GW1-2021-01269_Well Construction - GW1_20210209

WELL CONSTRUCTION RECORD L���
Fe lawrmi the ONLY.
71a fwe ii1 be sea for weak a aakpe arcwa \
1.VIA Carraclar Y6rusdm
Robert (tiller
wall camaco New a It
2675 R' L
NC Wen co molar Cend)olaw Naaaac
SARDACCO Inc 0 R 5' a 2• la, ecE-!0 PVC
(ogow Wet MA
L WON Ceuwwehm hrmh p: R Ir. t►
I"as aFp& W,wrlrprnaY.Ili.Ca .de.V.,wrr.b*Ksk t/A'.1
ti R. is
L W40 Um(cbwk wen Wink
warty S.ppy Well: FOOK To
OAgmvk W OMmLVd lAw 5' a 25' IL 2• hL 1 .010 1 SCR-40 PVC
OCaeollm"(Neatiw cooblR swply) OResdemol Wow&M*(Sw4k) IL a 4
Obdusum Comm"Cull ORaide•er Warr SWll(sherd)
ohmogm 0 K. 3' R. Portland pour
Ne►waler Sappty Well: ff. IL
m mtc
Injecdes Well: OL R
OAgd&r Redmge OGnRRdwaler Reeadie m
OAgm(er Slolage W ReCOVCn ❑ssumo Barm !' R. 25' IL Silica Send 20/30
❑Ago(er Tea OSmrm Ma Oraim¢ (L 6
OEWemscaW TccWwblp OSWmdmm Comml
OGeo&=W(Closed Loop) OTw 7O es
OGeodemd Rehm) Dods,1CM&MUeda#21 Remaks) 0 a 22' ti Tan Silt
22' K. 25- IL weathered rock
ADstewdU)Cempllad: 1-22-2021 well MoMl-1 ti IL
54.wen Lae stun. w. (L
Ernestine Property IL A.
Fwc11n A3aae,Nalot Fude)MN(if appkublel R. R.
6251 Deep River Road , Sanford, NC, 27330 1 IL
Plms al AdRelc Ca).W Zip
Lee One foot bantonits seal from 3- to 4'
(-ane) Paaxl lateerltewaa No IMN)
5k Laalmde and 1-am(flwde In dqp=Vmkm*eahwwb w delmd Iepect 2L Cerdrandow:
(d"CH hell ae balb'a ra/Rtwel
N wX 1/24/2021
DOC
L is(ale)Ire welksk mPesmrent er OTempwary
IN area,d.A++•e r 4rn►,.rra/.eYn Mr wG.!as Iwal neuuarNd Y aroNere
.vA r N NCAC 02C.0/d7 w 15A NCAC 02C 02W Wrp Caemvsaa leederN wd da a
7.4 No a rgWr m am esLtlwR well- w MNe ral6aJAu.eradkw 4rra PortlN a.d,wll o.w,
Hdu u a,rpeir,jW ar k.a.w rrH rovnxa wka•aRoa w/rglaw Ar welly nJW.
sell sdr,n_r,ee..A,sn..wa,eV kw4 of ee+Jwe �:.,',,'., � � �' 'y.sledhQamwadidarl weD/crab:
j You may owein the back of do page to ptwide addition wall ske details or well
A Nmrhwaf web mmmwend: 1 ,]'^_�.�^p{ �v 1, deWls. You may also roc►mMkk Al padm if mmeary.
Fw GaYab mtk Oca w aoa-wr,awM wM ONLY.wa dr aeetteesrmwl�U f� -\1l,Silill[1TAL
p,TaW wdl depV blow Iwwd awfa 251 fl+-j- Sin ► r AN We41e Sabmil krs fain wales 30 dns of m*kbm of well
/'w.wbwk w0.Ism dlMPas HJllbmo o awk-Je2W'wf 7e imn cid/Owmom to the(obwfall
all.Stack man lewd blow M of cmbm (ft) Dkkim*(Wow Reaemrce,howu atfen PrmelilR Unb,
H.aw,k l efwr,atl.e.r".- 1617 Mall Semite CeNw,Raldpik NC 2709-I617
11.0 dirmaa:S.25• (in.) 246.Par lefeedew WNh ONLY: In addmbn to amdmg the form is the adkem to
24s allo%s. din vAek a copy of Ibis four wkhim 30 dint of compidmw of well
ILWell eanamweWw mgb,& 4.25• RSA mmtractmw to the tdbwlw
lie aw.ale),emle dacct pink m)
Dhwm of Wow Reaartes,Uadermard bgwd w Camel►f"MR,
FOR WATRR SUPPLY WELLS ONLY: 16A Mal Savloe Cemw,RAdgb.NC 276W16M
t3a VkM Ippm) Mehad of say 24L Fe,Wow Sawwb•��
Also snI one cop of this fain wkW 30 days ofcomple in of
tab.gbbtwdm Mm -- Amwase— __---- well com ucum to the manR rt hea &Tmtmm of the cwmy wine
-Ipd
Faem OW-1 Nash Caokm Dgmmm of Ee mad W I Rmmm-Dnwwaof Waco Ramlras Re.wd Alplalao