GW1--03424_Well Construction - GW1_20230518

Feb 151905:43p ClGalwaterWellDrilling 828.622 7244 P•i
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WE L CQS TRUCITON RECORD(GW 11 For internal Use Cob,:1. 11Crntrat r nibrmatic : — 1
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i4,WA ZONES t i
WellConaadatNaiar zo a r , u
rt: rt.
ytDLl?3 - A - • I- - • a. n.
t'eaiodor CediflaYlost Number
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Comp reyNoma itr ti. A la. 1 1 V
2•Well Codlalradlott Penult tit U V Pc Z) �4 ' V 16.INNER WM at O mcr It �retaln+tu� 1 Vfi wu..
GistaNgplrlicablaem llaa►rncibmp rmtts(La IJIC.CornYy;Sie1a Yalatlee.ere,) g, ' ft. ire.
3.Wdlllae(data well Use): ft. fr. 4n.
weterSupplyWc11: — '"tr.SCRs
�$tictllhiri�. !'t'`lW101 llC � � ► �' ormolu* _ TtatemV�8 I smrterrot.•
Qeattierate] •' Waldo! hasa SUPp1y(single) 1 a, {t, i - 1s .(13eatingfCoollag Supply)
htdustrialtcommeraial j •isktentMl Water Supply(shared) a gym, i
kiln:Won : hoar z raw. r rw,►t)wte� r, pAuotarr
Noe- SupplyWeb 1 "- D �- ni '1 ►t 2 . a
Matitorirtqq_� f Reenvery ft. ft.
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njecttanl' . : - -Ruth/tatn It.
Aquifer R
F3GrpuodwatcrRcaucdiatitm ,19 9ANIlKiFZtVBLPtiCK�(1[
gDife' and Recovery DSalinily Beale: _to loam TO tttl ta►8@ia n,- parr
AquifiaTc DSoarmwatcrDnlinag0 ` o'- ft.
Eitperitnratal Tealnlology rnmil ubsideneaC ft.
Gecthetaai(Closed Loop) Mauer , 0.1R1LLl ;1.11CItiittrd► Mal
Geatttetmal 11itatinriCooting Return) Oilier fetplein under 021 Retnarksl x ff. S a. klltMilsa►c:T ivr etaltt ttv act
4.Dare Veins)Completed: —\2 73Wel11Dd _ 5wbiz. *, ` U
rig,WeHLaeatlno: taAitior ~t1� S�� 2 i 1 t l.Jt..l n:r - -T, -
a' _�_ ��—�,.' Facility lit lif,;,pli�a�,ia) r. n. ft.
Dyainni Address,Chy,ond2%) rt R., {n Worm:x;i 1 'r :iµ `ram Ur,;f
' ra-s 1 v, ,Vu a .a^t. afARKSs__ l ;1 c5 ,a;
Consiy Poledtdontiileetian tan.(PIN) I _
Si Latitude and longitude in dtgrelr�tenlmltehlaecoedsordecimal degrees: I J
(OPaw11 field,ono tat�angismdliotent) , 3 lion:
ast t l 1ki N ma '- 1 n w 1 4 -7b - 23
6.Nam)the welt($) Ptxmeneat or Tee pr ry signer c of c iiI Tc4 Well Contractor i t>
By erRnmg WM Perm,J h t 'thet the mell(4 Mar Oren)cneanta Ile aces dietee
7.isUdsalepalrenatecad*Sagwell: Ma or Ptah,
o udrh11AtiC.icO2t'.AJ00arJSANC.ACa]C.BI9O Well Craven eeSim *aartthina
Mid g Iva mob: euthmwniwatrel:Ay dN+a b eutan ah,amnmoreofta op?'af1WM Word Aao7ieebptolddtdinMatfetlmvner.
tM.patrradar All rua*stabut wan*back oflhlBIon.
236 Site diagram or addltdonal ma&tolls: 1
8 Mir GeopratieMPT or Closed-Loop Geothermal wells(tuning the same Von may use(lie back of this page to provide additional wall Site death or well
censtmetim,00ly 1 GW-1 Is needed. India a TOTAL NUMBER nfwclls construction details. You may also attach add:done pages Iftweemery.
drilled:•_ �°—
5 t J - AgrpeU' FAA IN FRI:TIONS
Fo��u�bi Nadi t depth belownetsgrficc. ( ) Ms. ,orw8 W_elgo Submit thin form within 30 days of completion of hell
rX lade aramAlu-302G(rasdafamo7 construction tote allowing:-
in.
.Stad a water level below tap of easing; .• _ • . (it.) Division of Water Reeeurees,Ldbrmaton Processes Unit,
Utlntaptontlisahmmnaing,me " t Ib171M1Stuu aleeCenter,
Q- Reltdyh.dYC276�i617
11.FlOmaote1ti114etet; Q (ta') orb.For hlceNa Wetly !a t ioa to sending ding the COM ID We Addams In 24n
)Z Well IA1r6Ql�D above,aim submit one copy of this form Matta 3p days of a mpletlon of well
(i c,Anse;may.cable,fund Ind,aim) construction to the followttt�
• - (Division of Water Rernmrats.Underground lojeetton Central Program,
NM WATER AMPLY Wirt 3.�R GAILY: 1636 Mail Service Comer,Raid",NC 2769911636
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13a.Yield(gm) 11 Method of test: C lac Hnr_witer.dpnilr 4 Infection WebIU In lxldrVon to sanding(b Conn!o
i3b 1ltainfectlon fife addiros(cs) above,ease submit one copy of th[e form Within 30 days of
typo .Ammmi ��_� completion of well construction to the county health depatpeent of the county
- wlrera OOnt mieted
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Pone -1 North CamlitmDapodmoneorfnvhbnihontnl Quality.Division of Wear rtcearaees Rev(red2-22.2ot6