411595_Well Construction - GW1_20130211

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1. WELL CONTRACTOR:
Joe Zuncich
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3324A
Well Contractor (Individual) Name
Applied Resource Management, PC
Well Contractor Company Name
257 Transfer Station Road
Street Address
Hampstead NC 28443
City or Town State Zip Code
(910 ) 270-2919
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# NA
OTHER ASSOCIATED PERMIT#(if applicable) NA
SITE WELL ID #(if applicable) MWAOC-1
3. WELL USE (Check One Box) Monitoring 5( Municipal/Public 0
Industrial/Commercial 0 Agricultural 0 Recovery 0 Injection 0
Irrigation❑ Other 0 (list use)
DATE DRILLED 1/9/13
4. WELL LOCATION:
4971 Arendell Street
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Morehead City COUNTY Cartaret
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
DSlope [Valley Flat ❑ Ridge ❑ Other
LATITUDE 34 ° 44 i 1.7100 "DMS OR DD
LONGITUDE 76 ° 47 ' 28.7200 " DMS OR DD
Latitude/longitude source: VGPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
NA NA
Facility Name
4971 Arendell Street
Street Address
Morehead City
Facility ID# (if applicable)
NC
City or Town State Zip Code
Joe Zuncich. Annlied Resource Mat. PC
Contact Name
P _ O. Box 882
Mailing Address
Hampstead NC 28443
City or Town State Zip Code
( 910,E 270-2919
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 13
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO q%
c. WATER LEVEL Below Top of Casing: 3.83 FT.
(Use "+" if Above Top of Casing)
12. REMARKS:
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411595
d. TOP OF CASING IS 0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
: e. YIELD (gpm): NA METHOD OF TEST NA
f. DISINFECTION: Type NA Amount NA
: g. WATER ZONES (depth):
i Top 4' Bottom 13' Top Bottom
: Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
: 7. CASING: Depth Diameter Weight Material
Top 0 Bottom 3 Ft. 2" SCH4( PVC
Top Bottom Ft.
: Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.5 Bottom 1.5 Ft. Bentonite
Top 0.1 Bottom 0.5 Ft. Neat Cement
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 3 Bottom 13 Ft. 2" in. 0.010 in. PVC
: Top Bottom Ft. in. in.
: Top Bottom Ft. in. in.
: 10. SAND/GRAVEL PACK:
Depth
: Top 1.5 Bottom 13 Ft. Coarse Sand
Size Material
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
/ See attached boring Togs.
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• I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
: 15A NCAC ELL CONSTRUCTION STANDARDS, AND THirr► COPY OF THIS
RECO- - AS =EEN PROVIDE; We E WELL OWNER.
SIGN RE F CERTIFTEb WELL CONTRACTOR DATE
PR TED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - Information -Processing,
1617 Mail Service Center, Raleigh, NC 27699-161, Phone.: [phone]
Form GW-1 b
Rev. 2/09

MWAOC 1
Steel Manhole ---,
Ground Surface
1' Bentonite
1
Locking Well Cap
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Applied
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tioneretaezi, NC2SM45
TITLE:
Concrete/Grout Crown
3' Riser
A
10' Screen
. 13' Total Depth
Type II Monitoring WeII.Asbuilt
JOB: SCALE:
12098 Not to scale
DATE:
1/29/13
DRAWN BY:
EFC
WELL ID:
MWAOC-1

MWAOC-1
BORING LOG
NKC PROPERTIES
4971 ARENDELL STREET
MOREHEAD CITY, NORTH CAROLINA
DRILLED BY: D. Cummings
LOGGED BY: J. Zuncich
DATE: 1/9/13
Sample
Depth
Description
Water
Content
Blow Count
2'-4'
Gray -orange, fine grained sand. No
hydrocarbon (HC) odor.
Low to
Moderate
Hydraulic
Push
5'-7'
Tan gray, very fine sand with abundant tree
roots and wood fragments. No HC odor.
High
Hydraulic
Push
10'-12'
Green -gray, silty sandy clay. No HC odor.
High
Hydraulic
Push