GW1--04892_Well Construction - GW1_20230728

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Feb15 1 9 05:43p Clammier Well Drilling•
828.622 72�41 p.1
-'WELL CpN FRUCTION RECORB(G fhr Intcmnt Una only"- .
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2.1V H Comltrpetlon Permit if: — �. fr h, 'n in.ilsialJ ny>jr!lmAfa trailrnutmtmlan pbrrrtlls(lu WO Caalr{},iSWlr,Yarlrtttcr,ete4 • I -1
3.Wen 1ttc(dwelt wen es*
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WaterSNppyrWcfl. -— — 77 0 - mown* IitOI 1 17t1Ct� 1N� *Al.
t: ! )aktual -Ran I e 1 onl.ipa!JPublta tt R. in,
ifQcatlternadgleatiugCGnitngSupply) r3RelidenttoiWater5appiy(aingic) ` --.R . it.
)r lndusttialiConm ratai DRcsidmitiatWaterSupp1'(sharat) &am - ' - : -
NI WI!mien zo �ten�sa►yxfaa�-�-n L atv,�xtcsaunw Aran-l2v
Nnn-Wnter&IPpt_Wle 1 n 20 �',ee t utll 11 10
••A4mritorhig QRettavary _ . tr. fa.
1nlet'ton Wed: �- n. 1t.
IiiI Aquifer Recline ClOronndwaterRem:Sadan f9S N11I!RAVBLPA 1 l t...;
iR •qui fa Stoop on4 Roomy °SalinityBatria m:•.• I• ,t nalrlocrogirrmeicon
a Aquifer Test 13smmnwaterDraipago IL S.
a Experimental Toelmology t3Subsidenea Control a. ft. .
+r LOG
III Gr Geothermal Mooed Loop) Crowe; _`.1,-,? -1. nir•Tr+&coma
MI(iconic met cello lltr Room) Outer explain under#21 ttcrnncic
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Physical Mateo;COL and ���� A L .
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c:a y � 1 ilicalydontifiodionNo.01114) _
Sb.Latitude nod WO*indegrersiodtnrtest.9econdsordecimal degree=
(ir well Odd,one tsNomjla udtielail) e r i adopt� S' S' 3 A N 2 1t Agg Lo-23- 2 3
4-Mere)thewdt(d) Permanent or Dr mporar� eta*reedited WeUCa.traamr 1 Data
�..,( I rhlk_lorata be ehrant4fj,taut bur.ndl4) riru i cootooterad4E acoordawr
.1sthisarepairtoAroant' logwcl8 �1Ycs or OlNo with'MA:CACn2C.410DurISANC.ACO2C.42110WaiCnratmaiw,Staftdarde in!dos a
'jthhdvorgMlr.ANo rlmnivnwllcaagrnctronb(k+,martanonrlupinIr1b.:mmnenTib.. OPP allies terordigQa+lenMi in Mewl(mater.
rramtr wide,btlrernatio=xlay Iran rin:kirk nfrhrafain 23.Site ollaysto of additional wettde411e:
S.I;or Gesprobe/IIPT Or aosatiltosp Geothermal?Mistiming me some
1'+m m�use the bock or Moss to provide additional wed Afoot/moth or well
txmsltucrimt,attip I OW 1 is needed iitdiese)TOTALNUMBERofwotts tasrlbtntctuttlttdails. You'blipttltOttilnehstbll 1 pages if accessary_
drilled. ...... - -. §0111417TALIIME'RLlQ1<ONS
a..itetstt wcii depth below loud milieu LA'qjS-- ( 4 no,gr Al 1Ve1G: Submit this Ann within days of cotnptaden or weed
For multiple weRxii.Nariddpacir b.nwl(example-3tP)O ow Maw) CanSITtaiDtllO the fo111Reing:
Id.Statki woberievel Wow top of es s1nl <tt.) ildvidoa utWatar Raow'ccso lidi matLi Procesiag Vidt,
Ifw ater:um!Isalvtve caring tee"• 'l(( 1617 Mall Sinks Center,lt*I r(C,z7d99-15t7
11.Bonebotedlamnitr: ! " l0 .Q".1 211.i rr(p1ectr4D Wed= fo addition to sanding the bon SOthe:Wong in 24o
roye,also submit ale copy edits rout within 3fl days of eomplentm or welt
is Nail coueenetlanmetliod: 1 aunttnetiotero the followinir
ti a.maw,too.cable,direct push,am)
. DIviaton orWtter Reat»utsel.Vadctrgitrttad i Wien Coned Peoltrata.
FOR WATER WELLS ONLY: 1636 MaliSercla Caner,'Netdlr NC2769M616
l3 .Yieid(gpm) 3 Method anew `q 23t;IV Water Surly�F 1(ui�on Wei: lit Addition to mom the Corm to
the oddrtrss(es)nbdvn,also su(mlt one copy of}Ms Rem w1i1i1n 31)days or
tab.tlt.tareett nl type,; ,Moue': completion of well cond.aefon to the county health ddbtatlment of the county
wham amntltaeted.
NonGW.t Nord,QaollmrDapnemontafawkinaumattQrmtitg-mime nt'tt/amt'Rormaxa. ! Retsia222]D16

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