GW1--06173_Well Construction - GW1_20230922

!. tl I 6 ue•C jr 828.822,7249 p.'t.
Feb 16 19 05:43p Cj6rater Well Drilling
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•WE. L t► t:j 4• I ' � i.!lS_.t GW-I For Intemnl vt+e Ontyy jw" - •ram..-.,
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Well Contrraa`ont Warn — R, D. H
trtntc tittonN hde ' st . '` }} w.
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LisI al applfcatiteieall owincllaii,.r ,flS flit 1I1G,C000p',41a15 Vdrfirncv.cIa) a. ft. in. -
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3.Wen Noe(Methwell rise): .
WaterSupp(*Well: 12. y• :,. , MOO rani= WORM. t+uatie�efai.
X Agrieutmrel funlailaPubl c (}. A1: i. �'II anathema] eatiag/Conlieg uppiy) x�'�j�'ResidentialwaterSapptY(single) ..-.4. . u. in- i
X tadaatriel/Cotnmerafal aiiiidainiat Wave Supply(Mated) -� .
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X AQanitoiingg I:Remrvary it. re• j;
Inneetlon Well: - — - O. R
%'Aquifer Recline 1firoundastaRemediation >ZLPA�3 S�NAIaR�VV ... ------1
- giAquifi�r Storm and Rccnverp °SalinityBanles �9 ttolyaNsirernas
illi OquiferTen rIfitannwa fs.
taDrallutga 1
Ltperimental Tsdatntngy niSubsidenea Conn] a. ft. it ?
d1 Geothermal Closed Lao Ercnecr Z3.1�(iLOG = , t
X t3eWGtxmaE( •p) �'brh ax andorif121 iternarks � •.�`��•.':t�-�•, '": �'�'�'�!
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gm Well ft N ....i -1 --
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Calmly ince!idopditmtionNo.(PIN) I, tflt°D+*+ ``,iP! •r,- :Ig1ir.3'
ah.LhOtudn nod to Nde ladrgputact ntondsorflraltnnl degree= (v '1 1�tom+�
(n wpht ftalt,one ietgoohtin entifrtcnto • Xt.Cad tiara
Ito .5.gs (0SO - 5-a3
4.la(;re)the wal(s) Petrnant a dr �9rnrY Si am steer rd vfeltcnatraeter I DtKv
duu.rom.I h J.ymalht t7ai Our wdl{X}was Ow)PvitlArtillai in aCZIMance
:.L%f ilsarepairtoamexistingwalla Mlles or AND ti:ilit liAliatC 42C MOO orISANCACO2C Nile Well antratotan Sandal*and daa
ft."'"rePainflimithwiI,w41 nulioni k+r inaGodaProiaAu:umumelin a�Al'afttsfsrw'arrlhoar rptordetardovirlimos,.
n it t�ader fin macula=Ilan arm 0 badeilas fame. 23.,Sue ilillrain or*Maoist?will degas:
8.Far GaollrobelllPT or awed- p Gedbcrmal Wells having imams
Yen may um the bade.ottttfs Ma to pravtde mlttlt~oaal wait ailedmeEi,or well
gmwuct ttn,oniy I OW.!is . rndiaata TOTAL NUM66RRoSwells c+M9tatetinadetails. Wm wog also attach addlrioflatpagetftin4e.i 0!y
drilled-- -.. f il!<tVUTFATAINSTRUCTI
1h 'af5ltwell*Pe Mow badSP a Ei"r•D " (a) ma ikcAt_se, Suhmit gels Itch within 30 dcyc of comnplmion of yell
Par isulgakwelisHymndepths ff &amok-3&, lOraad':r' WI a strantinotothalbllowinv I,
111.Stade martial/el betax two acing: AC610:Y (it.) Divisional`Water Resourats;loibtnaatltae Proentoke Volt,
{f waterfowl 1snivnmcaring•ow-.��", 16171Nh1*lift Cesslif,ll8tlll$b►lYC27899-1619
IL.Borehuftd'Jtlmt txr. V (in.) 240.Fnrialsethip Well= Io addition to smirks the&MI la die adios 1R 24n
1Z.Wet]ennaeweHmmmatbod: a above,
of ret thefotiawing of this!Drat;within 30 days of compie3la►at'vralf
(i e.opga;,ran.siitlhe,diraetpatb,eta 1
U{t+ialon oPWater RtalNttClinUadtt�toandigfaefion Control Aeo&tmR.
int)R WATER$l;PPI.Y gt)N6Y: 1rt36iNaAServioeCentar,RlttrJglt.P►C2?®9.1Q&
Oa.Yield(RI>nel) Wontedto MRCV-et 2M.Par'Wp�ler Sanely&f{aleathar Welha In addition to sw ens the rw n tv
1 the adda ss(es)above,dso submit Otte copy of this time within 3A days or
t3A Disinfection tYR ,AleDtm>; aomplmion of W It comtsocuon to the comity health tat paAtaenl of tilt county
- where conamtaid. 1
h arm GW.1 • word enelienDapnanumtafiinvtrdnn u teniQnatitF-Divisionaf'Wettr'itorotums Reviee42 22.20ib
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