413179_Well Construction - GW1_20130429

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2345
1. WELL CONTRACTOR:
MARK GETTYS
Well Contractor (individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Narne
176 COMMERCE BLVD
Street Address
STATESVILLE
City or Town
( 704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
NC 28625
State Zip Code
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) AS-2
3. WELL USE (Check One Box) Monitoring p Municipal/Public 0
Industrial/Commercial El Agricultural 0 Recovery p Injection 0
Irrigation❑ Other j(Iist use) AIR SPARGE
DATE DRILLED 04/08/13
4. WELL LOCATION:
5314 OLEANDER DRIVE 28403
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: WILMINGTON
COUNTY NEW HANOVER
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
El Slope [Valley iAlat ❑ Ridge ❑Other
LATITUDE 34 ° 12 27.7200 " DMS OR
LONGITUDE 77 ° 51 48.2600 " DMS OR
Latitude/longitude source: BPS ❑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.)
RM R - 6261 N/A
DD
DD
Facility Name Facility ID# (if applicable)
5314 OLEANDER DRIVE
Street Address
WILMINGTON NC 28403
City or Town State Zip Code
CONOCO PHILLIPS
Contact Name
420 SOUTH KEELER AVENUE
Mailing Address
BARTLESVILLE OK 74003
City or Town State Zip Code
( )
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 44.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO 51
c. WATER LEVEL Below Top of Casing: 6.0
(Use "+" if Above Top of Casing)
•
omptetion
aleigh=, NC 27E
FT.
•
•
•
•
'113179
d. TOP OF CASING IS 0.0 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): NIA METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount NIA
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
: Top Bottom Top Bottom
Thickness/
: 7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 39.0 Ft. 2 INCH SCH 40 PVC
:• Top Bottom
: Top Bottom
Ft.
Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 35.0 Ft. PORTtAND BENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter
Top 39.0 Bottom 44.0 Ft.
: Top Bottom
= Top Bottom
Slot Size Material
2.0 in. .010 in. PVC
Ft. in.
Ft. in.
in.
in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 37.0 Bottom 44.0 Ft. 20-40 FINE SILICA SAND
: Top Bottom
Top Bottom
11. DRILLING LOG
Top Bottom
• • 0.0 / 5.0
•
•
•
5.0 / 24.0
24.0 / 44.0
/
Ft.
Ft.
Formation Description
BROWN SAND
BLACK SAND
GRAY SAND
APR lrt
...1':
12. REMARKS:
BENTONITE SEAL FROM 35.0 TO 37.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
• 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
• RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIG A U U e RT WEL
. : MARK GETTYS
• : PRINTED NAME OF PERSON C
04/10/13
DATE
rrn -lb
ev. t)9 .