411941_Well Construction - GW1_20130304

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2480
1. WELL CONTRACTOR:
Lewis LeFever
Well Contractor (Individual) Name
Parratt-Wolff, Inc.
Well Contractor Company Name
501 Millstone Drive
Street Address
Hillsborough NC 27278
City or Town State . Zip Code
(919 ) 644-2814
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# WS0800931
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) WW-18
3. WELL USE (Check One Box) Monitoring 0 Municipal/Public ❑
Industrial/Commercial d Agricultural 0 Recovery 0 Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 1 /14-1 /17/13
4. WELL LOCATION:
3901 Castle Havne Road •:
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Wilminaton COUNTY New Hanove
. 1n 1
d. TOP OF CASING IS 2.0 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): 7.5 METHOD OF TEST Pump
f. DISINFECTION: Type N/A Amount
: g. WATER ZONES (depth):
Top 17.86
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑Valley iifFlat 0 Ridge ❑Other
LATITUDE 34 0 "DMS OR 34.32773736 DD
LONGITUDE 77 " DMS OR 77.92864322 DD
Latitude/longitude source: ❑GPS Vropographic 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.)
General Electric
Facility Name Facility ID# (if applicable)
3901 Castle Havne Road
Street Address
Castle Havne
City or Town
NC 28429
State Zip Code
Contact Name
Mailing Address
City or Town State Zip Code
( )
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 105.0'
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO Gi
c. WATER LEVEL Below Top of Casing: 17.86 FT.
(Use "+" if Above Top of Casing)
Top
Top
15A NCAC
• RECORD
SI
•
•
•
•
Bottom 105.0 Top Bottom.
Bottom Top Bottom
Bottom Top Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
: Top 0 Bottom 16.5 Ft. 12" Sch40 BIP
Top 0 Bottom 65.0 Ft. 6" Sch40 SS
Top Bottom Ft.
8. GROUT: Depth Material
: Top 0
Bottom 25.0 Ft. Portland
Method
Tremie
Top 25.0 Bottom 30.0 Ft. Bentonite Tremie
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 65.0 Bottom 105.0Ft. 6 in. .015 in. SS
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size
Top 30.0 Bottom. 105.0 Ft. #1
Top Bottom Ft.
Top Bottom. Ft.
Material
Sand
FEB252013
11. DRILLING LOG
Top Bottom FAQIR OW r c CTION
INFORMATION PROCESSING UNIT
4.0 / 8.0 Tan, wet, fine SAND; trace silt
12.0 / 16.0
20.0 / 24.0
/
58.0 / 60.0
84.0 / 86.0
: 12. REMARKS:
Sump installe
Gray, wet CLAY & SILT
Gray, wet, fine SAND; some silt
Gray, wet SILT: some fine/
coarse sand & gravel
Gray, wet SILT: some fine/
coarse sand & gravel
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
A BEEN PROVIDED TO THEW L OWNER.
01.1_ iodir
OF CER
Lewis LeFever
PRINTED NAME OF PERSON CONST
IED WELL CONTRACTOR
I ACTING THE WELL
El
DATE
AR 4 2013
Submit within 30 days of completion to: Division of Water Quality - Information Processin ':c'
Y p Y 9, r.� ,..
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]
Form GW-1 b.
Rev. 2/09

tg
0
z
Lai
—J
1 ....:
•4`.,,11:„., '4,„ , ,___ 4,,,,, i- .
,..., -
0
0
0
Lt-t.
0
cr:
o0
cc
Deff-KIXSZDIE
DdrEOXSLOM
DdrZOXSLOtt
van-0x= te
:sawygt
vsti 143nvisasoct 1W etazisat :034J.oict 81.3.-nrund a100a3-10101014 — 40000910 (54001.S141)SLIIL ,f3N3YO'd C107.67.4 %BAYS t urto,k, ...07P001t0tcw900drrr0mo9s09tt000chi00s00000e00ta40
.400,-100:..-moC0oho1 (WM. 5011045904 ttdokrt 1:1311,13S041:139 ovoma ,nolromito Am.Rsnovws 5053