GW1-2021-00660_Well Construction - GW1_20210203

WELL CONSTRUCTION RECORD(GW-1) For Internal Use Only:
1.Well Contractor Information:
VINCE FEDERLE u WATER ZONES
Well Contractor Name FROM TO DKSCFU"10N
ft. ft.
A - 3552
R ft
NC Well Connector Certification Number IS OUTER CASING for oddaLall
-eased wdb OR LINER d
GEOLOGIC EXPLORATION FROM fL TO fL DIAMETER' THICKNESS-MrMATERIAL
Compam Neme 16.INNER CASING OR TUBING thermal closed
2.Well Construction Permit#: FROM T . DIAMETER THICKNESS MATERIAL
Lis,all applicable»ell consrrucnan permit,(i.e.U/C,County,State,Variance,era.) Q.0 ft. 5.0 fL 1.0 '^' SCH 40 PVC
3.Well Use(check well use): R fe. fn.
Water Supply Well: 17.SCREEN
PPY FROM I TO I DIAMETER I SLOTSIZE I TNICKN FSS MATERIAL
Agricultural ❑MunicipaMblic 5.0 fL 15.0 fL 1.0 in' .010 SCH 40 PVC
OGeotherrial(Heating/Cooling Supply) ❑Residential Water Supply(single) rL R is
❑lndustnaUCommercial OResidential Water Supply(shared) IA GROUT
Olrrigation ❑Wells>100,ODOGPD FROM TO MATERIAL EMPLACEMENT MMOD&AM01'NI
Non-Water Supply Well: 0.0 fL 1.0 R MRTLAND e(NTONmE SLURRY
191vionitoring ❑Recovery R R
Injection Well:
fL R
❑Aquifer Recharge OGroundwater Remediation
19.SAND/GRAVEL PACK(ifam,Iicable
❑Aquifer Storage and Recovery ❑Salinity Barrier FROM TO MATERIAL EMPLACEMEWNIXTROD
❑Aquifer Test ❑Smnnwater Drainage 3.0 fL 15.0 fL 20-40 FINE SILICA SAND
❑Experimental Technology ❑Subsidence Control re. I ft
❑Geothermal(Closed Loop) OTracer 20.DRILLING LOG atach additional sheets if necessary)
❑Geothennal(Heating/Cooling Return) OOther(exlain under#21 Remarks) FROM To DESCRIPTIO.N(rolur.hvrdn,..miU.k e,nc.
0.0 IL 1.0 IL GRAVEL
4.Date Well(s)Completed: 01/07/21 Well 1D# PZ-3 1.0 f, 15.0 f, GRAY CLAYEY SAND
Sa.Well Location: R R
INTERNATIONAL PAPER f` f.
Facility/Owner Name Facility IDN(if applicable) ft. ft
1785 WEYERHAEUSER ROAD VANCEBORO 28586 ft. ft
Plryainl Address,City,and Zip
h. ft
CRAVEN 21.REMARKS
County Panel Identification No.(PM) BENTONITE SEAL- 1.0-3.0 FEET
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: "'PRE-PACK SCREEN••'
(if well field,one lat/long is sufficient) 22.Certification:
35e 13' 38.39" N 77e 06' 27.73" W 1/15/2021
6.Islam)the well(s): MPermaueat or OTempoe'ary Signature of Certified Well Contractor Date
p{ Bysigning this form,thereby cert�that the well(s)was(were)emseructed w accordance with
7.Is this a repair to an existing well: OYes or MNo ,.{ v (3 2021 15A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Consimcaw,Standards and that a copy
/(ibis m a repair,fill am known well comtruction information and er�JLAe mre ojthe ajlhia recotd/ws been prov/dad m the well tooter.
repair under-21 remarks section or on she back of this form.
23.Site diagram or additional well details:
8.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same You may use the back of this page to provide additional well construction info
construction,only I GW-I is needed. Indicate TOTAL NUMBER of wells (add'See Over in Remarks Box).You may also attach additional pages if necessary.
drilled. 24.SUBMITTAL INSTRUCTIONS
9.Total well depth below land surface: 15.0 (ft.)
Far multiple walk hitalldeptbstfdipirewtoemple-3®200'wid 2®10&) Submit this GW-1 within 30 days of well completion per the following:
7.0 24a. For AB Wells: Original form to Division of Water Resources (DWR),
10.Static water level below top of casing: (D-) Information Processing Unit,1617 MSC,Raleigh,NC 27699-1617
IJw.far level is above casing,use"1"
11.Borehole diameter: 8.0 (ill.) 24R For Injection Wells:Copy to DWR,Underground Injection Control(IUC)
AUGER Program,1636 MSC,Raleigh,NC 27699-1636
12.Well construction method: 24c.For Water Su I and O n-Lao Geothermal Return Wells:Copy to the
(i.e.auger,rotary,cable,direct pwh,eta.) CDlmty OnVlrppme0la th department o e County Where installed
FOR WATER SUPPLY WELLS ONLY: 24d.For Water Wells producing over 100,000 GPD: Copy to DWR,CCPCUA
13a.Yield(gP m) Method of test: Parrott Program, 1611 MSC,Raleigh,NC 27699-1611
13b.Disinfection type: Amount:
Fain GW-I North Carolina Department of Environmental Quality-Division of Water Resources Raised 6-6-2018

2M Savage Road SOIL BORING/MONITORING WELL ID:
® Engineering LLc Charle5lon.SC29407 PZ-03
a Member of The GEL Group,Inc. (843)1697378 Fax(e43)7697397
ENARMMWrAL I ENGINEERING I WRVEYNG a gelatin PAGE 1 OF 1
R.Marn solves PERMIT NO: PERMIT DATE:
CLIENT: International Paper-New Bern PROJECT NAME: Landfill monitoring
PROJECT NO.: Inpa00720 PROJECT LOCATION: International Paper-New Bern,NC
DATE STARTED: 1/7l2021 COMPLETED: 1/7/2021 BOREHOLE DIAMETER: &in.
DRILLER: Geologic Eaoploration CERT.NO.: INC CWDX3552 GROUND SURFACE ELEVATION:
DRILLING METHOD: DPT/HSA NORTHING: 539,107.14E
LOGGED BY: BPB APPROVED BY: GAD EASTING: 2,565,152.563
NOTES: TOC Elevation=4.30 GROUNDWATER LEVEL(24 hr): 1.80 feet from lop of casing
{� Z i:• n y $ o
c1
u o Tests j o Lithology Description Well Construction
n
o m La
5- w
0 Sandy Clay:Black,damp,20% 0
• medium,20%fine sandm 50% Grout
Gay
0.3 CL
Bentonite
1'diem.PVC
Gravelly Sand:Gray,40%coarse,
GP 40%medium sand,20%clay
�.
Sandy Sift:Dark gray,wet to
_ saturated,wood from 4-5'and 3'
5 at 9',20%medium,20%fine
sand -5
NIL _
Sand Pack
10 _ _ _10 V Diam.Slotted
PVC Sawn
Sand. Gray.75%medium and C
e e a 25%fne sand
Sp iii•
i i i•
15 iii• -15 ; ;