrr thin ir
23-Sits diagram or additionalwail dentlim
8-Varrcti pro��PT ar Oast d LA aD Geothermal Wells having the as tic 1'ou mal•use the back refills paple to luaVido ad
drilled• only 1 GW.I Is feud, 1Iid a(o TOTAL NUMBER ddwells c nis ructioon derails. Yoit dlii a aeU ces delsiit ea well
•-- __ may also Mitch adiflUatrat pages ii'ntltx�aty.
9 bops well de - • RUQMPJTA .1 aTRt(f-ttnae
e+'+h4 wetletmaGdenravir a�,- v� or.Miriam
1 .-..,n walk: a m n mis Aura ntp o 30 days of
1Q Etude wester level (f T7� construction to the fa(lot conviction of wrest
Ube bgus boyorcn taxing: lQV • '
rrmlrr lore!Is water
l a el b use" a t (R) Division of Worse R-
1617Ma8Scrvicee Information Prmovsest IIRtf,
11_Booeholeddaeahr, Rakish.
(In.) 2illr Por iatcctiaA wens: To addition Lp spading i2.Wad constriction towboat 'r � above,also submit one the than to ttte odious in?An
(i a m a c,rotary. copy Ewen whisk 30 clays of eOrDpIaHD1!of 4vdl
s tatsk,etc.) cnnstma ion to the fallntrittg
POR WATER SEMI/WELLS°NM il<iVb1D11 a11Va(!i RlEo1ll'lB.l(i1dC
1036iNallSmokeCenser aDdiq�C27 9.me 1636
IX Yield lupin)��_ 11?ethttd of tasD � �!�"�'•1YC 276�➢-tbi6�®,
241oNnr VMiter Swink&Woman W In addition to sondiog ibe Ann to
13b.0►oinfCctiOq(Y� the oddrasc(es) above, also Sett*ono copy
A mob completion of well construction to tha'eolegy pedal deparpttcnt op the ty
allure consQDct a.
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North CoolimmnerutmentoftinviNeineernl Quality
QtcU 1)ivisrnanPWatq Retanreac
^•---- ! �"aeda12120lb
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