HomeMy WebLinkAboutGW1--00160_Well Construction - GW1_20231229 gyp_ •
. This Ins � •
QNSTRucr1Q�opp. - --
Wei flrsiyla IN rwdtKVmalls risifee.Use ONLY.
1:Wel Caatru'rr:stn.%i7atr..
SP r,r`'1 13G Z,Z r i'; ��ln_-4 ._... ..._,_
•
Wa..ere.ecarA+.., ,�C.. 14 _....+: .•« ._ _aw
•
Hiw�llca.f,r -filtitk.t:.r ,...,K ► •
,• t' 1
Uor r .'rde! i' careen l'A .1., l JA1.
w�. 1_'.'. .._ a L LJf LL /Q,-•14. C „�.I -�/ .2:7.., .''- ;r r� 1� / 1J•L
r� I 1.`wrlraCAsiwgocr )
2.well G.Mrr.tw.Tarn*r: D .3,/4j ;gal , •rh r , • .nut ualcaaar.
tut Jl.woll„ear•ma -- , 'A. I', A.
.wwww wow,w air rt. r:novY..t....t/awwV.sir.) _ �'
1.Waft Uu(eL•li wail rr ft 1f I• _a
fWaiKlippb'Wel: - . - ..._waw•a ._. Y�LV
CAgewltury - I J , •wr UM 114.41.r�T
fT00rltl+srrttai fHal)riJCppltng SAY) ad vhtc•9t nCly(,toato) 4 h• � h►
04nlvyhtsUCwtngerl Jlcetbcntlet Wives Supply(duo) I •• -
'J4tilalton' •
._�`ie IUD,•tn��+yr :�l >�k•
AtM-Wok/dle�.1,Welk (� K R .� •
A -
" ItOR•uovery r< I
_ ..--- .._.._. wawa..._. • If. I It a —.
' OAltihrketcu p Oarourria.tcr Rem.dul.d.; I
OAettidr Sttrrype gut R•..,nvay •U9aliniry Barrier
ji_. Gjl nrrLw[�t C�._
M
Q tiles Tea A R
f : C,I,umwtrr lkwn.se
• I CarporiieOdJ Tarr:re OSt bruanc.Cordrul ~ A `
O(icodwmal(Clow!Loci!) U'rtca 1 lot t •'C rim m (au .azi..4 hwy.eri.city. '• -
,00ershsrnal(Nmtl uuS e••idw.t.,uw&ew,nwe a At.'
�C 1�Tiat4f>yl OUery(c,ylam tavl,r 111 ltamarlu) h I It
e.Asaware)c�..pt.tie:///.—,.fc-��w-tr,.w _ /Uh �'/!S"L' �t.�
Ste.Well Tosatbr: (F Fe �b��e)~ j^Ol 'yam " __
• ee.Wy/t)rn�Nw —'—•----- n. �i R. .. 'c 4.a-,.k,.,•'lb,�.i, ,:-...1
Facility IDI:if cwyheectt) + r rl:
/G 3r , .eol/`P Cka�AC. /41 �l p _.
Rrr e.,*Alma.C•'Y.••1 Zip -•"'�' .... R 1 R. �. •
!b.Latitude sod lwgite it is claire/e/.naetoateaeord,or decimal d.s;rar:
([well dalet col Wafts it•ulleieso 22.Carte adoo: •
i
.1.G•ws..1 .,I'Ir:,.aw+sar' DatO
• d.L(an)ter.elgt):;p(laruurra or OT.raprerY
�� flipmx/km Jlrs..I Nra�(wrjfr!A.,W SION MN:POW uwnwrr/U d 110140 a.
T,is Ibis s repair le as eaieeiap wall: QYer er G V p ' wes•/1.1 mu('or..0101 w ISA Nc..K.•IX,'OMr ll C.ralnNW,Ma. ,r .1 OAP
. '. ll'iiaq•+rXN/owAarewallawu rV•aJru woo,/rulien/vawr•A,nUrvfio,.r..
r.aiow:l�lrt.alr,n dad t:.v�o,r iM.ma,n y/the^r"'r..uir,I)/,...rra...•.w r..a.•ac*,!,,.u"+... 2).Site diagrams or adellIsooal well details:
1.Number of walk constructed:, You any us,Uw bualc of this page so provide additional well site details or`welt
A..d ur be crack,. ci stnu:.on decant Yaw nay atao made addltfenal Non if Orteesby
Mr kr..w,.r se• walls ONLY we.a4 mow r.aae>v..e.a,yo.tar mom,Mr16..
�q W D1143TrAL INS C%iCUON1
+ri.r!.Tulep tYp1 belowv!■ed wiser // I(J 34a. rer AU Wails:!' Saahnti: err ram wititvl )C days of cw,pl.ei•un.,r ..c•
Poo.wtaptewell an etdy,A►(//(lfr,r.r(e:w.v4.•. )30•..d] /oo')
� eorut:u;lion rd:the fdlovrins
t O.3icalt altar live/bolo*top of ratios. ' pq�- Drvinoa of Wear
• r/..r,.V.114.fp,.,w, e.big-,.- ,R t Quality,Informs tics Trvcctstat bolt,
1617 head Ser rica Csutse,Aalsigli.NC 270314617
11.DetOltal•dilemmas,: '‘
. .,I 'ea./ -web g [emit ,i Welly In teddiuon to sending h.kern to Ihs apdrus to:as
12.Wall eo.grttertaa taw. �'+(S^ �� f - Wve •u st' .;eq. of ... H. • v unto .• day/of eamplation of tcelr
(i 4.Odher.rain.Octal/•d;r'•I pall'.' ) - (2_ r<I -
c nr ,.:r I.o- All fal'I.
tr
!'OR WAtICIt 1R1lK Y WILL ONLY: - vs' o'W.. [ 'j.guy. ••.,irr...'' etelioe Costrsi/coins,
/ Iti31 Mad Service Costar,Rakish,N4.2140.1►Ji
13a Yiald(pa) M•.:..d N wt. c(,i/. tt/0(..v IA 2K•rr 1�4 hrr inset•i a hurdle:.Welk: bt Pillion to soadule tits firm io
Ins// make ss(M).ab.vi.l sipsvavrit one sopy of this font• IOW% 30 days of
136 Dielaitetl.s tyre:C►7 L O r/h F Arsonist c C) o 2 rr'fipleUotf of wall eobienretwn to the eottuy ltcs(5+ depustt„n:c•,''he:c..rt-,
- whin cot:strucW.
ewdlb':.r•.I Ns.a.t a.sa..a.t• 1 r; i,
I