GW1--04830_Well Construction - GW1_20230728

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feh 151905:43p OIeatwaterWell Pitting 82B-S22 7241 p.1
'ARM c_CINVIRUCTION RgiCORD(Gwzx t`ArtMtetmn)Um Snly:
1- 1CnntraetplrRt thinuwdion: eRe
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!t 1_ +.ecta 'w i .W*f zemtS
raosiata
WcftCantrmorWarner !!. fe.
?tC Wail CnT ' h .
ort eRaAt a ton
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2021— C0 n moza t .
2.Weu conatsaetttm remelt 1t= .,.. [e, ht.
i.Jsr all appikrOfe trtlfcrtnsr►uaflotJ pww#s(fu WC,Cmrigii,lYale,Varlraxa,�._ - •
Ih
3.1141E itse(cheek wen use)! it.
Water Supply Wag: .. . - 17 to • THAVIIM KAMM i muci ban MaTal tak.
, Agricukaral unlolpnVPubiio 1) [t. it
04anicna]
� (1leatiuWCantingSupply) esidendol Water Supply(Angle) '"-- fa.
tndoetttalICommeotal EIRetidemial Water Supply(Aaron) tooGrlf .
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AtaoIl�
rdRnifn
Nan-Walcr Sippty W ' ' L e^ TZ0 [' � � a
A4mtitoring R J mrory [t. fo
Anjeationcif: _ n. 1w
wife=Ueclttugr elaromdwatcr Rcmcdistirm i SA}tiill[iRA,VBL PA /1[ )
Agoifi�'stampa and Roomy SalinityBatrio amot tclt rTrternon
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AqulferTcst r3StormwaterDratulgo a.
1-.)(perimenral Teetniology
ubatdencaControl h-
Gcothermat(t:losedLoop) Di)cnccr 'HritnaLi To LQG1a1 '''' Q.:,'
oti `�Gamma!(tit:atini4/CaolinR Ream (anploia under it21 ttemurks) • j ttti `�(O te. ��.Yl r� �-' I'�' ____,
4.Dart:Wt11(a)Conapletad;l!1-iQ'23 Watt 1DY t®R` Z ZP[a Q-t u
r7a.vieU 1,nenth : Z02.0 i t c r S ,210 D 21 ' ;41 l I ..�._....Y
_ vifl L Ku _,-en i Mtn- ZA it Cp0--not
Y:teRillfOevnet Hama •
.� Vitality ii i(ifapplieA4tc) R' i - -.<'
115 AlLn R Ash Ile LC _ Os tt; . f•-
poy.icni Manes,City,and Op ., AAtt4
Ctuuty , Yatee Irdotrti1lationNa(p1Pt) JUIL 2 ���
Si.l.gtitudeRat$ran} tttdeiadcgraelbainttesfsetandsordsctthnidegree i3L.::� ,."74:.rr:'w :.t...., ?.Sl1ri
(goon ftcld,one Moen Atdttrtcnt) r a :a. a canon DY+`QI OG
6.M(ahe)the wdt(a) Permanent or �IT1e:t1i[ttfl'n1' stn�t or(lntitrat4feilCearCttatm ' ¢
Jki alprtfag rlrrc r4rrs,lbwrhpt #4ti,dm Or,tt O)na (lt'n?crostmctrad lit aceaMMwwr
7.is this a repair In do artitititig w In Dins or a bilk 13,E N AC ri2CRIDOorl5A YC.dC t►.7L'.III W IMidt°riMmcnm:Sim arrta end gun dr
ifMkIN repafrfllfarelFnnor,ma'.masuyuroatgAreamGw plain rb,.admire dhu 40/4)aflh/stet'a►dhasnleipto= Yltnthew°mwta.
retitle Ruler Atf tin amide kickoffbts farm. 1t,.Site atomism or adiltianalwelldeans:
8',For Gcopmbe(AP7'or Cltlt+¢d-itelnp Grathorntal Welts having ic'moo
1'ou n ai& c the back ai'>ink;t +to vidttadt Otte1 well atte+rmeitt rtr Well
ematntctian„enip i C3W 1 is heeded. (Wane TOTAL NUMBER orwclls cr>1f9ttvtlinn[iliRiiv. 1Fbterbay also 8ttAlChalhii(tottel pow iFtteCeaeRty.
dr='llsk,,...a ..., AtRwarrr-A't.liR 'a_tt[Z
".row wclt depth wow land wtrantect tiR 4 5- - (r.) WA, Inn'All W.019: Swam*this Than within an days of comet:don or wan
Far nrultlirkwNtelitaaUdepllrt'rfrtr orArr+eple-V20(eartlWel rnnsinictitmtot to following:
111.Sunk watarleval h&c,tap of saatag: <R.) DWillion of Water Reii urnsseinibrn of Processing UiiIla
!f',raturtrrcaf isaivrrecosact foci^4 161177Ma SCOW&ate"R eldgb.PfC31694-16in
11.Rorebolediamt tsar: l.(6 (In.) zilt).Parinicetio)t Walla: io addition to sendinglthe roan to tlttaMassa In 24n
12.Wall cnnttniegan metintt: rn 31.J'llA a a►nsitut`tiata ubmifolittwi Ism copy of this form within 30 gape ni cowman of welt
the(lo.mg,many.eft,direct mob,in*
uivFelanpfVlrltel'Rc10RttCed.Undtttlnad igjan:tion Comm)Petl�ranr,
Pt*WATER SEPlr!VcWEELLLS t)NLIt 7ft36 Mfdi9ervi�ewer,llln .IBC t:7ba9"t16 6
13R.Yield town) J `) Mala n ar test: j(� lief Wytcr_St►ttdY&101241111011,wen in uddRlan In sanding the Chem to
the address(es)above,also outtalk one copy of Ma goo wilidn 31)days of
1 b.IHainrccgtrn tS'P'� Ammo Division
of.vdt communion to the county he deponent of the tamtttY
_ wMre comttneted.
Non CW.1 *till Cuolinnn apnrtmantafinwteinnumt nqueity-Diviamnof Warr Rotuma Revraed2 22]Rib