GW1-2021-00630_Well Construction - GW1_20210331

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WELL CONSTRUCTION RECORD (GW-1) Fra Inlcrnul INeOnk
I.Not,ell('untractur Information:
Sean Cropsey C. d .INATER 7ANE5
Y ❑Rfl\I ID UES(RnT10N
tAell Cenna,mr.amc
2485-A
prluk 3 1 202, 65 In 85 ° Limestone sand layers
ri or.
s t'ss ill Conoazu,r('miGenu,sn�umbci lDfOrmotn❑ t'fO,�L-5"in( 'TER CASING farmulti-used wells OR LINER ifa 1'wable
Applied Resource Management, PC DIfdR sac^cn "°" "' """"'" ""("",. "AlF""`
it. ft. in.
('onipnm Vamc
W19-0306 h.INNk:RCASINGORTCRING eothermalclosed-tcap)
2.NN eR(011strllc lion Permit N: FROM 10 I)I\Nflf:R 11O(FNf:ss V.II f:NIdl.
�rl,,,,nl, l c¢ ( 0 It. 65 h. q Sch 40 PVC
3.NN ell I se(check\yell use): 85 ft. 100 ft. 4 In- SCh 40 1 PVC
AN ater Supph'Not ell: 17.SCREEN
FROM I to DOMI:TI:R SLOTSI/.I: THICKNESS NI,OLRILL
:A""Cultural E]MUnIcTal I'uhhc O R R. in.
(ieothernml(Ileating C unhne Suppls l 0 R61dCtlal 11 star Suppl) Itiln-alrl 65 H, 85 ft- 4 in
20 Sch 40 PVC
IndustnuUC'omntcrnal E]ResidentlalA1'mar Suppk(shared, 18.GROUT
Irrigation fA0>I 9T) \I AI f:RLU_ rNUTA('FNFVT NIfS"OI)&AMOUNT
Non-Water Suppl) Nell: O p, 2O fI' eentonile Chips Poured
k(oraoring EIRecotcn
Injection NN ell:
Agmrer Recharge E](imm,doatcr Rcnwdmtiou
19.SAND/GRAVEL PACK ifa linable
,1i t0 fer Storage and Rec,o en 13sallol6 ii trier fRO\I TO It FRI41 I1sort_I(Fltl\TNIF'llbil
-Aquifer Test �,Ctnrm ,er I)rolnaae 100 ft 601i 4
2 POUred
EcPerinlenml lechnoloec E)Suh.Ideace Control ft. ft.
Geothermal tCluscd 1.oopl OTmccr 20.DRILLING LOG Founch addid...I sheets if oecema
nFtif BIPTIrIN¢nlor,M1nrJnvss,wiI rock v e ,xin sue.roc)
Grolhermul ll lcatln eLuulme Rciuml M001CI lecploln under=21 Remarks FROM lfl 0 ti. 10 to clay
4.Date NNell(,)I ou pleted: 03/22/2021 NNeII ION 10 f'' 40 ft Rock clay layers
Sa.Nell Location: 50 to. 60 ft. Sand
Tracy Czajka 60 f' 85 f` Limestone sand layers (screened)
saln, F;iahl, 1D 85 f1. 100 1i' Clay & Fine sand
Shelter Creek Dr. ft. ft.
I'In,mel \ddreea.(lip.and lip to H.
Pender 3361-38-3569-0000 1 21.REMARKS
Lunn P.aml ldumilcaooaAo PlAI
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(it ,ell Iidd.On,tat/Iona is suRiaentl 22.Certification:
34 37 9 77 47 32 N .5'¢a� 03/29/2021
6. Is(are)the well(s),IOPermanent or 13 Fentporar) Slgnaonn,n nlfisd A1'0 (')an 6111, Dom
7.Is this a repair to an existing I+ell: Yes nr ©No �,N,� s 11 11"n n i /1. ,�y 0,0, n 11 u, -
UN , mpu. Il b,n, .. Vs, mv. J .r, s... , .1, 1i. , ..nnn.I
"' ....der,,/,. R son.„ 0-` .k.4,1 ,n„arc
23.Si le diagl am or addition al well details:
the some 1'ou mac a-c the back ai 11,is page to p rosldd addlti)nal odl site details or sell
8,For Geaprobe/UPT or Closed I Hop Geothermal NN has Ing p
construction.onl_c I GP-1 Is nstided Indicate IOLAI.N!'VIH6R Ot smlls wnetnrti n delta is Wui mas also'itrsh addl;lond I ae .if neeessan
drilled AL BNHTTA[.INS]RI,(TIONS
9.1 alal well depth below land surface: 100 (ft l 24a For All NV ells: Submit tills form ,,If.... 30 doss ar completion ul well
,"..... lour/l.lolelld"ah,ndnlnvua n...Is "I'l m,/_n lL(I'1
construction to the Iblloswne
10.Static ialer lexel below top of casing: 20 (IL) Division of\Water Resources,Information Processing I-nit,
It o,o,,,/:cal r,„b„r,-..nor¢.n , 1617 Nlail Set-,ice(enter,Raleigh,N('2-s699-1617
11.Borehole diatneter: 81 (in.) 24h. For Infection NN ells: In addltlon to send om the hone In the address m_4o
Mud Rota aDi te. also submit one cops of till., than euhoo .I d,os of n,mPletion (it'sscll
12.Nell construction method: ry .nn>I Hilo nn w the Inllosrm�
u 1 _ ,olan.cable.direct Pnxh u- I -
Dilieion of INater Resources.I nderground Injection Central Program.
FOR%A k I F,R S( PPL)-NN FI.I.S ONIA 1636 Mail Sen ice('enter.Raleigh,NC 2-699-1636
13a.)field(gran) Method at lest tic. Ior NN aier Still & Injectinn AN rill: In addrtom to ,endlne till Ill'In w
the addres(csl above. olu, suborn line copy or this porn ssnhnl 3u does or
13h.Disinfection hpe: Amount completion or well constnrtion to the counts health slepanment 01'the COWAN'
'Mere cunstrdncd.
I`olm(AN-1 N,soli(:m,lma Ucpa,olItt ul hm unomunal pu,dnc-Un won nl Al:eu R1-11 ace Ro,,,,d]--_Mlh