GW1-2021-00576_Well Construction - GW1_20210224

WELL CONSTRUCTION RECORD I,,,ITIiell,al I „nvl v
I III,li+on aao b,a.cd H+I.lode I r nnlluple+vIII'
I.W Ill 1 Con l factor Infer ma lion:
Virgil Wilson ht.WATER ZONES
Fxoxl Tn pcccxtn ION
Vk III lAlnuaen,Aanic R. ft.
4473 ft. ft.
\t-\\ell(\mlralnr t'cnl Gcaunn\mnlwr 15.OUTER CASING for mRlbcaaed wens OR LINER ifa ti ale
rlO{i TO DHxIFTFft Till('RNF55 {I\TFftI{I.
Parratt-Wolff, Inc. ft.
nnpan. \anti. 16.INNER CASING OR TURIIVG 7o0e7zjdmelNaa
FROM Ttl r \NETFx TI... NENti MQERI\t.
2."ell Cnnstruction Permit a: 0 ft. P5 ft 2 rn I sch40 I pvC
.In,ppll.,Inle l„err pe.,Ir,L,. stale. rl,.Ial,...rI,I,,. :LI
x. n. I
3.Bell I se Ieheck well use): 17.SCREEN
IN tiler Supple TIN ell: FROM Ttl M%METER SL(ITSIZY: THI('ENFSS \I{l'ERI{I.
4en.ultural "_Nlunlclral Public 25 ft' 30 b. 2 ' .010 Sch40 PVC
-Gcothennal I I Icdtine C,rol ln_e Supph I -Ro,,dennalAl are, Supph Rlnsle) R' I ft. I
n.
-lndm,tn'al'Gnnmercwl CRcnJenualAC'etel Supph (shated) I&GROUT
iROM TO %IATERI U. ENPI-\('EMENT%ITTHOU A]MOI NT
_.Irnati°n 0 ft21 ft Portland CentTremie
Non-Rater Supph'M ell:
7Nlo mmnne _Recocan 21 ° 23 ft Bentonite Chi Trernie
Injection\\'ell: ft. n
-:%quit,,Rechar_ee G(immnd\\ute,Renicdlanon 19.SAND/GRAVEL PACK R 'aNe
mollTO M{TERHI. FMPI.\(F%1FNT{IFTHtm
AymferSmragc and Recacen ❑Saluutc Barrier
23 h 30 0- #1 sand Tremie
--4y oitcr Test ❑Slormaater Drulnag ft. ft.
-I'cpcnnuntal'I-cchnulo_\ ❑SuhslJcoce(ontrol
W.DRILWNG LOG fifiew►DF-St RHTIO%,bVnerusa
-(ieuthennal(Closed Lm+lv GTraeer FROM TO DrsexlPrulN i<aar.harettss.sat A.a t. - -n..ud
_Geothermal lllenmi�(winii Multi COther(ecplaia under=]I Rcoiarksl ft. ft.
ft. ft.
J.Dole R'ell(O Compleled: 2-2-21 R'ell IDa P-32
ft. ft.
Sa.R'ell Location: ft. ft. { O
Granville County
Ia.IIIII Oanel Aaloe I:rcI n 11l=1 11 tpph-lb del �)
f. H.
6584 Landfill Road, Oxford, NC 27565
Piic,ical 4ddrecx('n% and lip _
21.REMARKS \.
Granville
CnW,IA Pais Idcnuti.auun W II'A
5h.Latitude and Longitude in degrees/minules/seconds or decimal degrees: 22 ( rI fira Lion:
uI 1111 ida.one larinnc L..ulllacnu f
36.370445 N -78.618727 1J X, �e c
S
,u.m 'cmticd AAell('unuealor Uzm
6. Is(are)the well(sl: 'Permanent or DTemporar 11, , e Ito+llll,1 1 bosh, „rip Iha,the ndlnl .111 Ill 11,,I,,,,,,,.ma 111 a„ar,I,III
n lib'I Sty! AI y'rrY mew„ 1l I AI JI W, u'IFIIfM, ..u,o-u.aim amn✓anl„nil fume
7. is this a repair to an existing well: ❑Yes or ?No ,I,pl ,a din n.ard b,L+been prlll We✓la toes udll ul„ter
G rbn I. rpvin litho..hrc„III II,JI.on+Vlu IOJI IlgdrnromllI"I'd-plain Ft nururr o/Ibr
.I....ender 'I reme.R,lawn....on the ne,k n11h,,Inrnl. 23.Site diagram or additional well details:
You mac use the back of this page to provide additional \cell sue detulll,or\yell
S.Number ofwells constructed: 1 conslmcuon details Ywu mac also attach additional pages it necessan
I„r r.... rmleeuullurvnnl-.I,n,r mpph "Ill'ILW.) IIh Ihr some cunsnuninn. ''Ill wn
...b Ien.-,.trip SI-RNIITTIll.INSTII TIONS
9.Total well depth below land surface: 30 (ft.) 242. Far W Wells: Suhmm this (nm within 30 days of completion o1'well
l.u'mnluplr Iml6landl d✓p✓n"✓pima..luvellFill, I%d'llb noel_`u tail, UonitiUcWID to the tolloAHne
III.Static wale,les'el below top of('sslug: None (ft) Division of Water Resources.Information Processing I nil.
II r 1,-1 1I,eh.,,e,ml.... .... 1617 Nfail Serxice Center.Raleigh N('27699-1617
11.Borehole diameter 2 (in.) 24b. For Iniecfon Wells OMA: In addition to send,n,the livnn in the address In
8 1�4 HSA ' n
-Tuah, e. also .uhmm o a cope f a this loon vthln 3n da%s If conipleon n of well
12.Well construction method: constloction to the follown_
u c lu,it, aorl,cable.duea push.eta 1
Ilixision of W'aler Resources,lnderground Injection Cnnlrol Program,
FOR WATER SI-PPLN BELLS ONIA 1636 Nlail Sersice Center,Raleigh,Ill 27699-1636
13a.1 field lgp to Method of lest: 24c. Far%Haler Supph& Injection%tells:
1kn .uhrol line copv of this twin within 31, days wfcwnipleoon of
OFF.Disinfection h-pe: _ .%mount: "ell conAruction w the county health depunnient of the caunn \\here
coliglacted
I.nOI C.AA-I Sorill(ll-licI Ucpalilncnlnl l moonu0ni.mdA.eaodRcc.,,,-UIvIa000lA%.nu Rc.oumc. RcvucJAouam_rl-
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