GW1--06431_Well Construction - GW1_20231009

•
•
4,1 ' 'f o;SJDiNrg1Al WELL CONSTALICTIOvjRECORe
;Nlik%tr� - ,-� t huetit Combat;Dolan/hint of Emironmunt MO 11411061 116606.1010•D.VIU n or Went Q a.tat
r�
�"' wE1.L CONTRACTOR CEIITIF1CAT$ON•a . a54 .,v
j i Wtu CONTRACTOR:, f. a$PI ICVION:iffiqvit ttr a n.,. Wiliam /
woo Cowan* 1 • WATIR t0111If t tt+i
armor(Ye01MOteaq Same
firl /OG,44t o q/
! •-7 COt+�r rootot Cony Tamilja-,;;ed4,1 C►em G A 110 /S',�' a►a„��TO ._
STREET ADDRESS _ c, j7"l i)H+�fda R. { CytNO• IPeCluvii+��
p t,$ K � ii/. 7 S `7 Prom -I'/ ��Z. Pt D�n��wl�r way_ +� ,r i
City M Town .,. Stow - `�'r pi. » -vw'� , �i r�
1 9 y'9-�• Ctalia •era Tp,....�r.#t...A..�� i
—�-�-- t
i Z.wSl.l 06PO IATION!Aloa too0 Mao number
T. GROUT: pt p(n • WIMPSITE WELL ID alit awnwrte, kw 0`To ►t�4Pni ar.:41 J.
I STATE WELL w••.'r/,•
3 1 I � 9 Film F► Tom /t.
rtAAlliTatA teO,o�; lm f Tp rt
pWOatOTtelR PERMIT�:T ,wowao+a) _._.� �._I.... ......�,�,�..�. .�..�,.,. 1
I YtaLt,tiff(CMpI yOlewet•Sol) Rwaa+tW(WSW SOP, Iretttt � Tw �ItN. in
MfgOIHLL1p %n' �� A Pam To.... Ft in In _•
{ TINS C01116STtO/16. ,,,,..2•. 3 AktaT OPM/
3 wed. .00BTICN • SnIW1Al1AWL 1"itCK:
Lao MOM •
From T
I CITY ' COaNTr .�k 1/4. i .,��• 0 it.
t G{ ' Frio TO�......v..Pt
•
i STNO:NMI.NWnMrO C11616106 ‘01161000 lwt 101
Tasoorutrrnc r LAND SETTING I
es+�a, pet+p its, CA' g. ot3ww to.Prom
LOG 1111
o �,1 RhRI To Formation 0lwetptlon
CI
ro� r oak LAT,luDE A1+�-L^ -
immoral bra in I •
t ! / t.ONGITN �- uo 4 fewhill IMYwt I ,� j `�'
Latttupeifor>;►tt+de source: �t3PS CT ia+ +etn� " '� '-L tiy) •.
14Ca1On d ttsN ewal br MOwn Oh a US Os kW MOO ono _ �'• • 1 —.-- � 'IA
Hheret 10 NW bon i nOt Oro ORS,
'1 i.welt.owNSOI
! _�OWNE1t'tr-NAME - - .O ;^":"', " a .5+r ? �:
1 DQIRE$S Gt L } o § A. t+«,'H,s f �' k, :...r
'Toga,'A
C' or Gille i . Sumo - Z0 Cala ,Su
G 3 6 ` ' ►sr-r::.� _ ,2 t I,,%.
I moo600a• fM1M mangoE3`,v.,'2S C.
t II. REMARKS. i ,
I $ will D. II AIL• � /
a. FATAL DtVfl+. /
Str DOS W Irrt•*1P.AGt t tiSTING WII. 2' alit C N '
c ttrATtlt Walt•ti0r Tao at t 10O wins~yrsr Two •
Nee A m 70 T Ct o C�,- FT . lM iIiC mot..CGwttw 7C.Clfata os na no. a 0:01r WwC!w•«
i TOO d CMmp) : IMC9AO eta reOi,iOOD?D 7M1 wtl4t •
r.M.•~;Or r pr n,p
tl TO►Of Qtt$INO M«„�,./�...;.RT hoofs iM1E',k+n�Di' f��b I /�
'Teo a qpn@ 1uMtItlyl Mt bow Itk10,awlarw net two,
•r'/�T f�a wunpt,to+eowrne.twre 18A NCJIc ZC.att ♦ Ir.
04,..i...4,;y
W� RTt�) VG•r::�:bNTAIt``Tt'3R �,,. `�a ..,•) .fQQ Y5TM00 Of TIi1 fy, dr a;{r h - /'., I rJ dot a.= --•
.
• I NAM Aid N Obi. i.iC 104 Tr :.
Submit the original to the Division of Water Quality within 30 ago. Attit.Inaonitaat fib)..
ill?Malt 1.rvlca Comas._1rte1a1p1.NC a7S9I..101 T ►haves too III%)923401 a oat ISO- I s Oidv•tt
no. l000
. i

.
•
•
•
F10�i11 Well Construction Permit For onco Use oay
Franklin County al h He Department • 'CDP F(e Number 391749
t� l 1071ndustnat❑nW4 - 1519 Number."VOI )f Louisburg NC.2.7549 • 928919- -. -
(J Uu'l 11t` Phan3. Tan Lola: •Tat Kook t:
•
Evaluated Fec .
•
PERN.Ir VALID UNTIL• 0670112028 .
Propeirr Oy.•nec DRAKE FARM INC . ' AppS:ant A5.IANDAAMATO -
Adi:ress. 8429%WITNESSORC CT MLess 485 RANSDEI L RD
nly. ILLIIGM Cai LCU159U1tG }
St,telLip Stalc?A't:C 1276t5
DC/27E49 •
Pouts a: 1'Mnn B: t
. t •
Property Location&Site Information
Mldrasdlcad4 Sian!Venn WALSTON Phase lit 5
•
• 43a 17Mt50ol1..NO 'Paap¢std use of Wort s
LOUISBU RG DC.2f549 IlOthen •
•
Apple.ant Email -
(Moe/I.mad .
Directions:43ortnNStiEtl 1t0
Well Contractor Information '
- 0n
Iha0u9 Conlratti�,e �•�ry S
�R L( Oilier RCgs,raeCn F/ Cj
•
Permit Conditions -
•Penna Condoans -
•
•
•
- eau urns...contusion Wd pdeY.r rust e:[M al uatnaolocatreyL,toi aM trot/toaupeo,'era ror e .eft7.a,aalocea
pa.lerto a at the LXrl na,U,eep✓Mp,l DCe 0,4 mryt,rev&,Oa14trylrvf,,ga1ye to Co,*v-O4ovison rt,WYXo,lhav+.)d
. aoYo.v]4,041tolo.teon aca;44l/I1e 14:iM6.`CYnMilb ronh pVs:tM No the Ivo.quu]sase-sdtc^,b..t`a'm,T e
ccr,.tfw.I.,.t.l!ry/M1.t.ani)f4ri.AA pfl+e-tkin tp,iv.,.nWae11epesM..4.edU41.e141.k..1kn Eery/mel'maned 1M
wit fart,,Cs!W41.*.teeeYcf:oJYre•Skyusewa'erreylutc,!ontMvttece It n intv7v1 a r61o.tJ ..
'Isstlt'd Oy: Oe,rJc4..be1 'Date 0113v o. r�'0Il2023 ,
ntnt»r12ed Sale A3att: Q I land Dunning Imp.on O,mnr3 .
Omudzed'nf. "Site Plan/Drawing attached.j '
Faso I tl2
• I' .
1 .
1
i
i
I
1
I 1 .
1