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HomeMy WebLinkAboutWELL-08-2021-155911.TIF 1 I . N111 %it\Nh,t.\ll :11:,: ::1: , i KisIin�9 Jr. I ',: 1 t „11,I u• I,rt.r„1 1 i• 71,. 1ppnn,u1.11r t„II,t11r 1,t w.,ttr nnt,,lnut: m nrlllsl.- ,l 6 & K Well Drilling Inc _.--- I i nit�► 11fit.1 rri l ►\I I.I •O\I. : ___ ___ Chlorine O 45.1.��,C rItrruldi,ilit:iloaf 1h,d. . \l,h(onNld,tNa1l'crluit ,.. /���� / "d .vu„ rlt o(Jlnfcrtrnl ustd: 0,.. S . _— \\,11u•e,:hcth,tellUscl: —_ --- -.. --�, ____ 'e.sr.ihm;ntat.rtJls used(cht ck Al That rpph 1: \ , \lun.c aal I'uhh, -nt.•nd:t hip,..i feller- c'iucnli•+I\\.o:r weak ho,ilrl ri Sa l Ccr::,r:t,...kit t'. . ..::..,. Nui C k e., ��� t.e1111:11\1•Jlcr NO;Cu:h:,:, Urrk I.I1dlA:1 �l l`n:,c it:l/r J..; �01 11.tier Sunni? Well: —.._._.____-- L7. S:k'aJln lho.i,' °t:i I I1'spl J,r::::`i:: ''1 Ilkctol'cr\' buck Well: r E r,h.J,,,. 71.For each material%del lid rhme,Imosidc anlinnll III nl.uc/iJlt used: •- �.,`�'!� r(in+undwatct k�n:ed,;dion 3 / e �j L 1:0!:,"I,I Ind I(c,u\ery o •'^_..S.5___-!" ~fi/(Jk — 1,5:,6n1t) lid,,, :1.n l!c 1...., i:\,o,rnun'rr 11ran:1,c �— Lsrcn:iientJI Icchn,d,•:‘ Suh.:dcncc(: :r:,l (;•ot'.:cintal t( '4,'d 1,,.,p1 ".•Pros ide a brief description a the abandonnu•nl procedure: "fiat:,r t;,•,•Q;rnnrltllr::lr.ct ,,hnNitra �„ , ,^'_/ t °/C1 ---__.-_ 1 1•I:r!IcaplJt.1 un,lct :1,!1 1 3L_ / LLffll�y--- -- 4.Date nclits)abandoned: ....J Z_______AtZz._ — - _- C,1.\%ell location: — - r a rhJ-r// / _ -- ------ tv.:..y III,IA..no..,AI., r.(cttificrhon: gas c�and /Ir L it 111 'PJ. sit,,.(is g,rr,/ / s-=/e- d,), Pn,,n21.a Pr,•,>.C R..and Iv S0a" " a g6D7/6 '31' 4 7 , H, •v,•,:rc•,1i,,, ,n•n:. I I'rnhi „'r:,/t ilia( li „lif,) io,,,', ,d,. i t`''",'1' I'a,,el ld[nitlicau,,n No 1i'INi , i.,,J.,,r,r,••r)f 7.;7 \,.'IC'&I2t Woo,•, '(- (I?r)I)It,/1('r.n,nu,',,,, .•:,-;n,i, and,h..'ri,op: ofrv;'word kashe:,rpart:awl to the„c17c„a., 5h.Latitude and longitude in de'„rees minutes seconds or decimal deli •• ,,t;te'.I tn,:d.WIC lit lent•e,,V,,,,011 9,Site diagram or additional nett details: YouIIJ\ u,c the hack of this pal..:to prosutc addt1101 al w:.'I ,u:dc:la:I.in5-;I N J:1Jrh:onnl:.11 d:IJ1;, 'IOU tn.) also.n:J,h additional rJ.:c,11 n:C:,,Jr: r(riifKlellO\ I)I.IAll s(lf \1Ftalllif iv; \li\\Dust.I) .IB\IIII \iI''IKt•(•'rioss 10a. For All Wells: Suhnnt this holm s,tl'an ?1I d.ni. of:'I-pl:l,.,it 01 ,'e; ,ibiiii ounr.o a it,t!t:I,,!ow 11: . ea.1\rlllU?: I f Ihtisinn Of Water Resources.Information I'nxcssie (nit. Oh.Totd well depth: / lr.l Inl7 Mad Sets ice('enter.Raleigh,\( '_70.4_1bl' 10h.For Injection Wells: Ir.add.tioe:a sending the tor„'to the J,I , " , or.Bort hole diameter: 1/ (lo•) those.Jut.>t.hmtt one copy of Ihn.loin:s.tthuf 2.0 Jai,of:ornpl;u.•n e JhandonWC:U to @le Iollowinl:. od.\%alcr Irscl bciun ground surface: 3 O ,11.1 I)itisiun of\1 atrr Resoure es,t ndcrground 1njrction Control Prot au,. le4o\fad Senior(-enter,Raleigh.\C'270o9-1030 in.Outer casing Itn�fh of 6nnnn7: Itt.l Irk.For 1\:t1,'!_Slal% ,C Inieelinn\\ells: In a.Id'.:t.,n I.,,,'n.:•'1. . . .:ddre,,re_„above.also,t.hr:'ll one will.'"Ilk-,form is 1;1',; I'.''I. .:,I. ' f/ :t \'..II Jhdm J" , neal to the county he::'Ih ,Ie rr rar,r„r rr II,; ,,:u , ..':s •he bt.Inne1 casing:101 ini Ian th(if;shim nl:_ _.(ft.) G1�' •.r� �,"i og.Srrcen length(if known): _._.1t1.1