GW1-2021-00826_Well Construction - GW1_20210215

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HELL CONSTRUCTION RECORD(Gw'-1) for Inmmal Ilse fnnle
I.\\ell(bnlntclor Information:
Brian James Bents 1-t.M_vTERZONES
FRO'l ill f1r51 RII'IIIIA
VA: -oun adrn A W tic
7.11 to >8.35 11. water table occurs around 7 ft below ground
NCWC 3510-A
n. D.
.� A'o H( 1. '10. IS.01 TER CASINGIfni mold-eased weld OR LIVER I ifs IicahIf
WithersRavenel, Inc. FROM to 011111HR IIIICR VITG ........
NA n. D. m
npui„ r.amc f{Ip 16.INNERCASING ORTCRI\Goeothermal claaed-lao
2,yy ell("onatruction Permit a: I A FRDAI Ip m{AI r-11 H I(Io hNLy, Al al FRI U_
'I n,,,,, 0.0 it 3.35 It- 2.0 '" Sch40 PVC
3.M ell I(cheek well uael: to. D. o
�\ 17.S('REE"N
afrr Snppk\Yell:
FROM 10 IAIMVTFR V11)TSVF ITII(S\E� AI ArER.AI_
\_''cull umt DUuniapal PUNIC 3.35 Fh B.0 1t' 2.0 "' O.D1 inch SCh 40 PVC
Gnvhannal 01canm_Go"In" Sapply 1 Diz-oaou,d AA,ace Swmv ("I'll", ft. ft. to
InduslnabCommcrc"d D RId c, cnnalAk At" Supple l shared) I&GROUT
lineation FROM TM MRF.RIAL F.MYLV LAT ENT\1 TO 101)& {MO1 NT
Nor-Wider Supply Wen: 0.0 0- 2.0 f6 Concrete Pour
X Mom0.xing �R ecovern ft. ft.
Injection Y1 el1:
D, ft.
Aymfer Recharge E)Gmundvvater Remedlauon
19.SAND/GRAVEL PACK ifimp
livable
\4adPr$R,mae and RtOn en [3.S'aII11RRarrlOr FROM TU \I UERL\I. E\IYIdfF_\LENT METHOD
dyulter Test 3Sn rroo atef wallinge 3,35 1', 8.0 16 Filter Sand Johnson Pre-Packed Screen
FNperimcmal I echnolo n [35uhsldcnce(onuol ft. O.
Geothermal(Closed l oop) 0Trocer 20.DRILLING LOG himach•ddid..l Eh.b ifneenu
FROM TO DEM RIPTION(color,bardnea..odro'krt a see.
(ienthennallHcanne.Cuolme Return) Other leyplam under d'_I Rcmarks)
- 0.0 IL 1.0 1', Crushed stone
4.Date Well(s)I ompleted: 2-4-21 Well ID9MW-1 1.0 f1' 8.35 a Brown fill sand underlain b
;a.Not Location: n, natural white fine to medium sand
Trenton Market 0-0-01259
Faalnc t ..n,i IT)=.I Lprpll.zblq
101 West Jones Street, Trenton 28585 ft. ft.
Phs,Iral Nddrass.Cory.and lip R. ft.
Jones 449822725200 21.REMARKS
C'rnall, Parecl Idenutleafinn S„ PIVI
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
lotodl field.ones lei tutu_:Is"LaTi entl Hificalion:
35.063644 N -77.353346 2-10-21
6.1,(are)the well(s)EX Permanem nr [3Tempurary Slm t - ,f(eadr,d 'dl t oeaor Dot,
�ly�, . tl I -l Ir I I ' ( I ll.) I dun e
7 Is this a repair to an existing well �l'es ur )',o yy I b 1v1 I( 011 nlou /,I \1 to ) r o nl lr ll ...o„a c 1 1,and d,me
till Ile r II...........v ( ( 1.rpbm drr6�ip/I►e1114 re.'orJln h rpr.rn4dt I •llnraer
rclnn under 21 rearcvk,.roenr or ,, or,h...'A ,/lh..h,rm C
23.Site diagram or additional well details:
R.For Geoprobe/DPf or Closed-Loop Geothermal N ells harm_^the same _ You wide use the hack of this pa_e to provide additional \\ell site details or well
construction anh_ I GY4-1 Is needed. Indicate TOTAL NClIRY.R d(Mcl% conotrllCtlon details 11m may aL:o attach additional pages It necess'an
dulled SL BNIITT U.INST RL('TIONS
9.Total well depth below land surface: 8.35 (ft) 24a. For all Wells: Submit this fnnn srdlun 30 dos of completion of\vcll
I ..roo11"'&-Jl.ln'I till 1""h, «rmnpk-P.i'nn'"ad'a M", construction to the Ibllawma
ILL Static water Ie\'el below lop of easing: 7'11 IfLI DlwlFlrin of water Resources,Information Processing I nit,
it whore a,..... u„ 1617 Mail Sens ice Center,Raleigh,N'('27699-1617
11.Borehole diameter: 3.0 (in.) 24b. Far Iniection%Nell,: In addition to sending the form to the address in 24a
Hand auger in UST excavation above:Ilse sDhmit one cop% of do,, G.rm within 'to dugs of colnplenDn of sell
12.N"ill construction method: cunt ucuon to the follo""m
c aug,r-mule" able.dimes pu,h.oc
Division of Water Resources.1-ndergrouold Injection Control Program,
FOR W.YTER St PPLY YN-ELLS ONIA 1636 Mail Sees ice Center,Raleigh,NC 27699-1636
13a.1 ield(gPm) NA ,Method of lest: NA 24c. Fire NN ater Supply'& Iniection\Fells In Acittmn In >cndmg the plan to
the address(es) aho.c also artim one cop, tit this loan vMthin 31) dos of
13b.Disinfection Is PC: NA lmounB NA coal of well construction to the count}' health depanmem of the county
\\)lore eoo'ti U'a,'d.
FwuGNA'-I Awith f.umina Dgrailnmm of l9mronnwn al l "'lo"-DL Ls......f R'etcr kroum,. Ncci,N 3-23-0Illo