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HomeMy WebLinkAboutGW1-2021-00326_Well Construction - GW1_20210312 WhL CONSTl2UC'TTON RECORD V\ F(olatc mrlUseONLY: Tbs foxy ort be gmd fa sick ormm[ift naens: \� i.Well Contractor tMarmiitiow Rich Lemire VROM- T D li+fitlx %!'WiCrait MCW Naxrte ft I ii. ft. ft. 2593A XCW41 Conixo dorCcoffir.niouNwnber ltFl = FROM TO .01AMrm TtRGKMM I MAMRIAL SAEDACCO Inc ft ft. le. Coatp,my Nam FR M Di %IEV'6R TMClCNM I MAnWAL 2.W41 ConlorlacdUn Permit# 0 0. 59' ft. 2" 11L SCH40 PVC fjo 014 oppadJmNe XV41 praxr ih t i t Canaty.S &r. Fnriamrr,Ir ecttor;�r.1 3,1Vtl.klsc(eMxk tvcll tx rej; ; �VaicrSunitlp roll: PR ry PIAMVV%ft x Y w'"JICKNIW MATMITA4 DAgdwIlural ohlualdpmwolic 59' tfi. 69' ft. 2° !� ` 010 SCH40 PVC i3Ckntbcmrol(HeatingCooling°;Supply) OResidenliai Water Supple(sin*) CTtndu tiallC mittetC+il1 MR4*ideutiat Wstcr Supph'(Sbamd) r..' r M , n. A OM TO MATBR[AG tPiAC�iTilTiliBfllOD# IOIISfi - t7hN 0 ft. 53, ft. PORTLAND TREMMIE Tion-WAter Sapplt Well: R. tt. MMWtoring ❑Rt�at to eci 011 d1: ft' fi MgUife r Rech0go t7GtouIW%Vtcf Ro diatiori [3AquifcrStovaSeLfM 13cCot ❑Salina Hank;` M to RrAt awt*r D 57 ft. 691 ft. SAND #2 0AgViferTest; C1Stoxitm tGrt3tttm ge ft. ft i]Saj►Cr MMial TvChnotcw DSobsi&-=Col#tol .MfG n► _ _. 13C"ftnlW(Closed Imp) 13TMM FROM To DFAMMON four,Horde *fvrMK eye R ) o s7' sILTY/S ansafi AND Ctzohe lttati ot Renn) nC1>r aitnndee21 671 ft. 69' $. Pi R 2-9-2021 DMW-1 4.hate'R`cT1(s)Cttiaipletetl: Ydett II1A Se.Wto tnCathtn: ft ft a RED OAR LANDFILL ft. it: Fecili r)M-wrNama Facility MNOrapptiratble} 3678-3288 State Rd 1524 Battleboro, NC 27809 Nash tt. ft; BATTLEBORO, NC, 27809 FloskniAddmmCithr:en zip NASH BENTONITE SET FROM 53' TO 571. C"a Idy Patecl tAeatttleaticrrNO;iPt t) 51%I stitOd+c-anti t.tin>ltsxdc In t p iatitRitCsl ondsrir dscimal dc�rt t �2>Ccrtif tinny of sr�it tistd prk Nad/tor�t1;SrdtltitAi 36.034663 77.895918 tY _ tG:ev.%t. 2/17/2021 Si r-of C:�. _-Welt C�rrm�ctar. .Qms 6.Is(ore) tt`e!i(s}: OPmuntat err a.ltmportr} rST`Sgi/t� ,,CD7kA'i� ••.+y!r�74r1t13`W�E�r-FSdS>fMAY�Ii'�J d'Gg1tP/lfFllMj elf�C*rD1' ff n=lth.1,3A NCAC flTC.pft1U er 1SA dt'CAC fP3C;tIc'AU1 it�pi C.curxrrtern SmnAt�rlr ead dartrt 7.Is this a reptir to on edstr well- L7Yes or MI No r�c>t'rai rnrurrt i�fls i�w pan&k�rn rAe mrtt.�rr�rrr. ij+hPa b e rr�rJr,,titt aar ri�n yule€+asva�eafan datJ'r�mvxrttan ram rr,�Nadrr rbC nr�n±ror�rhr rrna Ya�efrril2l rarnurdr a cliun arxm tprr lmr4 of tbtg firm 23.Site lititj;l'nor addiflonat wdi detalls: You may tise the back of ihfs page to pto%ift aM1J01W 44 site deM is#f Ott)! 8.NnntTfcr of tt ells eonsitTtcted 1 CMtrdodon detgtits. You ma}'also[[seed atiditianal p it nxesser�f. For mkirte in fev W or Rm•rr wo,jjpph vW1h lJhrl,Y 140 tam wMv conamr9m, *rem �arstemsoforru.. - '��r311�I?�"PdL-7'I11,�}tC'1"1'OTI� -. 9.Total►dt dgnb belms I*nd surfac 6 9' (t1,}' 24a tint It M-1s., S*Iwt this£ncin within-10 tia)`s of compWon of wen For vn bipk ww1r FriF 09*11*1 if df,Qirmr terrP tste J 2 mad 2,91 Y) Wnstntttion to ft f9llowing; 10.Stattc-isater 10-O l dOW tarp OfaM5111fs 8' {tit. Division d Water Resoui .tnfarntation Pre ng Qnli, lfwWwo,lewt is sbcvr einrtwjf ruse"+ 1617 hMab Service Ceater,Raleigh,NC 276"-1617 111,Wrehoic dlametcr:6" tin.) 24b.;Far fnhx;iia.n 4VCttc OPIt,Y: to addition to soling ihe_from to the cddrM in 249abmve.,also LMMjt a;copy of this-foam"bin ail dxv%of completion of moll: 12.VMTd1 oon4 mfioD mttbod.:MD ROTARY Camme-6n,to the fOUoudn& ti.c:a taeaty.raebta diaect pnsis,dc;l Dhision oR Witter R.cROorecsUntlergroundtfiJMlon COnfmiPn►grnm. FOR.irVATER SidPPLY°t!S'RLt,S ONLY: 1636 TMtat)Sen ice Center.RalcEg NC 27M1636 13a,1"it4ld(dim} Method of '24a.Porgy Water & rJotogb WOW Ato s0niit one cog of this form ttitiiin 3dl.daysof C0mpTdian of 3h.Disinfection,ite: Amount: well conamcdan to the cminy health depsoment of the toamts whoe Ccnssxni:icd Farns{:llr-t A?orthCmsiUnsFi mmtaf€rn mama tmaddlniucatita�omas-;i3h iennlWai it is RevisedAtCUA2013