Mecklenburg_Well Abandonment_20241101

T F s 5 i's'R 5.: IVY; r s - <;t$ 3 Fx - _ - hF,F:: rcT HarR-. V ,gT 45 9^"g- R '"s?y
WELL Ga .lO , (1, . :+v 4s•att» tiICJat'e:l: !
•
• 1.- TeWatotost infe..hnL?s. p t y(� t sr?rrag:uIAgiaiP J z'k s f 1�� - ••t y�t � �9 Jl y Win ?. tBY>L IB,TC-:&r9'<L diS>L `- &apv^i2th6S' 7W-?ji`4's1£.i ttieFa
CeIICoait is Abmeierv.}"t�cw.Tiri arsf&ivia$; cs; to 7 Fir�wlmli rdwibos}y6 st'J Oise' .3adieaTo !'A1:NME of• - •
NC Wei Crat is Muni=
5,,-.A,s�s 7b..,^ to:ram .a=.•sue'^-,,a ,g tat rv,
2 G): j ,0 ,fgal j
a E Ccasamy �i1 3{i> i
1 2-WellCoast-maim Fa IA; 40'0 * II
Do r lr4ro-svifaa< s 27s-a Ff avey, e Tc.i�ww erst : T •
943 Amami of d %2 �� S V
1Wa.*(6,166[ -euGalt
I
W — V rvat I Si.w atbsg =lab lebeez aRt'thy a ens):•
ufi i �:n aitaial 0 •,,: tram": 1 or!U R'1-1 �,e cacr, 0.4 RmisiEe> c I'eu.A is
P t3fs otiaFespa)filest ng/Con?in?Stipple, )414-.17--.klie Water Supply tio } .X Said^ tf .g.xyclay
I hit ' 0 Cear a g
�:s37�.ri�3ts�t>s*--��l �^4-.nit F.�atu ,� K �.
Doer-Weter8 o,'4y'TeN: a 8cuaovi!e Slurry 0 Oth (e7lain wider 72}
,0W4o itort g UII=ov ry
• t tgettlo �1ol%„ • I Tas tia matcain?ftbeteti et: g-ortiibouna cli t o..1-is s-m3:
GitsmiteassataSe cod ps�arary tt 'Lr€yi3saa� ,
Oki 'felt ,rgioasa wst. Dial e .1.1� k ., Ott _rt:- _, ,
T7€vrat..0aET�t cy L$r'+rip+rnn{ a JITI u47J1¢m p3 i
Glirat a- --� 1'
10 th:utl(I3 r it llvtti ) 00.etat( •al/a 7idl PPei A t 4L,,,N. `L �`' 1�� e.vt.A -�' ,
>% .a t L1 'e� ' C.. rr r - . ,, #
& t r).o ..-�: /0-1 " .li to I _ -. ; g
Ii�'P(kith,'_Ai,. y.4ViA' "y t.n.-•.t•.,'R.'...:c `,.: R,> d 3-',
r c s)r m- i, 1 )tyOf z '>a� hn i •
t t ICY 1��c+ne� dJyl�eyY�C? C C. 1NI„-. v>R-21 '— !r .i e C + n r >
ttri d.64..i,•1t-.C.,: .,.04 S'rga amof 4, •ric^c ealsnttattaz«FJa?la¢`rat ! t3
c.rA ., -,�- e.(" .1+ fi>zoning this f�7:,t Bhm.,ir ra' •tirt>i 4,:re sttritrw nva 11sw}at:drare Jaa
Canty y_r.73'_c'�GcaEm?ta-f7"'0'-,l"A :tee&-r?ncrzsr'.thJt RC-1CD2f'..D�I�lpiy0^ 2:.I-?7a'r rig.:t..s•:le}s`m,.,.s,�,::
fir. a'7�°- tsz='^'�P.,.�-.L'? Ag�t:..ern_J-±nr_sFs�c3:a nn�^..y�;.c@ns•i r3 , rrli Ow....r sopyofBU F'otGt„sb=6-Nr` FtO?vn e±,yier
tir143r+,ate » }. G _ {{ L 9.F3€:n :.mo ,tuarltcar .
