GW1--00625_Well Construction - GW1_20240119

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3.WM Use(kla+veil use):
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eeniernetimt tmlg I GW4 is deeded idea TOTAL NUMBER omega rtl69t1ttetittn Itelmis. You mdyal�snob*Mgr tt MttilEeslalyr.
draw:._„ gfflagliali
9'T41411 wedge betas sorbet: 3/0 ('i) 2416 tib__W S 0000 Ws Idibin SD bars of(61130alab of wall
trarnuhipioturaliatolidapIkeifl ►ant Pb-3@l ari WW1 ennllltYGlantotile remits:
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ilo,anae•,mew oak direlopntb,ciai
---..... . . ..- ITIVISAilor tatter ftaliilcalllndggi san{11sj(estioe C Plaprialt,
FOR WATER t3EPPL li WELLS 13NL1ft 1636 ass =ca:rmn;aEnia ir.R'ICI 144ti
13e.yield l . 4 Methtui onto % x Ilrar Walar Snpnl r W he WARN,to srmdlag the Gm tt,
um s(es)above,also auto*ass dppy or thin ban within 30 days of
rahOttinfecttaq Oro _• AlanunI: - nompalion of well consteaatlon to the+eomrip health depnnmets of the atilnpr
•whore ommlt .
Jim CUM Wadi C raih Thipwtmentafhm+trdnn mtn1 @thy-DrvitionorWarr R Revfned2-21 snob
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Wall Near S.1f-dimput awilessem
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da
ova
ilioruby cad*that the above referenced wel was gmuted in in
acardance with
aI1 Weil tales.
w im n ti sA P/urn'ws Signed:
cam: <<3-7 -A
Construction: Quit: •
Tarene : C t I
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aims : tQ`tS
Height
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