GW1-2023-02358_Well Construction - GW1_20230331

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Feb 15 19 05:43p Clearwater Well Drilling 828-622-i241 .I • p,1
E C, t7CTIOfl RECOliO dGW 11t For Internal Um Only:
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1. ICnntrattor informallon:
S 1
1d,WA TONES 1
Well ContrsaorNama mao�t ern nolpurnow
VC Well CoeiragtuCRtlflWioa timberi [+• a.
' ISOMER CASING.flit waibIs31t Wu
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2.Well Caa$truclion remit d!: ZD U 3 4-3 , nwi to o,n. �•Q•,� }
+srdi oA+lieele teeltarmor velea
0 e IIIG Camay,Selo,Yarlase, elf.) ff. ; lb In.
3 Welt iFte(Cheek well use): n: io
Weh:rS■p Well: - 17. gn/
ASnatkurolof �IUftitiailiaUPoblic RO m ntestft trt maroon ^nl>clor= .i rem uttaL
n ft ft. lit.
Geothermal(19eatatglCoaling Supply) �ttial Water Supply(single) t. ft. lb.
Industrial/Commercial Residential Water Supply(shared) -
ifirais amber
hi ion
s.�Otlr
Nun-11 nter Supply Wall:
7 1L ,90 11:_ce(!t 1( A! yy�/r Iv Jilleeelleg. /i
Monitoring QRommy f r t�l ,l F v[
n1ecIion i: tr ft.
Ter Rechargeit.
©Grortedwatcr Remtdiatinn
arw tl6can0Rnctn�ly , )9,SAND/CRAYSLPACKdi ttla)
AqufferTctt EiS ry Barrier _num To ntA t• Z
g RIAAC ltstertaentoo
onmvaeerDrainagc n- tr.
Evnerimeinal Technology D5ukcidence Central lr. It
Geothermal(Closed Loop) Maw 21 DRILLiNG LOC keeh TO = ll rad
Geothermal(Ncatingrooling Return)JOlher(explain mkt#21 Remnsks) / x ft. /'n 2,R mar L.
nrn t us,.trJ 1
d i)atcWdl(a)Completed: z—�-Z3WelI IDS / cl�
(� - .�(0Z Orman--bc
Ss.Well Laebdab: tJuis I dens Z fJ iL 5,0ft•_ U-�-c
d of d Ise -* + SW• 5-05-f ra-n •
via:a t m..rm. . Feeilay Wit&a tplicable) n. it _ c
0 L 4aoch • A-I.-6)c L _ R N . ,, r a 2
p.oi�lAdd.,Cam,amtErp �UTAk 1023 A 1
• C:auy �• Parcel Ideoti1ication No.(Pill { 1'i i n: ._1 i�i 4 ;^rW '3 i�ii:
r+b.Latitude and lorlgilnde it d .kv ti a Qt:•.'4;>i.
Sb.l lieu.euts?argo 4Rnedmimtfeslsecotdsordecimaldegree� -
agiawildcat)
N Oda '3S ' cgs :2. ont
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.6.Nam)the wdt(s Pamaterftt or �fleralmrarr Siam of(atn'ical Welleaptie'm• safe
le nits a;eppirto enabling ay miming»W,fern,.I hetrhvtwt**ANIJic nr!(�i raj acarpla,ycyt in�oraGmre
7.rJlenit fill walk owca or igNo with l3,t:YC.IC:oVC.0IWorMJANC.ACVC.0209 eliCeer/mcttnrr&cedar&and�hm.r
ftMIrs oP r elabicce waft ratoonktformatkon awl explain the mewl?pPhc +AP1'oflhrarcrandlrcurbranPratiedln rite wellai'a�ask{scalon wait*bark affbarJarm.
8.For G 233.Site Annan or tddldoaat welttleadts:
�`oprooeMPT or Cluaed l,nnp Ge er Wells having the name You may use the back of this page to provide ad&ngal silo details or well
Imustr Q°.only I ow-1 in needed. Whine TOTAL NUMBER ofwclts construction details. You=yids°allaeb addltianal pass If lrncc aly.
frit veal do 9MI TAi BI TRI,CTI
9.To
(?tit below land ma'am 5 Submit this for
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horinfriplewensli ralldrprin ife#rant(h 3901pp•om1;0J�g i '? Z'In.for AV Milk Submit within 30 d of completion of well
rnnstiUCaM1 to the foitowelll0.3taaksty�•g:yN beim mpotcmting: ��
rWai�rtaraJlSthirIO tee''",^^~ ( ) Division ofWater Resources,lnfhtiuntlon Pry UM,Ii.Botrltatediettltdet; t t/ 1617119ai1 Servier Center,Wtd24NC27699-1617
(In.) -• - Mb.For ptection ethr. In addition to
12.Well eoriaVaedoo met? tf above,also submit one sanding the thou to rhom neatens of well
f l c.cumcopy of this ram within 30
""a"p' .dratputU,ac.) - - canal/idionmthefallotvinir , d> °f'completion Weal
Division ofWAter Resources,Undergroa a nd Nadi Cow pl
jOcjy • 1636 Maii3ervice Can er,Gado,NC 276994636 ogramp
MR WATER 81'PPLV WELLS ONLY:
13a.Yield(gptn) Method of test: ge`g f4c.For Water Su
poly&Tnfectian WNtk In addition to sanding the Rom to
13b,indurationtypc the address(0) above, oleo suborn One copy of Ibis form within 30 days of
.A Moab completion attrRe[u of the county
oftwell
construaioa to the comity healthty
whore deA
Form CW.1
North fkrolitmDapaumontofthwkiiitiM ialsty-DM:minorWaterRemotes
Re°iwed242 201A