5 q t 5 / , .1 J7'J 2...t,:. You may use*Owlet of this pose to *iwi&I dditi l wall site dota`ls or veil r
j, abandonvocat dri&a.c,You may aka addiucamt urges tfaaccemay,
aElt— i.=c.0.t'.4Fimago i,d;;L su'' 1L'AA �i---it —➢ I
ktcrtr^#JwwG...nutz'? 1nfarz_eatle Fite+adtAuer m'a�'m rerun h
+ Fa:tit:Pw.sarr.. ".a>:.'rkau:vinii:.r:}aucc: :.:n is ,
t MIL Fes itti W -. Submit this form vri Ca S6 days of ogicitoa of ueh
fn3.761:1 t.:r d'20 7 i C aS3 omo.!wile fi,loydsso*t 1 .
ry 131vIslat bl olatS Ware t;i rtr 4c;7:ao&slifgUri%
gt-Totaweli€eg`&'+., -al. E68773"aail ffetal t .P.olelgbi,Nee/B046/i
tq tint.For Alf-Winn ligEt<: In addition to mating the form to ti>q address iris 1tlu
G t cic�3: above.also sit,&care of this fovea within 30 days of wwcw-n o;all I
- a62a damuito the fellow-tow.
.0 aixk�aigtatsb;ri w s - } Rial tou rifTliatT l'i errn,ThAerzu..:tabin:M c"rs., sclAsaftaam,
;t?
g t1 ,S =2 rya,z:. -..o ,,liol.t��9 Ne.1"7t3SLS',
Cv,+3u r+'3a#;Lc g!fly E.6.ru}: !f7 Gam) I0r.Fux FGcfca Suputy i Sr Ee ci wen.3tt 3t Bolton to s ine:taC haul tole
bat s(e�ab w. ,,o?4Uonecops orthis'bm.tw 14,., 4m di.pl as
j ar'v6M.aiiifdcmuit as the county health.s:epannt t of the county vole
a.arailerceshrdi ableg t .,(if Palm* /0 gfr) a6 danced.
•
.r a.sw`.,dir Willa Quothar.ertsnwsaarbas.arstatQuaiity-pis:iaan.PAte>••.aeaourm I ilmi.ei2-::2-Ta56
•
''
i
1

k, EE ANON .. piartmermi1 ,-• .
f'ry SG, •fib t a/34�tf* l 1�t� 9141>\ 7a.3'nr 64intit't r`f er+L° -Lgorr IfI? ai�NnRs t�
tYtv`I - ivta,c(Srw lluwn s uitisgdta':ta�im� v., ii du. -,) - ,-,aaTyl sr"W isitc-eddQ..,imtea ;a:l11'}ly ;33:ef
2,2 9 —
NCSV,Capuitsior+CcvSmamPbs'at Th.Plrg. vskwAsam:lea'rotsir - €;-os(s):_,
le-Ar tr‘r SCV-C)r‘et-- , 1 Feol VIAWR SUMAC WELLS MIX: i i
Cn lin.7zo o?etatrisl welt: I?3'7a r` +L c L y }f,V e f
2.1vasa,,.,st.: .a .t„. 00¢1q g5 1
&sr,ail eptiatitlattlFw.va.,glen,a. 02tileFEZCerm Xa4s;tana1oftiSMa ct':3gA:
Sr Y M.seiceseolawell cask _
gin,-TG a 'W 0.ie.tks-ntinga �-ls na= i ttw dx ,
OAnrcoimrtr *t3?t nictsai!fnbge ltca Czak-iCaoot Ea t.tsontoChipssmitills
r.30 s i-rnn:t(FrostireCo saSup Supply) eat# t litsnm.Supply(nlogk) G suttd CommFGroin 11 Thy CkV
[T:. ia7/C\r-•=•-'dot ' ' ,13,t ia=gupply( i:;d) :ppm GT'a , , 0 o.l.o3)
s�`.rns ' r' ,
Ilea-I'Vater&tinily-Wi: aTici.^if toSFnity CICittac(emteit:codas7'g)
sitoti 6Reemrey •
Etectlon. . ?I?or cads teat--ziai ss?� a:We,prorLo amotht ofsr tea s Sri:
anoi t-aSwageen2R..,svny USoNnlyBooni x!{ 1 4J+F1 fc e YifO "
t soft Test eSsonsoni:rDaixioSe ----d„g,--
17Fa,;,,,sFitnlT,-1mnayg or...,c...11.l -. r'•`' "-• < ,
Ci` ttiatoinr( earstap) EMT'in= , aamfirreh � c d .
