GW1--00159_Well Construction - GW1_20231229

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I.Number'of wtlb coelrtrrclad:,j a'•Iri You:nay use Nicke Nickof this paps to provide additional well site details
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le.State wa ar lawl below tap Of cat;,.
• r/.wrw.,rp•Io..,.,�r,.,._ �'f�t Division ofWat,r Quality.fear tlialiooTrocctstagVoir,
l617 Mail Service Ceuttr,ll<alalpti,NC 276f54617
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his.j -••b:!r Ulu! na*ttu: In addition to sending he fo m to Ihs aadran en:ot
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ti•.low,tart reDle,ter•t �'�f^ /� �r Ili= nr ,c:r •a 1► fo towtry
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I FOR WATf411R)rTLY R'LGI.�ONLY: Irnik of •W..• `,,.only, '•.egve...•: iodine Control Putman,
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type;_ s'I L . r i h P Anro. _ C) Z. completion of well conatnlotsun to tho veiny halm depilates:of'he:slanty
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