414971_Well Construction - GW1_20130805

NON RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION #:
1. WELL CONTRACTOR:
D.T. Chalmers II
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) USTLCH1 120-MWO1
3. WELL USE (Check One Box): Monitoring IX] Municipal/Public ❑
Industrial/Commercial 0 Agricultural 0 Recovery 0 Injection 0
Irrigation 0 Other 0 (list use).
DATE DRILLED: July 2, 2013
4. WELL LOCATION:
(Street Name Numbers Community, Subdimsion, Lot No., Parcel, Zip Code)
CITY: Jacksonville COUNTY: Onslow
TOPOGRAPHIC / LAND SETTING (check appropriate box)
❑.Slope ID Valley ®Flat ❑Ridge ❑Other:
LATITUDE
LONGITUDE:
34.7259 DD
77.3375 DD
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 # Of applicable)
Street Address
Jacksonville
NC
City or Town
State Zip Code
Contact Name
Mailing Address
City or Town State Zip Code
Area code - Phone number
6. WELL. DETAILS:
a. TOTAL DEPTH: 17
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO EXI
c. WATER LEVEL Below Top of Casing: 3.85 FT.
(Use "+" if Above Top of Casing)
4 Arif'.1<
d. TOP OF CASING Ic 0.00 FT. Above Land Surface'
• Top of casing terminated atfor below land surface may require
e variance in accordance with 15A NCAC 2C.0118.
e. YIELD (gpm): WA METHOD OF TEST; N/A
f. DISINFECTION: Type WA Amount: N/A
g. WATER ZONES (depth):
Top
Top
Top
7. CASING:
Bottom
Bottom
Bottom
Top
Top
Top
Bottom
Bottom
Bottom
Thickness/
Depth Diameter Weight Material
Top 0 Bottom 7 Ft. 2 in. Sch. 40 PVC
Top Bottom Ft. in.
Top Bottom Ft. in.
8. GROUT:
Depth Material
Top Bottom Ft.
Top 0 Bottom 3 Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 7 Bottom -=-17=Ft--:=-4n`SIot-010in—P V??
Top Bottom Ft -' in. in.
Top Bottom Ft. in. in.
Method
10. SAND/GRAVEL PACK:
Depth Size Material
Top 5 Bottom 17 Ft. #2 Medium Torpedo Sand
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
cCr'r lfl tll' SEEM : ,f r.r•n
12. REMARKS:
ATTACHED
I DO HEREBY CERTIFY THAT THI
15A NCAC 2C, WELL CONSTRUCTION ST
RECORD y,AS BEEN PROVIDED TO THE WELL
WAS CONSTRUCTEDORDANCE WITH
S, AND THAT�e PY OF THIS
�• irk- //�
SIG TUR OF CERTIFIED CONTRACTOR
D.T. Chalmers II
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-1 b
Rev. 2/09

WELL
LOG
0.�'ATLIN
Engineers and Scientists
2130e4
Wilmington, NC SHEET 1 OF 1
PROJECTNO.: 213084
STATE: NC
COUNTY: Onslow
LOCATION: Jacksonville
PROJECT NAME:
LOGGED BY: Corey Futral
WELL ID:
DRILLER: D.T. Chalmers II
USTLCH1120-
NORTHING: 3845134
EASTING:
285973
CREW: Larry Wessell
MWO1
SYSTEM: UTM NAD83 (m)
BORING
LOCATION:
T.O.C. ELEV.: 31.6
DRILL MACHINE: CME-550
METHOD:
H.S.A.
0 HOUR DTW: 3.9
TOTAL DEPTH: 17.0
START DATE: 7/2/13
FINISH DATE:
7/2/13
24 HOUR DTW: N/A
WELL DEPTH: 17.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB
o
s
L SOIL AND ROCK
c DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 31.6
0.0
-
5.0 26.6
o.o
>
a
0
- w
em
3.0
4
-
5.0
-
3
3
3
4
0.0
..
W
(ML) - Med. brown w/drk. gray, SILT. Uniform.
Loose.
7.0 24.6
-
7.0
10.0
10.0 21.6
-
-
woh
woh
woh
woh
0:0
W
(ML) - S.A.A. Sandy SILT. V. Loose.
12.0 19.6
-
_ 0r)n
oa
_
_..
2 15.0
15.0 16.6
_ NN_::.
-
-woh
t 17.0
woh
woh
woh
0.0
Sat.
(ML) - S.A.A. Tr. clay throughout.
17.0 14.6
-
17.0
_
E 17.0
Boring Terminated at Elevation 14.6 ft
in Sandy SILT tr. clay throughout.
-
Bentonite Pellets
#2 Medium Sand