412764_Well Construction - GW1_20130415

NON RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION #: 2927A
1. WELL CONTRACTOR:
William J. Miller
Well Contractor (Individual) Name
CATLIN Engineers and Scientists
Well Contractor Company Name
220 Old Dairy Road
Street Address
Wilmington North Carolina 28405
City or Town State Zip Code
( 910) - 452-5861
Area code - Phone number
2. WELL INFORMATION
WELL CONSTRUCTION PERMIT #: N/A
OTHER ASSOCIATED PERMIT # (if applicable): N/A
SITE WELL ID # (if applicable) USTCSFF-MW28
3. WELL USE (Check One Box): Monitoring IX] Municipal/Public 0
Industrial/Commercial 0 Agricultural 0 Recovery ❑ Injection 0
Irrigation 0 Other 0 (list use).
DATE DRILLED: March 28, 2013
4. WELL LOCATION:
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Jacksonville COUNTY: Onslow
TOPOGRAPHIC / LAND SETTING (check appropriate box)
❑Slope ❑Valley ®Flat ❑Ridge ❑Other:
LATITUDE' 34.7197 DD
LONGITUDE: 77.4518 co
Latitude/longitude source: ® GPS ❑ Topo. map
(Location of well must be shown on a USGS topo map and
attached to this form if not using a GPS.)
5. FACILITY (Name of the business where the well is located.)
N/A N/A
Facility Name Facility ID # (if applicable)
Street Address
Jacksonville NC
City or Town State
Zip Code
Contact Name
Mailing Address
City or Town State Zip Code
L.-
Area code - Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 12
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO XBl
c. WATER LEVEL Below Top of Casing. 1.40 FT
(Use "+" if Above Top of Casing)
1
412764
d. TOP OF CASING IC 0.00 FT Above Land Surface*
• Top of casing terminated ator below land surface may require
a variance In accordance with 15A NCAC 2C.0118.
e. YIELD (gpm): WA METHOD OF TEST: WA
f. DISINFECTION: Type WA Amount: WA
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
7. CASING:
Depth
Top 0 Bottom
Thickness/
Diameter Weight
2 Ft. 2 in. Sch. 40
Top Bottom Ft. in.
Top Bottom
8. GROUT:
Ft. in.
Material
PVC
Depth Material Method
Top Bottom Ft.
Top 0.5 Bottom 1 Ft.
Top Bottom Ft.
9. SCREEN:
Depth Diameter Slot Size Material
Top 2 Bottom 12 Ft. 2 in. Slot .010in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 1 Bottom 12 Ft. #2 Medium Torpedo Sand
Top Bottom Ft.
Top Bottom Ft.
11, DRILLING LOG
Top Bottom Formation Description
12. REMARKS:
SEE
ATTACHED
I DO HEREBY CERTIFY THAT THIS W ELItAS CONSTRUCTED IN ACCORDAII��C��`` WITH
15A NCAC 2C, WELL CONSTRUCTION STAI IDARDS, AND THAT A COPY OF T(P`
RECORD HAS BEEN PROVIDED TO THE AL�- OWNER.
S NATUR F CERTIFIED WELL CONTRACTOR
William J. Miller
0&4 3
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
DATE
Submit within 30 days of completion to: Division of Water Quality - Information Processing,
1617 Mail Service Center, Raleigh, NC 27699-1617, Phone No. [phone]
Modified from
Form GW-lb
Rev. 2/09

WELL
LOG
CATLIN
Engineers and Scientists
20914 SHEET 1 OF 1
PROJECT NO.: 209114
STATE: NC
COUNTY: Onslow
LOCATION: Jacksonville
PROJECT NAME:
LOGGED BY: Corey Futral
WELL ID:
USTCSFF-
MW28
DRILLER: William J. Miller
NORTHING: 3844695
EASTING: 275487
CREW: Larry Wessell
SYSTEM: UTM NAD83 (m)
BORING LOCATION:
T.O.C. ELEV.: 19.6
DRILL MACHINE: CME-550
METHOD: H.S.A.
0 HOUR DTW: 1.4
TOTAL DEPTH: 12.0
START DATE: 3/28/13
FINISH DATE: 3/28/13
24 HOUR DTW: N/A
WELL DEPTH: 12.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.511
OVA
(PPm)
LAB.
o
1
s
L
0
0
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 19.6
0.0
0.0
3
3
5
7
2.6
W
...:
(SP) - Med. brown, f. SAND. Uniform. Med.
dense. Saturated at 1' BLS.
2.0 17.6
1 1 I I I I 1 I 1 1 1 .I 1 —1 _. L__I ___-1 -.I_. 1 i 1 r
N N C
b O O
2' Sot .010 2' Sch. 4o PVC
Sch. 40 PVC
to
m.
1':-:.
6.0
—
5.0 4.6
Ns
e.
mir
am
2
:''
ZNs
5
6
4
4
7.9
Sat
(SP/SW) - S.A.A. w/ weathered rock. Loose.
Uniform/well-graded.
7.0 12.6
10.0 9.6
ss
mi
Zi
mi
:rr.
Z101
Ns
m
on
so
ea
es
us
Z>?
10.0
woh
woh
woh
1 _
0.0 .
Sat.
::
...:
(SP) -*NO RECOVERY* Cuttings suggest lt.
gray f. SAND. V. loose. Strong NCO odor.
12.0 7.6
M
-:C
E
m:.. 190
Boring Terminated at Elevation 7.6 ft
in f. SAND.
'C l i
APR 15 2013
-
Bentonite Pellets
#2 Medium Sand