411593_Well Construction - GW1_20130211

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR 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
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-10
3. WELL USE (Check One Box) Monitoring Cl Municipal/Public 0
Industrial/Commercial ❑ Agricultural 0 Recovery 0 Injection ❑
IrrigationD Other 0 (list use)
DATE DRILLED 1 /10/13
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 DValley elat ❑Ridge DOther
LATITUDE 34 ° 44 ' 2.8900 DMS OR DD
LONGITUDE 78 0 47 27.9800 DMS OR DD
Latitude/longitude source: V3PS ❑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 Facility ID# (if applicable)
4971 Arendell Street
Street Address
Morehead City NC
City or Town State Zip Code
Joe Zuncich. Applied Resource Mat. PC
Contact Name
P . Q _ 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 ❑ NO q/
c. WATER LEVEL Below Top of Casing: 3.85 FT.
(Use "+" if Above Top of Casing)
411593
•• 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
i g. WATER ZONES (depth):
: 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 Size Material
Top 1.5 Bottom 13 Ft. Coarse Sand
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
: Top . Bottom
/
/
/
/
/
/
12. REMARKS:
Formation Description
See attached boring logs.
r
F B23r,92013
2013!a'je_ri7�.��jfs j Proce. 5iti
g Unit
• 1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
: 15A NCAC 2 ELL CONSTRUCTION TANDARDS, AN AT A COPY OF THIS
RECO- ► 'AS - EEN PROVID WELL OWNER.
`-3
SIGNAT i RE 16F CERTIFIED WELL CONTRACTOR DATE
PRI ED NAME OF PERSON CONSTRUCTING THE WELL
Form GIN -lb
Rev. 2/09
.ry
Submitwithin 30 days of completion to: Division of Water Quality - lnformatiorrProcessing,
1617 Mail Service Center, Raleigh, NC 27699-161, Phone [phone]

MWAOC1O
Steel Manhole
Ground Surface
T
1' Bentonite
1
Locking Well Cap
Concrete/Grout Crown
Groundwater
Table
1115'Sand
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3' Riser
10' Screen
FEB 2O3
. 13' Total Depth
TITLE:
Type II Monitoring Well
Asbuilt
JOB:
12098
SCALE:
Not to scale
DATE:
1/29/13
DRAWN BY:
EFC
WELL ID:
MWAOC1 0

MWAOC-10
BORING LOG
NKC PROPERTIES
4971 ARENDELL STREET
MOREHEAD CITY, NORTH CAROLINA
DRILLED BY: D. Cummings
LOGGED BY: J. Zuncich
DATE: 1/1 D/13
Sample
Depth
Description
Water
Content
Blow Count
2'-4'
Tan to dark gray, fine grained sand. Organic
odor.
Low
Hydraulic
Push
5'-7'
Dark gray -brown, very fine sand with abundant
tree roots and wood fragments. Organic odor.
Moderate
to High
Hydraulic
Push
10'-12'
Green -gray, silty clay with soft, loose texture
and low density. Organic odor.
High
Hydraulic
Push