GW1--08129_Well Construction - GW1_20231215

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. ••=La..%..w.no 11CU1,11V1V KL!•C.'UKD(GW-11 For Tritmlmi jj3B
L Well �prma�ea: •
Ricky Corriher — - - _
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ellCoDiirdarriON
24fi4-A �� ! �S Q —
NC Weilo �- rt.
er
Frank A.Corrriher&Sons Well Drilling Inc. - - --
IazaII construction3 9 7 � Fnti iii Mamma=-`k.,4 ;::, isaremai.-
WC Comfy,Stare,Variance,etc.) +1 WM.. 1/8: in. SDR-21
MIMI
[ 3.Well Use(check well use);
�-t �%
4 y.. W' Supply Welk
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ClAgdczliuhal © � Inementra'�.rri,f,r, mionesat,•
ie. • �_°Geothermal Coobig�FP1Y) 'lir
. (single)
dal Water Supply( —=:R I
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V DOI}W fffigation DWells>100,000GPD r �!_.,..!•, \+�al.:,•,.r,. :.r1-.;-__ , A
t Supply Wen: 0 & s I�. r-,,.,
Be
❑Recovery ft. ft�i4lte Hole Plug
v) Injection Well:
- ❑A4�dSaReebatge DeromdwaterRfxilediatioa
T and Recovery Manly __,� .. ,.=— . _ 2E _ -- -- --- _ - ., --
ft. ft.
ElAquifer
Teclogr DSnbsidence Cannel• R in
Cl (cloaaLoop) ❑Tian
CI DG c DD (�lam.under tF21 Remadss) . -�, i -�__�>
weB(e) : /0-3-A3 Well mr* MIMI 3 /d -
y
Facility/Owner Name ,r...- Facility Mt(if applable)
/1721Addass,iTtn,,rattrap
Sd.1-nt nde and longitude In d hminntrslsmoada or decal degrees
35034� 'N 800�-A7 '3ei/ wu. ,-, . '*
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04 la_L_-_ -___-__-a.9
6.Ware)the waftor �Te�orary ... _of _. •W D>te
By tidyla Lab ISA o�1,fiat ewelI nos 6sergl dItacconiancewie7.Is this a repair
t�sitexi existing teeth � 7Y _ QeW� and that copy is r w construction and gdea the nahme ofthe eeordhar been prod well owrer.
yle.
mes
ell
rep&under BtlraarLs section oraadfeb cka¢dris Ants - -
23.Sim diagram or additional wide
&For Geo pT or Geotl Wells Laving the same You may use the back of this page to provide additional wellconstruedoginfn
doleck
aoly l GW-1 is peeled. ladicate TOTAL N 3NIBER of wells (add See Ovet.ia Rem is Boa).Yoe may also attach addttionalpages ifn
24.SUBMITTAL INSTRUCTIONS
•
9.Total well depth below lead sedum C�OS-
Farmai:4e Ti &talldepe depths aaa(e 3Q200'and2®Jo0r)
water (ft.)) ShL�RtlhisGSV-lwitlhim 3g
L� days.of wewellcoma per tieefellptiiag: .
18.Static water level helm nip of casing: / ( ) 24a. For All Wells: Ori l form to Divisiona£Water
Ifiara�tend fs above easing We-i- Information Ptoces�g 1 ,1617 MSC,Raleigh.NC 27699-1617 Resources � '
11.Borne :6" L) 24b,For Injection well=Copy to Wilt,Undetgloond injection Control
1LWeUea Air Drill �'1636 � 8�+NC27699-1636 ��
Cu alga, 5, d rectp limb,ea:) 24c.For Wafer Supply and
O�Loep Geothermal Retina Wells:Copy to the
FOR WATER SUPPLY R'ELI.S ONLY: county ofthe county where installed
'Y (� ?� Air 24d.For
r Wale,1611e s '°�180,908 GPIs Copy to DWR.CCPCUA
Method of test: MSC,INC 27699-1611
13halitiofectionSterilene • Amy c.r4 CapS
FOOD Ow-1
North Catalina.Depmtaxatof]avaoamrntii Quality-Division°M rResrnuas
• Revised 6-6-1018