411601_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 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) MW-2
3. WELL USE (Check One Box) Monitoring (( Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 1/2/13
4. WELL LOCATION:
2031 Eastwood Road
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Wilminaton COUNTY New Hanov
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley elat ❑Ridge ❑Other
LATITUDE 34 0 13 ' 18.1900 "DMS OR DD
LONGITUDE 77 ° 49 t 0.1400 " DMS OR DD
Latitude/longitude source: 'WISPS ❑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)
2031 Eastwood Road
Street Address
Wilminaton 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
( 910o 270-2919
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 13
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
c. WATER LEVEL Below Top of Casing: 4.28 FT.
(Use "+" if Above Top of Casing)
411601
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 4.28 Bottom 13 Top Bottom
: Top Bottom Top Bottom
Top Bottom Top Bottom
• Thickness/
7. CASING: Depth
Top 0 Bottom 3
Top Bottom
Top Bottom
Diameter Weight Material
Ft. 2" SCH4( PVC
Ft.
Ft.
8. GROUT: Depth Material Method
Top 1 Bottom 2 Ft. Bentonite
Top 0.2 Bottom 1 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 2 Bottom 13 Ft. Coarse Sand
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
: Top Bottom Formation Description
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
.
/
/
/
/
/
12. REMARKS:
See attached boring Togs.
4.5
. 1 2013
FEB 0 2013
(information Processing Unit
DWo/BOG
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
: 15A NCA C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RE = ' . H • S BEEN PR•- • - ' TQ THE WELL OW
: SIGN , ` E OF . ' E P W yL C ► . - . TOR DATE
PRINTED 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

MW-2
BORING LOG
NKC PROPERTIES
3021 EASTWOOD ROAD
WILMINGTON, NORTH CAROLINA
DRILLED BY: J. Zuncich
LOGGED BY: J. Zuncich
DATE: 1/2/13
Sample
Depth
Description
Water
Content
Blow Count
0-0.5'
Concrete
Not
Applicable
Not
Applicable
0.5'-2'
Tan -brown, very fine grained sand. No
hydrocarbon (HC) odor.
Low
Grab
2'-4'
Gray -brown, very fine grained sand. No HC
odor. Soil sample collected.
Low to
Moderate
Grab
5'-7'
Orange, silty to fine grained sand. No HC odor.
High
Hydraulic
Push
10'-12'
Gray -green mottled red, plastic, silty clay.
High
Hydraulic
Push

Steel Manhole
Ground Surface
MW2
Locking Well Cap
Concrete/Grout Crown
/
---.-- ------0
1' Bentonite ----,
®®
um-- ....---
&um-- -----
r•�is�4 1°�rii•
:.....
•f1•*604I•011090
1000004 100i$0
r1i•!•41 0liiii0
i
r�•�•l4 1•l•�•�1
Groundwaterr • e ••.�
Table 0•i b• WV .+
)0% 0� 'l • iteral
l0!0!04 ®•®410®40
)••i• ®o®
•a 0mo`0
i•�•i•� 1�ii•�0+
1li.•. p�lili:
1i• ii0••
•1 1il6
11 1 Sand ►•! •••e �•:•:•:
• •
:•:•:••1•
l�ii•
•li•• 1®•l••
1
1•l i•• 10l i0•
10 • • 11;
. ••• MS
•liti!!!
!!il•®•
��•�•0 !►
•
ii:•:•:•:
�a1
••fi0 1•i•S'• �
!•i�i0 1•!•!•�
oio:•:•:•:
• •,
• • elk • •tee
••i•� !••�
!!0 a�► ��
0_0_0_0_0_0_0_•
Applied Kegource
ivianagernen C
',.Hmmptew4 AV 28445
TITLE:
3' Riser
10' Screen
.13' Total Depth
Type II Monitoring Well Asbuilt
JOB:
12181
SCALE:
Not to scale
DATE:
1/30/13
DRAWN BY:
EFC
WELL ID: