GW1--07204_Well Construction - GW1_20231108

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FROM.; `TO '41ATPIONI. hbrflACb'1 ENT•mril )n
• J;irlgttiki SfcRtgc arxt Reiovcn CSattnii�Batncr 43 : tt.:' 65 ft : Sand' #3
• C1 Aquifer Test' a lStonatwtirr Drains
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.3900:Electronics-Drive.:, ;Ralei h NC ••27604 . .. •4 r : ft-. CS. '
• •PlnsumiMdrosr.Orr and 2t ,
Wake..,. • • Bent onte.seal from-38'•43 . . .
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ib I iMude anti 1 rng tulle•til degIr .elm nutc.5. econdl er decimal dctirsi;.
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rxl air-40i6rb*2l.rrmar.F.i s rluro urvii iIi b.�t.L aiitMir foriik:: 23 $ite diagnRm or additional 11 dl deaall%`
You ti%p u.e 11 b icy of this j age to llrmitde addttionat rt�elt site details of lieli
8 'Isiiiitbel olsielIs cou.+rtiwned 1 coasti ictioitdotnt`is Y6itnias also:ttlach.atiditional pages ifoe.e5Sar
For tudrtpk 1n elllati et tOi t,*..'n pp! ells 0ivL rat rlw simr cortsfrurltwr,t ti iii�l r ..-11R►1 •
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. 244 F• or Alt.Wide; Submit this fonir vithtn Sit'ims of eom lefipn of will
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10 Statlesisitertaielbtlu tftpoft..tsing,' . . . ...•- (tkl OWl:Klonof'SVater nrC Rcytits,liiftlrmatonPn+icessing Unit `'.
1jiiiit linela-alrotcriistfii;•iii-+d: - 1611Misr SCniceCenter ltaiei;h NC.1769!11617
t1 Bnrchotedian etes:i0 (fin.) 246 Fpr Inlectinn Wdll •ONLY. In addition to sending the_fomi•to the adds .itr'
2 aatzaie alsti:submit a cops of_W1s foiitt within;�0 days`of eatilpIcaon of welt;:
12 :1VC1I eo tifr t1olt nzrthod HSA cctisiiiiCtiou t'i te'follotvi,i , } >> -
(i.e•anger`mta0'cable,.dtrict gall etc) ,'..:
DfsLkron of WVaterBetiourees,llhdergriiund Itijcrllon ControlPn gran,, ;
.PORT)VATFRSIJPPLYWELLS ONIX t63ei Malt Seriice Center 1 alcigb,\".C27t,99.=1636:.
•13a.. .. . .... ,4rcthOd of test:: 24 c.ForWiitcrgunPtr,&lnjeulon•Wells :
- • A,lao,sutbivl one. copy°.of tlis form i001:10:'�0 dabs of rouaplcitott of
. ., .cit aot>S6niotion to'zhc•'Ct1un lteaiih depaitinent at`thc.cotint$whei-
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