GW1-2021-00578_Well Construction - GW1_20210224

WELL CONSTRUCTION RECORD l„. lnlc,n,11 ;c uyI v
fhn tbrm can he mcd for anxlc".lnulnplc ucll,
I.\Yell('anIroctor In forms him:
Virgil Wilson 14.WATER ZONES
FROM Tll DLSCRIPEIUN
van r„nln,a.,,va,n, n. n. wet
4473 ft. "
\L'\\bll Cunuucini t'nuGcauon\aoil" 15.OUTER CASING far mold-rued weW ORLINER ifa ble
FRO\I T(1 DI\\IfTfR Till('E]F55 \I\TFaL\I.
Parratt-Wolff, Inc.
(-.�nryam \;uuc 16.INNER CASING ORTUENG11col6elow dorsal-loo
FROM TO DIINFTER Tlllc"E\FSti N\TFRI M.
2.N ell(onstructlun Permit 4: 0 f' 40.5 R 2 1 sch40 pvL
,..✓�,,TpLc,Is/'
ft. P. in.
3.\Yell 1-se(check well use): 17.SCREEN
\Y ater Suppls'\\'ell: FROM TO WIME.TFR )1 OT S1/1: ToRkNl:Sl Mlikkill_
\an.uhtodl =\lunlclpal I'uhllc 40.5 f' S0.5 f'' 2 ' .010 Sch40 pVC
lieothennal 0lcaune Coohne"upphl ClRcslJcnu,ll lYatcr Supph lanplc] t. ft. In
7lndustn;d(ar"o clal ❑ResiJenual\4'ater Supple tshdiedl I&GROUT
FROM TO M.\TFRIAI. EMPl \CFMESI'MFIOOD&xM01'ST
brleml 0 D' 36.5 ft- Portland Cent Tremie
Sun-\\'nice Supply\Yell:
7M..la,nne ❑Rccovm 36.5 0- 38.5 0- BentoniteChi Tremie
Injection Well: D. O.
-r\ywler Rcclsuee 7Gruund\caler Itco llun 19.SAND/GRAVEL PACK llo We
FPO\I To xnTFRIAL FMPI_\CEMENT METHOD
V udcr Storage-and e and Recoyen =:Sall m1y Bamcr
y 38.5 P. 50.5 P. #1 sand Tremie
=dgwlir Test -;Stnrmvwler Drainage
r. ft.
-1'\pcnmental Technolu_\ ❑Subsldenn Comnd
DRILLINGLOG aldeh ud CR .speed If Reerua
Ih_G20erltID (Closed LOU FROM
LJ pI Tracfr FPOM TO ESTJF DCRIPflO]Icalonkrdneas.sdUra<k Iv taco.
-_Gcotheroial(flcat1112/Coolln_Return) ❑Othertec lammldera2l Remarks) D. fr.
J.Irate ate N'ellls)('ompleted: R'ell 1D# P-33 D
5..Well Location:
Granville County p_
Fac1h¢On ncr Aa,nc Faolm 1[Y a t ipphcahlc
ft. fr.
6584 Landfill Road, Oxford, NC 27565 ft. f, r
Phs I"A \d,Lcss.Cm.and L1p 21.REMARKS 1
Granville
t loon Parcel ldCnnlitatmnAu IPlAI
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: 22 ( Ificabon:
Ili ,,It fidd le itI le , .1ic aal
36.370871 -78.619621 \\ }' �`I\ ��
6.Is(are)the welllsh 21'ermanent or ElTemporan
H, vg,un,¢rho Il.rn. [perch, .ur,p rbm,hr
nebII1 A, I, I'll' Oillb,vIZIA, A, 11Y' 01011I NI, on,vmanti ,✓nJwJ.nn.l rbme
7. Is this a repair to an existing well: -lFes or 'No n.,,nl he,neu,pn,c,Je✓cope,.,ill„..rm.
I'll,,,,,a..p.un till col Anuu u"Ill LI'lololl 11.111 upunne,um eml..phun d,e nwurc of,h,
Is .ur wnl., J.eon,.A, 23.Site diagram or additional xell details:
You may use the back of this pace to pro,ldc additional well site details of well
8. Number of wells constructed: 1 construction details }'uu ma, also attach additional pa_cs It neccssnn
1.. uJuplr„necr,....1), 1,11..111pp(1,err,mw.1'n uh Jm snmuuastrnetwir vw.an
,,,1,,,,,,. SLB\(ITT.\I.ISSTFCTIOSS
9.1 onod well depth below land surface: 50.5 (ft I 24a. For \II Wells: Submtit this tolm ...thin 30 d:ns of.ompletlon of well
I...nu,h,pl.udd,h,r till Jrprdvl d,pc.um,I...u,ple-Jhilu I unJ 4i I(... construction to the folluwmi'
III.Static water Ie"I below trip 11f r'A11ng: None (r't I Dnision of Water Resources,Information Processing 1 nil,
11 ,e,.-rlc,.J u.,h,,,c.f..,ne_o,e 1617 Mail Sen ire(enter,Raleigh.N('27699-1617
11.Borehole diameter: 2 (in.1 24b. For Iniection\\'ells ONIA In addrtlon to sc,rdtine the Inrm to the address ill
8 1�4 I"L�/� 4�� temp metal Casing2Ja dbo,c. also _Slhm1L a cops of(11" m u form thln 3n 1%, of cnnlpleuon of cell
12.\Yell construction method: construction to the toiloam_
o c au_ moan.cable J1nu push.tie
Ili,Won of Rater Resources.I-ndergruund Injection Control Program,
FOR W At FR SI-PPLY W ELLS ONLY: 1636 Mail Seelice(enter.Raleigh.N(C 27699-1636
13a.Yield(gpinl Method if.eel: 24c. For Wmer Supph& Injection\Yells:
Vso uhnln one cope or this holm oithm ill dmsot completion of
13b.Disinfection tips _ .Amount: _
yell coo lnlction to the count, health depdrtmmnt ul'the countv hetc
cultitl uJled
I..nn 0AA-1 Aonh Cl'ollna Ucpmmwnl otI u,u,n.m.nl and Aa,u,al Fcssnu ac.-D,.......o1 arcs R........ Ito..cd Auuusl"d l