GW1-2021-00950_Well Construction - GW1_20210203

\N ELL CONSTRUCIION RECORD F:mfowfu,,I .cnNI
",form can h:nxd far an k.—nx,llmk..ells
1.Well Contractor Information:
� 14.WATER ZONLS
Brian Ewing FROM�( 1 11) 11"RIPnOs
"-ell f r,emcu„N.vm fl. ft.
4240-B (1. ft.
N( "OlComrlaor(enrfN.nxn Nnnb<r 13.O1TER To
nuhieaxd we6l OR LIf1ER IYaaR4ahk1
mOM i TO b I 7HHKNFSS MtTTRI\I
SARDACCO Inc 0 ft. 12' (1. 1 1.5• ta. 1 NA Steel
I
ICINNERCASINGOR71rr_RING(j bl afelrne/4uoj)_
IRON TU DItminit TERk%F S F MkUM%l
2.Well CnnMtvatbn Permit a: NI0300399; 70002483
uFlipr 111— ( r. M1:u.r. 1' ,,.m. /fyHflO{.r —.
3.Well I w leheel(well aw): 17.li(1RQN --_-
W'aterSupph Well: - FROM I To 0lss¢Tr 111 sn1 TmcKvfs M\rrRnal.
I_14gls:nhmal I_IMwliaplf Tltbllz 12' h. ' 20' R. 1.5• NA NA Steel
I;Cn(Rhcmwl II12aungCa,blc;Slµ,ph I I IResidenllal X%rlo Slµ+ph Isingkl ff.
lndustred Commercial I IR csicicnlul Witer Supph Iskotd) It.GROUT
FROM TO T M\TERtm EMPLACEMENT MITMOD AAMOI-cT
❑hit^•ton (1. fl.
Non-Water Supply Well:
❑Nlonnonng ❑Roccom
Injectktn Well: ft. FL
-IAgndcr Rcch:uec ❑<imuld"ater Renedi:non u.iWRN:MVELPA(I► Y eaNel
A
IRIIN TII \NTf"Elul. CMn.CCFMf\T NITmIn
f7Atpnfcr Storage.lid R¢nscn ❑Safian Hamer R. R.
❑Aquifer TOM DSlnmmater Dr:dn7ec ft. IL —
❑EM,enmcnml lcchm,lon ❑Substdctec('omml
M DRILLING LOG(anach a11di1i�d s4e1s M acrosanl
❑G flffcmml(C'losel Lawpl ❑frica mom TO eE'WYTO\r..rr,s.,as,..,ai,ak nPr-vJ..w.wr.r
76cvtlKnlul lHcabne Cuuhne Reluml ®EXIKf feCLlm umieha.'l Remarksi 0 h, 20' R.
4.Data'W ell(%l CumldMNl: 1/13/21 Well ID,A26
fl. fl.
SA-Welt IAICAIIIIII: h. R. —
Remedia[ion Management Service Company It. ft.
F.K,bl.Oxrcr Nano Facdn. IDs uhleplcaDle+ 1
ft. ft.
2650 Shenandoah Ave., Charlotte, NC, 28205
Ph,,KA Wtim,s(in.:osi Tm 1 21.REMARKS
Mecklenburg 12710204 Temporary injection point through DPT tooling
Cowin Panel kknufn:.I.,o No O'O, ',..
Sh.Latitude and IangltRM in drgrarsfminutes/aeeonds or daritml dr¢nrs: 22 1erefeatkln:
❑f..d:I'dd ,,c lea hnn•n.Wll:u,d1
35.210533 N -80.801887 W Brian Ewing 1/27/2021
sr�mtum of Ccmfcd w'dl Gnrtvwrur fr�a
6.b1arr11hr"e1191: -Permanent or €Tempflran r r
If , I1 ..1 ',-2-1.,.r1lha,
7,Ls this a repair to in existing well: -11m or KNn
helm" .rr}rr 10 r.�i�n�rr ...ism .�i.nl.•rnw,. i.rr:.f. �,�i fLr.,.crn .,f:e
....,eo 02;,r,.+„�.e,,r.a.,. „�,no-nr:rc.n arh nine,_ 23.Site diagram or additional"ell drtails:
1cs1 man ow Ile bacl, of this page to pr%olc addnnmod..cll site details or nell
M.Numherld"ells constructed: 1 countwion drtails. 1'out nun also aftich addifiowl pa=5 it mwessen
/..,mr.lr,rd......,a.,r .,,:..� ..u.. v,. .rrr.•(Iq/ ""I.rite Ina fawm,remss
1,—. SL RSOTT'AL 1% TUITIONS
9.Taal well depth hrht" land wrfacc. 20 24a Fur All Wells: Imbnot Iht% foml "rlhm ar doss of conlpkvon of "ell
1nmubgrrr."0, ,ro....1, Im rvr ;,,ref':.nri1 :onsmletlon to the folhmint
lu.Static water Intl htluw top of casing: (ft•I IN,Won of M-ater Resoumm Information Pcoarssing 1 nit.
fr 1,"l r. d"•.r-„'-, — . 1617%1al Sm'ice f enter.Raleigh.VC 276941-1611
11.&mbeir diamncr.1.5 Ifm1 24b. For Inkrliun Wells ONIA: In addown 6,sending the form to tic;wkhas m
24a abo\e. also million a cop., of this loon mthin to dass of uumpldwn of wll
12.Well"inklMelion Imth,d: DRIVEN GoltilmCtmn to the follo"Ine
n c an,r,Iran.a,hlc.diao pug\m I
Dis iskln of Water Rmostomrs.Emlrrgnlund Injection Control Program.
FOR WATER SUPPLI U ELLS ONI.1': 1636 NlAil Smite Center.Raleigh.NC 216D9-1636
13a Yield Igloo) _. __ - __. ._ Iietitml of test: - 24c.For Water Soplds d Inj 1km%elh:
Al., submit eta cop\ n( this font ouhm 10 d'J1SJf CUIllpla'Iknl Uf
13b.Disinfection npr: Amwnt- "ell CnaWcrm S1 In the column health depanna nn lo of Ile cost "heir
- <unslnmlM
Form LN-I Sw+nh(anrluu lJSyanncnt rd frn,ronnnn nil�a,mlhex+wccs lh.n.•n e(Na41 Re*srlrm Ro ucJ\tg,d yr l+