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HomeMy WebLinkAboutGW1--06952_Well Construction - GW1_20231027 3ygioL CQjTSTRuCTLQN_REC RD - (t�w Lra'oa:UK ONLY. ' Mai Mai ma touted kr alp n,sultislewelis . — J 1.Well Castr.rt:r',afars;Veer., _.. ......._ _... ..._...� — 3 e rri r3G LZ � • .. 1r . 1 . i -- Nei t;ee+ovor Wu.. A. la! --___-i 7‘ �ta� NC Will Coto.dr•ty.tit eolko,N,cw&.r r.pi)'.Vsp.r!ai ,i. t -e.; S • d' ii9l i i ---i Li e3 r 1.._6 L 7 Li -•, a UA 2/ v -;— t.., f,p �.. V 06 ee,,a,.t. _ 2.Will Gt►atr>Heb.Troll d: � O tt. ,n.. � , 1...1lr�Nnrli...O wgrrenovrprewar Ilse Coma".Show./�...wv.Ir.) — - . ---• 3.Will ltw 43r,ti,41 a,,.; • 17.1C3U�Y _ ___. t.rkpplyWw, — --- •..-._.....-...�, p:--•.1 auguries ► .w►Uzi �L7�11 MMA'Irus._fJ ,rWi GAgtiwfafraJ i. -Rj! a l •v.•t.1d:• s 1 C?O.olh.tm&(HeUr.j Cling SWD)y) ,Rssr4orcd 4!atc•9uuply(+u,�o) 't ... h, I k 0)rldw4ltUCwuwceaJ JttetbcnUuN'ale'Su I shasea I ._L•r• DFy( ) '1lINi• , ■:LNI•1r!! l!�=•:)-.r.:.n:�l •. ....1. • 0lrreash n i •v k .r77_0 +R; LpA71-04- p'U-cLt;;(.0 01.onhm OReeuvery II --j 1 DAluiferRarharfs OOcou:d•wter Rem.duticet vat;MCYSIN. its.3: + -Ti_► tt+u ..stssmrroai OAotiOn Stomp tu:R.N.:wry U9aliairy Barrier h. if! OAgWfa1'ea i r.';etwafnwetertheinegc •It A, DUxp.r:R.nld Tee v.riogy 0SOW-tenet Cottuoi I 3t, • LOG date adilineetiltwa} trwdrY if , • • •• • I OCkotlarm.l(C1a i od L .p Wad) °Tracer TO ! �b�3l�fifiatra.. wawww w•• +tr .v.i.rlif.nf.' 00eotherfnal(Healln4CuullrestDatum) VOUQec Le►plant to.lrr'i21 Remarks) h I. I" — t�R I ile 1 4.lute Weal,)(7e.mpl.e.d:q>69 oc W-ll!pip ____. S .Will!Deaths: `-44 ¢ '/� �k.. C-/I a`, 7 Z60 iii" t� r"a 17 ,76 a.ciltylOwmar mum fe Finlay roc:trwevww%It) _ rA. ,Ar T /Je—r • ,z; /0 Or,. ,�'L..t'4.e:14-.. R I ,fit. fa�t��:vs Q.,..i a' ...•a..•.r' .I phyf.1.tdw.f.City,,seed Zipi T--""`e ,.0 _'_..__-' .OCT 2. i .Z0Z3 ' Cram, Pares::J.u4G...i..14 (TAB. Sb.Lalited,and Lassitude is ele3rec.I.uastewweoads or(kaoline'doara,: t.. : • '^^ (it r.UOKooeI.tMHiseulCtiw) 12.(.rt/ atloo: j / :�i f' 2 4) �� / CeV,N °•. /3 57/' w .� / C `t-/q-..2 3 '.Z ofG.ug+d �)tranftatror Duo 6.Isaw(an)the u(Q erateaw.l or C•:f,Opor.ry /: I!G .lyres,,L•.*ea,1 A ee!(y awn*!Arc W roils%)vat fosse)committal a.ewNoms *O.1S411C4C or:.0f00w I3A,o:4:ON:O1te0 rat C.rolnat.eSksoJerbwJw:.•e 7.Is this a repair I.as*sitting well: CI Yes er 0No rm..of.0'eiosl..,Mtn j►M/IrI A•1W we;oars,. 10*)1'1 i NW..All old 1l1own well 0OW,.wlia.r Afiorywasim a ra cydote ilk.CVA Qf LA. 1 ' nrri..writ.,lI r.warL rnr.v.r so saw Mei wr.nu"..,. 2).Sli,diagram or additional well d.l.lia: You may use the Muir of this peep i provide additional wall site details or wcll I.Nvtaba of wilb eoeutre.eted: C cxevtrct.0w details You may also attach additional papa If tK:awy Ow aalutrle ayrc,17l iv.wa . 0 a . a, v-4..d1,ON3T,rill,Ste erwc c.�aa.vraw..you dr, i ,.�.v..fr,..,, ipPgY4AL INIITli(TION3 • • f.Tell well depth below load.a,ssc.: e 6 lfl f 3Na. p.r AU "tcU1: "Submit tt.:s tiwm witititl 1C days y1 cw tpl.ti.xr it wc.' For nwtrri.rgHr art ell f.Me((/(f a sI(rn•cyl.•4200•owl 4111100') C.f it t..lion le the following i • Odra! 10.Slat.e wits,levelWtupofcain: 30 _ if() DrrieoserWstrr Quality.information PruceaetadVolt, 1f...w,k..li,alas rarely vac-•.- —"" 1617 M.el Venice Costae,)3aIMgb.MC 21d14.1411 it.11otshale dIsorea.r: -r... in.) -.cb.jai Loki' ,i_lke il: In.ddiuon to sending the•o•m to lhs addfsss v':aa ,� 4- 4-WC a. I It/ .al' a loci., of ..i yr, i v uses .' days of completwn of wen 12.Welltosurottia.ass._.._.• _j j S^ .. 7,�/ jet!�-— c 'It ,et, •r Afoelowtne (i e.sots.retry.antis.diet pail e• ) trvuk of W.. I ' .aftsy, .4v0... ieetio.CoabN lrognw, I FOR WAWA 3)U?PLY WLLLQ ONLY: 6341 iacM ii1N.rv .Cutter,Raleigh,NC 37491.163 13a Yield(anti a. M..:,.d al ells oW Y(Q W h 24.c For Weivr St1aie t dr leucetiof.Welly: he ad.ition to module the rum to W tidttaas(..) shot.. 430 submit wee copy of chit form vnthin X days o1 . 13S Disisktti.a type:C 4 L t1 r e h P amount 8 6 )z toirrpletiott of well ionalwctiun to w Gooney health depaisnclt c f'he:C%1tl *two cotutruc d. eVt.! ►r1,Cw:r.:Drra n'r,:•f:awone.•..•.w.l N 0.w1 a..n.a..• r: '' . . -