GW1--04930_Well Construction - GW1_20240816

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a.Ibise Well(s)Co+aptettd: " — _ - ,
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Sh.i.tttituda nod(ep�tltde In d Aont
(linen field,one htfking in snflM)crit) r
35' 58' 34NDig--) 3�O w Zq
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A.Wore)the wdi(s} mantot or , ,� ctmlflVeRr)M tpcttnrAmcr
ba Wvows dtar fat*i aarw►yeterry,Ara err w wet(k'atli
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Otis a repair to as martin wdl DU, or °
ratek itt NCAC a9C.OIOQ or ISA IICC G AQ WON&rui ous,Sew/ante and dim.r
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r,7vir train t N reaos*'c sawn ruin the hod;of IMi joari. ]:t.Site iliarpratts or additlbnal watt st11MM
Pt,rprAortafll Welt having the mac
Von may use the back Otis page to pew*ltddiii0aai tend also detat I or well
8.For den rotar/IiDT or Qoped-Loop a>Ibtrvaktnddils. YWt they also attach edditionat P>tgce f/accessary.
mnatnietion,only I C+W.1 is deeded ffidieato TOTAL NUMBER wile
- Sta&UITALESDIVAX106
11b1*1 wo l deptt Mlaw tend serfeect (L1 24a.JnsWeib: Submit this Britt Athol 30 days of umnsieuon or ‘veil
Pre putkIplcwrllr lit I al;dellltti( w(oaap'k ate*100 construction tO the fb(1Owr8:
Jill.fatatil;water levet befow top of sale - (ft) Division o(Weter Resstsreea.liafuraetlen Processing Volt,
?f wafer/or(it einiin eenn i,ripe"," 1617 Moll Service Camden lit itdgit.TIC ANI0-
It.fltfrcholc distorter:�._ (ln.) 2,11.1 orlstrttian Wet* to addition to sending the lbnn SO dia address in TAn
wirove,also submit one copy of this four within 31)days at cOmplel on of well
M.Welt tostetnteiton m an& Loostosetkoito the falidwift
(I o.swim,voter)'.sable,*cot push,etc.)
- Division fsrWater licaoucaes.Un 411mnd tojesitoe Coloured Program,
' _PO*WAT RaEPPt.VWiLLSONLY: .- I(.76 mail SsrlesCetsar,Rldei&lt.ltlC2?&g4,.1636
1Ja.Yield toa), Method of tot24e.*or Wrier Srn1 &i ikolie M- In tle dit uto unddlowithin 30 days ihe Rom 10
th0 it (cs) above, copyn!the enemy
of
I promo mitepMion of won corm anon t>D the coarUy' health clehonteettt
13A.Igsiareetfgq�yp� _ whore c n etteeted.
Norm(1W.t Noah Camillus Aapaninftt or tittvkriNIVVu1t1 QaiHiv-i)4Pi14 xt or W.Ac Measures Ravines 2-22 201 F