GW1--07276_Well Construction - GW1_20231109

lab 161905;43p Olestwater Wall Wiling828-822,7241 P•3 ,..
L ON.mUCUON RECORD{GW� T arTnCcmnt Use nty:
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i.Well Cno torinttotm i1 : .
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NC el1Cont►eetraCettillerdonNumber hi., itoe wind unlit bio
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2.Wen ema taltesPettnnfit 1lf --.. EL to ai.
Well applied*rwlleeerrttr eole leer la.ma ono male,Varrana d r - _
&Wen Hie(elreeit will t , . I
Watet'SapplyWcgs - '"-�jcer ej►Athentt ae nrai ,imbee 1ttliaitrAi.
11/*ladled tmiaipel/Pubilc B ft. , b. I
*Ooatlurmml(blentiugt{oollogSupply) taidan al Wow Supply(singte) - --- it. in.
91 indusidal/Cumtnand f Regidcmfat Wa to Supply(sinuot) wok . - - ,ht��'• �.�C
itti; iou
Noll-Wilier Sapply elia-" -. 3 n" 7i ' -en- '' PIO, ill " "
*Monitoring QResovluy► - 0.. EL
infection WO: a, R L
a • ,nifaitoebtuge DorormdwatcrRcmcdiatitw iti SANWIWYMUI
ilAcinirer&onoSrutRecovery nSnrmityBntr* awe c awn
a ttqutfer Test
ClStt9tmwster Did IMP d' n' -_
Experiment t letlnn1003? rinubsidenca Control it. ft.
I Geothermal(Closed Loop) D'Iltee r �3 4001 •
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II CenlUamat oat�,' ..1i t;Man 91 Other . , ander1121 Remnsics et i „0 --six
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`+ . el Location: \c70� 7 �� -
t'acBiiJv.'[3 rJmne . tunny c♦rye IL [6 ` �� ' �— r ,
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cal Addretaz,C IlideOlia,A_____. 01 tr.
ik. O. i I n�J v- a 9 2- 23
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Six Latitude nail fonpitttlieirtdcgcaeclma oondsardactoini degree.% M---s.
6r wilt fold,MO tatRengiamdria ) i tO t k2.Cartttiestton•
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dial Oenittrd Welt Otatmetcr I Data
b.ta(tlee)the wdt(a)0Pamnntat or aria rY
Zty galas fano!ha rhye ar/'attar a&c ud; 004 eonnntarod fit aeoondrw'
%la this a repine aucsisting weth Olio or RIM wok I, SA1aCAC 02C-0100orISA Ar.AC 67Cd1XJD iY GontlnfaiwrSral+dkrdrn vt ihm a
"��j rnnyoflhirreenntharAMPrx dlomeiwltnearer
lffhhYr�ropp►rfi(lwetlhMl�wdP+'az+Irt+WAn amr eapdarn�aaiargl'ih+* i
am*nttderb21 trrmndaNur/attt area*hnrfio lbtafamt. 13-131msikol or atttattdmrti e1Id*Wu
li.lrnsGrapmhe/Ata!'t►;<(allFed-$,tinpt�totntmrnatWdhtblwingetcsntnc Yooma]'u9utmbackorihis) toPfoYldoadt nNtvansheainolkeawen
also attach addlti i
sxmtlntctitayottly I OW-1 is needed. (odium TOTAL NUMBER orwatls Colt&UUctiGll details. YOU laity muff necessary.
eriva+.--,� Li it
�tJ�il�'t'4 �3 �
9C'!`atal m9Nt depth bele>,rlund aMelfeces 5 (E) ,for Ali WAL*: &dint this Alm wrlhin 3A days of comrledoa of ocit
Mu.mut**wMskialldepdiryffeastrenuapti-4120FonclMIMI gmytractionto the fallowals:
10.Node NatortmlWow top atamlig:_ 40 (ft) Dtvidoa ofWslenr Rom.nt>ibt a an Yt ocelsislg Utdt,
tfxnterttarl trathocacaaing.toe"." t C 1617 hid Slat ea Coats.'b Betel NCa<1699./617
It.Borehole "6 ' o (to.) 2ets for jalecfclt yfeilea To addition I to sending the loan to die Waists 1n 24o
dot ail choyo,oho anbmit one copyedit/1 lit; Mehl day al eompled<me of wail
12 Well awtlraCNMlriCtied:. ar tnaiontothefollowint Ilio,awge�,On*atlba,dttvapotb,em.) Como)
ilivtsiat01636i1UtRService+LarOl;11 �27 1Qb tEQt.
maRw�►�t��vw�isorr�,v: o`,
13a.V1tld(ttpm) iD lifelltaa Raga �", 2 tbrWater 6ugatr&1(it01t9I!Wetp: to ,,,(, tnsondOugO*tWntfi
the nddromtes) thovo also submit ono;copy of this then width 30 trays of
t3b.Otsinrecrton tom - ,Amman completion of well comnncilon to the county ho,,, dentinal of the:county
somas commacmd.
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Pam Ow-t wordiaeoHanmapratountoil:minimu m,Oolltr-DivilianitWela114lonreall i 1 Itavrsed222.2Dfl

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Wel Maw l
£/4 2SiQrc(
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thereby c fist the above referencedwell was gmuted in appeeraszin :..., ..:. with
�ncoun�rw Meg
wearkme ,.rj_L4,100-0-115 ,•
certmanw /37-#4
cam:
ORS" Ceputuf
Cain' g Misfit 00 Depth: /
Diameter: 0/�
Drive Shoe;
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