HomeMy WebLinkAbout397280_Well Construction - GW1_20110829397280
RESIDENTIAL WELL CONSTRU VDON gr,,CQRD
North Carotins Deportment of Environment we) Newel Rwovroa- Olvblon of Wow. Quality
WELL. CONTRACTOR CERTIFICATION Ir 3001
it
1. womooiRRAOOTORr
Wr ems
t,uA (Leta
�Y
ur►a
Wei
Conbaofa
'Mt tiT ADDRESS 19614 Pe)I (21.
rnotigE
ClllraTban Jute
LLA
glp
N.p • F11pM number
i WILL �A'ORMATTONr
SIM MU. ID AToFFllooero)
DTA" W!u. Pr% TM1t oommar 1 _ .
Imo.OTHER P M(U appAoaON) 1 I— (ta
MUM (Cbodi Applicable Ooo)t RoolOontlal W Mor 6uppq D
OAT1 0110.uo 1-2 S ►I
TN1Ilcourmur 5'oo
L, WRL LOaAT10Nt
OTTY;Xlwr�..�„ COVNTY
TOPOORAMI D SETT1N0:
CM,' OVik d"M O MVP. p Othw
DWI rFFrR► rmberg
AMo Pet
LATITUDE 41• 5 ° QO lty DJ min tit, monde a
%.OwQ!TUD1.1 0" Lei. 301 to In o doohm) Ranh
lAtkodelonikodo Kam ti(OPS p Topoinphlc mop
• • _ollbnoforinwo(Ot ohown on • VS(73 repo mip Ind
ikhod OM, Ibrm ino! voty OPS)
4Witt OMN1I R
(MfergtowiLJ au_r,_pur.,.Avu .�
MItSTAMMER ZLIA
V1 To ZIp Ccd,3
o
NM M. Phan runts(
WILL DRAM
oc TOTAL tent s o6'
of 0011MLLREPLAOR pt1ETINO tlME UT YEO p N0 6+I
wATIRLIM'stow Top of Calm: ► 17 T.
Nw'•' M A1oro Top d Casina)
•
d. TOT, CtAPIO p i FT AAv. LRtd du M'
'Top d oI1Ir10 Nrntinli,d Mkr brl�vw lend 991111991M riqu"
orwllnooh000adalO w 15A NCAC 2C ,0110,
?O WHOP Of Ttt3T__,�_,
1, aa►NFscT10N; Typo S2` o Arrow,
v, WATOR EMS* (depth):
Fram To___,__
Frain Igo . To���
Frorr, Via To
1, QAaINO;
Ram 0 °Torh 3.1 Ft.
From Tv Ft•
From To Ft.
From 340 To
From, L/SC
From Tom_
TTdolotwN
WILL,rIC
1, OROVT: Depth Mortal
Fran 0 To 3 FI. M"
!tor�w ToFt.•,,,......,_..
1, IonaaN; Depth Dlomotor Et>! Otto
FromTo___--_ Ft. _..,.,..
From_. To Ft._„_,.In• h,
From To Ft.�_...rh. h,
/, IIAN0/ORAVEI PACK;
Depth
Ftvm To
atmo carat
FranT9
FranTu_„_ FR•,,.,....
10, ORIWN0t.00
From To
0 15
Jq j2
22 SoS
Motrobl
011M1bn thou 1
/ I I'•
crr, 'C L.
214.•
11, REMARKS: RECE
n ormatton vrocesstn
DO rlMIT t;torrO TWAT 1?W rau wow "'"-m TA001'1 l t
AICO�D FW HIM Nt o� t MM wei.Nta0" It. a
�� �i•
,+Icl{ z.
lubmItthe MOW to the Divtilon o1 Wow Quay within 30 day', Attn: Intorm;tron Mgt. font `i•
1htMIStrr Ic,C,nt r-R.t•IOhr P4C nagvte1T Pion•
No, (119)1JZ•1015 oast 000, RN,1A6