GW1--03643_Well Construction - GW1_20230526

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WELL CONSTRUCTION RIEC.ORP: — Per Isse:val Usc ONLY.
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Campo.Noe' -.1a%Waal CAS Mg Oillrill=i11103144111g64 i
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(Valor Stipp*Well; — ' - ' - ' --—'-•-' ' '-' ' -72 rz—--7,r-- thansurir.n - ostir uts --IngiCkte, a ---
0 Agrioulturs1 ":94'..•.--7.u,'`OA, li. ft o is.
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flOwnhern41(HolUr4/03oliete 3 ) "Irteatctortial'Pater lialc•iy(Laitaiit) ' r!. 1, .
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OlnilustriitliCoatviorytal tittesticicrititi Wit:ei Supfly(i.lwr-o) 1
alniaption _
Nons-Watar iteple-ar virki 4 0 I' "., P.Iti,,i-itic- • p a c-4.1.-:e3
0 monierirs oR.,..,..v.ry h. I
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Nadirs Wog: .........__.... it Cl.
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1 0Aquifrr Rocha"; 00toi.i.4•vatet Fo mad uooc. .D IA *viirACif is. • ".
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cacti flo Suirao ane.1/....vovcry . l Wry auri c: • -
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attp:oritc•o161 Ttelv.r.ogy ' 0 31. .tottco Con.rtui - - I -
- 36, rAc(Inacaiiiiiiissai.busti if malailir). .. •.. . • • ,. •
I ClOccrthertnal(Clasod l.nt.il • DT ravor • - PM* i-T3 MCILIPlIONLme.6.4....t,tons&tyros**lac ess.•
. 0 Otottrirrnal(IloatirgiCuuktmillettan, OUthr..r l,cp1 tin tsv.iss-if 21 it...marks) ft. ! ft.
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L'inissy Pus*::44..4,6....i...&s, TIM
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Rt.Lillitis411 404 1.4agihnt I.is degree tioustills/s4cordi or ilcciatiil&cut: ,/ • r..-NVCd6-km —.-------'
U.Corti orloss:
(iCsreiJilsrlst ass 40444 is sagcleas) i
‘ ° i SI gg.0 N -77 j V6 • / / 7 ,
a.LI(an)the trell(s). Pertainc•I or On vapors ry ./ . of C......111.41 .1 resonator . Onto
/ njinmx ik.,jars.,I!gently carat.!kw eke roan)Imo:vire)coftwerkstl IA apeo.14.0.4
: 10 134 11C4C or:.orou of IJA*NC OX: ONO Irait C•rahstdmi Sitioihrir...41 li.J•...
.111 nii i a repair .t sa esibriag well: CI V CS or k wt
o c.v.,eau moors,Iiu 14en pm:ward so 164 rvh
r,01,,,4 myerr./lb get!mow,&oil oawryclio.;ilioil•11.1r.let usu.waist,ilia no wry gl Ai
rrpah‘1•410 12 i maga,revaa.dP,pa Ma beak a,1.411...... 2).Slit diagrams or*Cahouet well dosolle:.
I.Number of vnlb coattnietal: / ' You:uay Vie the buck of this pope ad provide additional wol1 It'.dotaitt or wcii
construct.o.churls. I'M ray also attach seelltional pew it octistitry
fine;loan**voltam.er-apa-IPWIl Milk r well CM.?PIA 1.44 Prow[nazi...awe.you Cd.,
Tio.i.10.IMP. ' ill.)pgrf AL Ifficrtiirrtoma
t.Tut iirs11 illepli below load silence: ' /VC cro. Ita. rar All Yecifl: .5%.thenit th:t forni WitilUl IC ;130 vr cum ow.,.,f ..,...
I 00.4 kipi4.1#.4.11 nn ok,744,(f Offirsvat firrrelpl,!WOO'and 2QII)00) cor.tin::lion luau follcoivinv
I I.State voter lainl botriti top Of --- - - - . Division of Water Quality.ittforma lion rrvvesalas Loit,
-,.- 11,17 Mad Servica Couto',14641,NC 21fritiiiii
. ,• ,IL atookoil diavbaln: . i6 . , i is., -46. f iilsr fl yeIgit in addition to Icrdinvi'..hc km To the athicess un:41
•04,e A. I SU .10' 4 Gni.. of .is h. • V woo . days of t>torieton of wctl
12.Wail coattnicitaa ...._Co4.. . --/4:.. 1 ',* 1\ ,2_74.0 1"-
- --X----— C no nt, v .1w fo(lowtru
(i iv sown,ran.sibli,dir'm pod,t. )
imar of wii. ','...sitty. -'.egrr . :_fectiott Costrol Frogroot.
I FOR WAT WA!AMPLY WILL1L11 ONT -Y: ' 1634 Mad Servica CSIAYSI,Radigh,NC 2/ff1:Ifig
13s.Yield(gau) ‘...Y Mt,:,fti et us/.62 cL,v ',lc),,,,„..\ 2 44.Ex...tazdusa./..kliustisza...taia-bi octillion to tosclint CI*Ct.=co
the ackkaae(oa) above.,alto submit one sopy of Oil fors totthut 10 dtlyi 01
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[136 Dialsitteloa type:C...1"1 L 0 r i A.& ApHociit: / (3 ckmpiotion of well cOnNTIMIWI :0 gap wars),huh% dcpaibitent c•f'Ix to-iti?
*Iwo coclatriiciod.
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