GW1-2021-01319_Well Construction - GW1_20210329

N ELL CONSTRUCTION RECORD
Lit I..,.».....Lc....I hi Sur,I,.,,,nn1I,I,,,It,
I.\\ell('unlrachlr Information:
Kevin White 14.WATER ZONES
FROM 11) OhCRl Pf illA
.cdl r,nmalo,v".I,, ft. ft.
2973 ft. fl.
S( .Adltb..uumr( ooli-no,I,Sumb,. 15.OUTER CASING for multisued wdb ORLINER ifa able
FRD\I 111 DI\MtJfER I'IIIr6SE55 \1\TERI aI.
Parratt-Wolff, Inc. m
I ,•n........ \,nn, 16.INNER CASING OR TIEING thermal elmed-lao
FRO\I TO DI\\IrTfR TIIoVH pti 11 ITFR1 11.
2.\\ell Construction Permit 11_ O fl. 39 ft. 2 Sch40 I PVC
,, . ✓pph,✓hl...dl p; m,,. .n.ru. ..✓r,. Ilv.en.. c._...n -r.,
0. ft. I in.
3. 1A ell 1'se(check well usch 17.SCREEN
\\ater SRpph'\A'ell: FRUV l0 I114\IETER slnTc21' TRlrl:\eSC
\encultural \tun,.,pal Puhl,: 39 F'' 41 ft' 2 in .010 SCh40 PVC
_sa h I -Rcudcnual AA attt Supph anglcl ft. ft.
(kuthcnnal Illeaonc(lu.Ln-• pp '
n.
-'.InJuunal Cornlnerc,al Ites,Jcnual\\ate, Suppl. shared, 18.GROUT
FROM II) 11%TERI:M. EMPI.\('ENECI MFTIME,& \MOI NT
0 h' 33 D. Portland Cem Tremie
Non-Water Supph Well:
\1...umnna -u..n.... 33 D. 36 h- Bentonite Chil Tremie
Injection Well: ft. a
_\yuu2r Rechar e _(iruund..utcr Rcnud,ato, 19.SAND/GR.AVEL PACK K aNe
FRO\I TO NI
11. E\IPE\('F\IE\TMETIIOII
-:Aym let 5 Storage and ltecu.en fJSul,nm Burner
36 f` 41 n- #1 Sand Tremie
_-:Ayu.lcr'fct p5hxm..ester Dr.unage
t. ft.
J.pcnmcntul Tcchnolugs CSuhs,Jcnce Cun.nd
2R DRILLING LOG attach DESCRI[TIONeb.,h,,dla
— if
GCU[hCn11a1Cu5ed l..upl _-17aCef IRfIN TO DFSCRIPf10\Imlar.M1urdnes swl.ockne ra.l
-Geothernal ll lean ne:C'nnh no RCILoa I ';Other(egllaul under xs-IRenmrkel ft. ft.
12/20/20 AS-15 ft. ft.
Date W'eRls1('umplrted: W rll Illq
fl. ft.
S..IN ell I ocalom: - -
fl. D.
Colonial Pipeline Company ft
Fa:Jrn o.. Fu:dn. ID=utapph,ablel
14511 Huntersville-Concord Road, Huntersville, NC 28078
I'G.acal Add.... (1n-and lip
SI.REMARKS
Mecklenburg No cover
. .. 11:ncrl ldcnnaa.nn..An PIA.
Sh.I.atitu Je and Longitude in degrees/minulesAcconds nr decimal degrees: 22 It er(ificalion:
It edl Grid on,[in one,.wtaanT
35.413028 N -80.804823 \ �� rv�L/1 j (y 21
Vr•,aWK.•I(c.;.rc.nAdu(bnnado, Ilan,
.
6. Is(are)the well(s): GPermanent or -Temporan .. .. l ...m. .n.mil.....
..,d, I it]..Ir u`, u]rru.,.I_+_t .. 1 .,_ nYm Ubll. me.,n„o.,n>,oudenh nud,Ome
'. Is this A repair to an rusting well: .71 es or ?,A n u ••r,lit,n.•..d h.,,nee..'monied h,do cell,,,.,",
.
II,Ar,n e rep.... /If/aa16-,na.rr a.//...........nit„m4mn..uo.....nd.•,hl.....Ihr neuu'e if 10e
.qs,,.....d.. 'I..,w.A.,. .............dm I ../dn,I.,.,o 23.Site diagram or additional well details:
Fuu mac use the hack or thu page to pru.ide additional .sell site details oI INCH
A.Number ofwells constructed: 1 Cunst,uauon drtu,ls 't ou Ira% also attach add uonnl puv_'as dnaac>San
1....ownpk.arc.n,......u.,,,-...u...aprn .../1'0%11 nlnb.come n,narua(i,.v. ,•.n..,11 SIBMITT VL INSTICTIONS
.anl,.,1 HI h.rr.,
9.Total well depth below land surface: 41 (ft.1 24a. For .III Wells: Suhmo Ih,, Ibrm wahm ;(I do,, or CompleDun oI well
I e.vnun,p/,a 11,Lv all J.p,In N,Lpen n,r r.w....1, n,'Ou euJ'u inn'. con5tQJLI on to the h HoW ne
11).Sm(ic eater Inel below tap of rasing: (ft.I Division of\laler Resources,Information Processing 1 ni(,
n a„rI.,d„„h.•.:,.,.,ne n„ 1617 Mail Senice Center.Raleigh,NC 27699-I(f
11.Borehole diameter: 2 (in.1 24h. For Inieelion Well s ONIA In add,uun to scndm=the limn w the address,n
8 1/4 HSA "Llabl.e 'Go suhm,t a Cur. of the thrm .solo. 3r da%s or completion of%oell
12.W ell coast,Action method: cunsln.clmn to the Iullu..me
a nn:n..u,hk.Au,.I pu.h.cm
Dicisiun Rf Water Resources,1 ndergmmnJ Injection Control Program.
FOR\\ VI LR S( PI'L1 NI I I S(1\1.1: 1636 Mail Senice Center.Raleigh.NC 27699-1636
13a.\-ield Igpnq Method of(es(: 24c. For Water Supph& Injection\\ells:
VI.,) >(IhmR unC COrx of thli Iural .Afirm of ill..Y.a Corfo Cut,l or
13h.Disinfection lope: Amnunlo ..ell amIfnoctlon to the counts health Jcpa,tnlcnl or the Counh .Nterr
con,ti wCd
L,nnr..AA-I AonL C...ol..u.Dq,..alll,lll It l uuumnnn, ,nJ A:a.ual R..nu.:�, D....cm n,of, ,,I R"i'a ,. Iia...ld Weu.I_N