411594_Well Construction - GW1_20130211

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTO
R CERTIFICATION # 3324A
1. WELL CONTRACTOR:
Joe Zuncich
Well Contractor (Individual) Name
Applied Resource Manaaement, PC
Well Contractor Company Name
257 Transfer Station Road
Street Address
Hampstead NC 28443
City or Town State Zip Code
( 91 0 ) 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-3
3. WELL USE (Check One Box) Monitoring i Municipal/Public 0
Industrial/Commercial ❑ 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)
❑Slope [Valley OW ❑Ridge ❑Other
LATITUDE 34 ° 44 1 1.5000 "DMS OR DD
LONGITUDE 76 ° 47 ' 27.6400 " DMS OR DD
Latitude/longitude source: cIGPS ❑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 ID# (if applicable)
Facility Name
4971 Arendeil Street
Street Address
Morehead City
NC
City or Town State Zip Code
Joe Zuncich. Aoolied Resource Mat. PC
Contact Name
P.O. Box 882
Mailing Address
Hampstead NC
City or Town State
( 910,E 270-2919
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 12
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO E/
c. WATER LEVEL Below Top of Casing: 3.30 FT.
(Use "+" if Above Top of Casing)
28443
Zip Code
y'�1j594
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):
: Top 4' Bottom 12' Top Bottom
: Top Bottom Top Bottom
: Top Bottom Top Bottom
Thickness/
: 7. CASING: Depth Diameter Weight Material
Top 0 Bottom 2 Ft. 2" SCH4C PVC
Top Bottom Ft.
: Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.5 Bottom 1 Ft. Bentonite
Top 0.1 Bottom 0.5 Ft. Neat Cement
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 2 Bottom 12 Ft. 2" in. 0.010 in. PVC
: Top Bottom Ft. in. in.
: Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Top 1
Top
• Top
11. DRILLING LOG
: Top Bottom
•
Bottom 12
Size Material
Ft. Coarse Sand
Bottom Ft.
Bottom
•
/
/
/
/
12. REMARKS:
Ft
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ee attached borings logs.
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ITCH!
1-ER 2013
,,, t/orrrtation Processing Unit
OWQ/SOG .
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
: 15A NCAC ' , ELL CONS ' + N STANDARDSD THAT •A COPY OF THIS
RECO: % HAS . EEN PRO THE WELL OWN
: SIGN
:p
711
OF CERTIFIED WELL CO ' ACTOR DATE
INTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completionto: Division of Water Quality - information -Processing,
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]
Form GW-'I b
Rev. 2109

MWAOC3
11'Sand
Steel Manhole
Ground Surface
O5' Bentonite
Locking Well Cap
Concrete/Grout Crown
misumm
nemmum
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Groundwater r • ••a
Table • • i
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Applied gcco r c
Management',
1-impetiowds NC 36445
2' Riser
10' Screen
12' Total Depth
_0_• �•_
Type II Monitoring Well Asbuilt
TITLE:
JOB:
12098
SCALE:
Not to scale
DATE:
1/29/13
DRAWN BY:
EEC
WELL ID:
MWAOC4

Sample
Depth
2'-4'
5' 7'
10'-12'
MWAOC-3
BORING LOG
NKC PROPERTIES
4971 ARENDELL STREET
MOREHE
AD CITY, NORTH CAROLINA
Description
grained gray, veryfine sand. Organic
y
odor,
moderate hydrocarbon (HC) odor.
Tan brown, fine sand with abundant tree roots
and wood fragments. No HC odor.
Medium gray, plastic, silty clay with moderate
density. No HC odor.
DRILLED BY: D. Cummings
LOGGED BY: J. Zuncich
DATE: 1/9/13
Water
Content
Low to
Moderate
High
High
Blow Count
Hydraulic
Push
Hydraulic
Push
Hydraulic
Push