Y 9 r c•n
EtC e> t tY iaFfe I.Cl stit rest ttuttitt 7) � tf t i� �° i`t vs �J�t'Yy tr. ,
�ty 3 j i ,_y i t ' 2024
�1� Opp,v..�f C \ } d ��y.11prwV^+.�iJ'pi-, r�U� ; i
k e• ^I-0 6e4 Ls..c- 1 C ®1�iC/ 5 �____ . Liu x u
rtyltrr Name raseezyiue(tr ) s. tens€a 1` ,
W rL ''. C� uk : c 4- ,ttv-eei, /a0to 5 24
t_1, M C carsp �"'� 'b '.c • J S"tktcrz.a* . WIett,cr ,,,orWellO r L
d e,�9 t '� . )!<� 0 6 '-/°' gy* it!"rid fcg`n;1.+mitt• jr em Y:ni thr widitV%at.inM;i c mtdai°fHn -
ram- ;ut-Ai7,,aitit IFit• $. n,^c-,clancv ihT11licS4`L.?£'_Luca a:•It'SoDirdic-,,•,E,.,,•ao,..i:ro;,,Ludi
FtcLvd «tic; etnafiE ,kX -.snit,sir a vTrts;:vx .I;Imtucny>a•oftktrr :da vfdd€a,tafert, trn:ra
(iit t 52Statiatii sv&ceitir :t %StQ
5c) (1.t� N QO v5L{ 35 the k ofthas�xeIIs?o s
You tttay use back of this pnc to ytavide tfittlivnai rr3>ite'eTat#s or well
• ahaudoatt fdcltils:You nig cho snitch Without pages Irnwass_.ry.
to .t�K, A a � � Ells ue�a it zr(iz�i� i
. dtarAnoth.o-vA eL mosinefdecre't le IrortnAttsmorms.strorsnnstroott.
.--r.5' r^tits. nae ;r'r`.•s .d4,7.-- ;:aa.:y zri-. _r:,;r.
:H se;AEI Welly. Srixon this ism:scant 30 dapTS wasp• i:ta a::r:
6a.w4.-47a;: i ell 0 ],t- tit.erv_n 4tmsttt:fogiesia
'b3iolain t ar otirElato t�s*InfaarCulluSsWoce Veit',
tic.TO.%levell 3a �) iUi7 A�y6IBvsralt Center,i3aleF h,NC Z76J9 I�i7 .
� t. iib:For Wootton Watts: In addition to seeding the fort to the addsesu in IOa
.r:' Ge,goyim tom», 4-:I, ) stove:also submit coo cam of this rem iiithir.30 days of completion of rxli
r abattdmmteni to foc folk:wine:
11,1-7.lsisrieslit hdonlryantogatseetn: ..,.41E_.�...._(EL) ItiVgto" t�s,Ica Undemnotol let?•45 Caml:ci Frolgrn.
4o.Ebbs'r stint ten (if(mosso): c 7 c:t (Q.) flits.Ersio Wks£tttito z itt totrElh;rt Welk:Iu ailditiou to s ading IQ fi asu 1:the
ttdtltths(:s)above,also att6trat one copy of thisrutin within 30 days oteompietian
� of well`nbandncm health to the county Ith degtar.n em of the county%Sere
GS&assescrs ¢uIt LStgT:t('ifi wn)i_ tV f 4 (E) absotheed.
•
��r::z1W-zv ?iu£nCaolizt-i3lv- +8oninmarablC.¢dity-c'3.v onoftyatrr33xaa•^. \ ftw.,oei2.—Ma \
1