GW1--02079_Well Construction - GW1_20240405

I , a a ama..:a ul au
WELL CONSIRUCFIONRECORP(PW-P NiatettorilisoOnlyt • —I' ------
: •
1 i
1.Wel ccatractor Intorrnatioan
Zil. T.44114 we --- . _,..._._
!stivazegzolum„..:4::;:z.„..,,E,..::„...,t....,.:..,.:,:,:.:::,,,. ..,,,,,:.,,..,..p,!..,:..„,.. ,.: .
„.
TO I
WellCoairagoation ...
445$19 IL I I
14
II.
l i I.
le irelliceil-aczo Catiaceigereacer _____,,.__ .
' +-.1.5:41VIERCOINC3reiLieeetstaieitedloORLINIR tit ' )2*., •:_...... : -.
\taeit s, vi A filP NM 1 so, Flamm= imam= swum
*1 i ilL 1 • 1.-1,1 i • ' .
Ontapayleanne
2.We a W Jr;
ordnifton. m* )1 V
llim ja% L36.32,14MCSNAIGORTIMAGOeimberetallimetliee)::-:a.•!.••,. -.:-.. .
room ,.:10 MalfTEIL =Man IITATERIAL.,
'in.
Lilt an aPPWO vadlconsinatioapenaas zoo.radar:4aq
3.Well OW(sttaehlieltso*
Water Sapp"With moss TO . . *anoiroisi skerssaz tosiii."%ess, isiAlEIOAL
1 icultural Dirlottioipointlfic ft. tt, is : .
Ocothe‘al(HatingeocraMSGPPb) Ft=witarsigoyoneo "ft_ ft,. ft.. , -
1.004 •Ittlislroatuttvipl
- - -
*roomationnos. . iaom. ratrizoostAmbt&cr
NortuipliiVit: ./19(,/2d
iii Monitoring A Itaxgrez- tr. ft.
- _ ...
ii AquiforRoAtatgo DCoosadvoteritonettodion
4S.S.C.41V6111Mic siaiiiireihie):.,2 :s--.;-.,,...;::,....?-:...- ..-. ,... - •
it •-l•-•Stosagoand Ramsay MortaityBarrier meal .To ' MATEIMIL Earrucoolacralemoo
id istpriforTost Eigtonnvorita-Drainoos
id Eve:Rotate!To=bnology r3.5alisictozoCcottol tr. ft= , .
-Gonda:ma(Closed Loop) Dream :oraotnirtiglitsGoonamestailasiketitriiaennor ;-,...: .'7., • -.
t Goo IMOD' TO EIC5Cirealenrinibim,s1*-yjn, gastutee3
thantaaleatingterrorultolurn) nOlberfFrelsio- nodeei..12onast s) - 0 a thi it.
v'll f or,
4.Date Wks)Cool*** t-Z6--M
IMO* - • q v
3_9.__:-.4-5; ft foidfi : if
sa.w.,tocate: i s 5'7 1 11* IOW r : . 6 —
• /11/1)_ 4/(A), . a r 01 ' 5 IL NIA e , '61/01/litsa -
Ficilitypown = ,„ FessTaylWor.. ..) ft. ft. r---,77 ,---.-----
luo I 1 oi f V i"A 1+1/1114 Pi st ft
Pli4;a1 Alison,City,toe* '------ — , W It.
Ap q 6 r. 20 4
C7at'S.-ioA •-- miemikEs : ,..-. •-•::-:. -,.:,,,, 7.,..:,-..• 17• '6..7,.. ....0
- county , P1liasifo,m2i0.(El*
i'ErvivrQ-30G
S.LOW&and longitudelodetsteesholoatestseoindsordetissablego= •
(ifwell Mt tartorlangis:actors) 22.Coreraratietg.
. 10 D N 1/ eV 73 w --EL, - ,7 I .
t-11-75
' Sinat6VtaTfteaiveit'4• ‘- i , Dale
6.kfare)ftweiktfilrerno.sunt or nitsoporm 1'
tiy.orjoing-tirtrfixos 1 booby cen1.5.,that the well(s)107$[pram)cassinted in montane; •
7-1.7 this a tvpir tout alslingwelli DYes or VINst sisk 154 ArCie 02C 4100or ASINGIC MC.0200 WO Constraciivn Readmit and that a
phi s kr a mar,fil 1 oiranosnwellsonstraakininfoncarionarlorkin do norantofft *Wed&nzavdharbir9Prsadat 10 theW ll,'Orner.
reyoir oncierg21 ronerksseetitizar at&oboe k ethisfonst. '
23.SItc Xtugramor additional welIdetalls:
YOU may use the hack of thin par to okInvide adcritional well site details or well
80 For GeoprobelDPT or Closed-Loop rTootherntal Wells havingthosaute , ccesauction dotes.yea=yak,attach idditicsug pa4es ifn . .
co °ray I OW-1 is nada&Fiances,TOTALNUMBER of wells .
thillcd: .., FRAVITAT.INS-RIICTIQNS i : -
9.Total well depth bdow landstufweVCi _. ,—.00 24a.II.41r,„_,Wilvir _ Submit this Sum,within 30 days of completion of%toll
Form/di:Le lartIrsoott*pan parent reoNapTell2eretyzten oonstroctian vibe following:
X0.Staticwaterievel below Saporta:4w 'i.PM::=% Ci 0 04 IRsnofWaterReamoces,linforssalionProcessIngilinl,
.ringer kw;isabovaviNg ase'I.zot ' 1617Ble SerstcnOtoter,Reirlea,NC27609-1617
II.Thereinto dia•moon fp ill GO , 24b.roI4iliag.waltz ki MOW ti.swag the form to the address in 24a
above,also submit atuogy alibis fano win*30 days*temptation of well
U.Welleonstruelinnsnetbod: 4,-y--,_&tart _ 0...t.t.i.t.g.f.s. ...k. 1
(ie.anc;todayoaliktlicestpasb,ctc.)
_ ... ... DitisionorWaterResooVre;IlsolevilualedllolintOndrolhossam,
FOR WATER SUPPLY WELLSONLY: 1636hfallSavicceanter;RatettOC2709.1636
• h A - L -e4 -
Lna.Yleid(gpagt Mcaladolagm i zi.zirw4w ,,,st,4..7simitosvicatlz b adc!.600,to staxralS ev ban to
—/- -;;*"--4 ilte eddy:ages)stove,also&boat ono copy of ttox Rent within 30 days af
13k uniitRoioniWpo:cfriki-14(4 Ammait I. ‘• V 1--. ounplotiost af We ortslincatzt to the oototty health*who=of tbe county
7 . -
' i, •
1 ,
1 ' ,
I. .