GW1-2023-02848_Well Construction - GW1_20230418

11b>tti•w w tool AraiatJia N tatJtisb aorlis Per laves:Um ONLY.;
w •enatatrAaas 'tr 'M.• tm c �t`'j• .... .-.-_.... - .-�-______=
.___-2 76 Ala, Zp n4
•
Nt•Wetl ... b �' Ih, �d
Catrae.. 6.tiCut+w li.,atl.s " ( 1 7'J i' .
12
_ ✓...y.._IJ t L� LL_'1--. I +( : .?. ,Trwstan,arL 9t��lfCkt,st C_ I
Conway Man
I to.lsLYlti CAM r /
3.Wen CGasaettasye Torah r: — "7 �(' O " = : •O. c:i..�i j
&nun Takao*well�Te�MJ+Dr Mrrorr/f.e Co.er Y. -- •
A. A.
Snow./o•+.•nv,.try
3.Wall Use telatiitealira;• MalP. a 1=1 —__
• altraapvy WtU: - - • - - 17. Ma •K ... ._._ --__.t
•
OAFiaahao1 _ �„ ar+wrru OW'nu 71 = tdA'itwa�
OInJw4rwt+Co�w�j liap SAY) /Rnieleeitiel ci(atcr 9t'ut•1Y(,iontp) I h. h, 1 fa rJI+ 1
wtldenUtr 4' . ! 1 I
Cirri tan Wove'Supply(demo) ' -1
NN WoNr sttf+M well; ■:� �i►• R •'Ds."rr� ri.%77 .Ms.
Oldonism O ac�w7ry -- :- V.. •�Phyv�li- U.�f^�, -f
OAIuhrRatharjs •
• rt. ( - ti• _�
OOrow4'aater RDmadutrc+n t
OAitiGrSWradeasst lr..,rnty. V21:PA wa i � �
❑Agdfo•1'at USaliniry DaJricr ■:�..��I. a1�LL"lSiFimtwrv,.
Q, to 1
1 �:rlunawatn L)eoirySc
iDUiper:reedai Tule.riory OSt Substance('OritrUl ~ t►
1 O(kodtaratal(Gland la.,p) O'raca � '' tact aJiLliaatrlta it I -
OdtoihetrtW(Haatlrta/Ctw! -- aaausiciyi. . ' , I
.,..._ ! OUP(c, Ism tuvler 1121 itamarlu) h � A W+"'a••�uw+trw..�t+s�t e4' l
hue Wta!t)CLwp4Nd ! /-'0 h
- dew-tt 1 /a ��_
Se.Weil Imatesr: ,
U Si�,�fo
R k
1.
4. A• f INi ,-..- ,,r:'i reecWyMrnr Nwm YaH{fy 1De:trappi:r bte)
Ptytit.t Aden%cry,as Tjp_. .... .. q.0.!'(yQ. h A, 1
c.�y Mita:Wmwt.a.e..t+e(7'ay. _ - --1n,orr��.'�n ='r..c:;� ;:_fl , —�
i r1
y L•tr it
Sb•Lad.lad Laapitvdt i■deareedaiiauta✓aeeord$or ileiiaaal decrier: <
vent;INK not 1etMa4 is waist e) 23.Certi Elea:
3‘2 3o a 61 ` N 7
S.la(are)tM Mltit): [ff'ruaor•t or OnEsporary orCwi./ «t r:,.,e+ceor
7•Is fhif a repair e / efAaur r}r it's,.l&pay soya Aim Leo'Wry).rag:owl uwJ�rrd In.eunHON.r
ptr to as saisfiay well: Moe .r • WO ISA)K4C OT:.'.P/Pow 11AMC- C M OM rat w1 lb",a
',iAwe fillow!tier,,will ao'WJK 410,7 ariJn awd r.c.1c-au'ai/M1 4/tAi ..a/�eu+reard ON tvrn/DwwArlNMwl.;home.
!,raffia.Rile.rr M oft'A n.
23.Site diagraas or sddlfioaa!wail dainty: •
I.Number of*sib coautrueled; C You mayuse the book of this pope as provide additional welt site site deceits or e
A+`uNs orrone s we-w.rer s+r it. GN!T rJp4, c,ttaVt4 t.on UM,. Ytw ana�„r ►(r Jew,ca.cr..a...you war Y also men additional Nits if too glary
• !,Twill tree waw'r1AL JIY$'!Ir(Ttq(,fs
faawll plb Woo load svetem Q
P',s•rMrtirs.lyd'f'�+1/dUfrru(revgl.- + thj 3/a rye AU Welty: Submit th:e hunt witilw SG days a cunpletiJo of we.'
GV•OO•end2011a7) eautt::lionto the following
to.Slade wain level bola,,tap of min; -
r/ii•tff ur..1rJdow raring.tor-.-' --- i •
R1 1Jfria;o■of Wooer Quality.Information Trvcetgaa!.'air,
IL.Data►p4 disown: /' r 1617 Mad Iltrvic.Cootie,Raleigb,NC 37d1ft.1617
_.eb.I Lam Jt1)!: 'let addition to larding he nisi to the addru,N i<a
12.via toastracttws too._-.• (y, ,Q2 f ,site J. s to Al. r ewr. 0/ ... H. D o..ro .'
(i I.Doerr,ruary,!alit,d7•.l �Gt� sit K;. •o- • Co!oohs of completion of omit
pia►o )
pOR WAt!{Ii 1RtTrL Y WELLS O*fi:Y: _ treieir or w., .sub. ••_eye...• Jeatioc C'oatrel Program.
13a Yield /�
1636 Matt Service Costar,aawlplti NC 376i1 1►Ji
(®� "*dMe.:.od N use:62-al✓ <t/n wry tat.L;r PifOrlkli
41f1lutt�;.Wdlu, toa0lition to wadult the Cute to
13b Ditlaltttita07e:C L'(;I-�hP .adrtu(M) abort. also submit one copy of this lornt anthin 30 dayi o1
Antonin.: D Z .planet! of well construe/ion to the co ,
- wharf corstrucW• county hulsb depaiaia-nt c•, Isa many
t.r}+Ctn:a:Dqa n.•:•f: v
a uoat-•..•,,r,INd,wl aaea•rses
r.-
1"•
.
I