GW1-2021-00696_Well Construction - GW1_20210203

N ELF. rCONgTRCC I]ON RECORD
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I.Nell('ant rzeb,r InLmnxum:
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Brian Baling 1N0M 10 n!RIYII(1\
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SAEDACCO Inc 0 D. 11- FI. 1.5" le. NA Steel
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FROM 1O 1.111IFitN 11111(bVFv, MUIRIM
2.\\'ell('u.,t,Mcn.,n Permit R: WI0300399; 70002483 IF.
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_ 17.5('REEN
Nxcr Suppl, Nl•II: FROM .. TO m\.671R It OF Mlt nul Ay.. IMIN111
IA¢1l:uhwal IIM1gIniuF,d Nlhla 11' b. 19' fl. 1.5" ,n NA NA Steel
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➢ilI..q i.d(rnuncr,r,d qi pick n[nl\Ce.r Suppl, nlml d., 19.GROFT __
FR(1_M_ F0 _ \I_U_F_RI\I _ PMrI._M PMF\T M f 11101)A %%I0[_%_I__
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Non Naler Supply Ncll: - --
fl. ft.
:llnnuenue ::1Rxm;n .
Injection Mdk D. ft. '~
Aquifer Rechafitc : I(iR1I1IA1I.eer ltenmAl:nloR 19.SAND,G;A 1:1-PA('K elf aplAwahile
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C,F\Tsmuened lechncloet ClSuhnAcrti_c flnaml
20.DRI1.11NC L(/G UItx4 addilinnel sbrtls A wrayn l
laothemnl lC[used L(x,P) ❑Irice[ raoM To d nrGr Ft[rn01-6r,F,rv".....•Iu,.xl
=lhotllemul r l leatlllr(oolnc kdunu 71 h1wr le\plam uWcr e.I keniarA,1 0 11. 19, ft. _ - -
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4.1/41 e,\ell 1sl Completed: 1/12/21 Nell IDFA7_ _
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Remediation Management Service Company ❑. ft.
Ft.M, (h,.,,Van, Fap4n ID=nl.hdrnhh• +
ft. It.
2650 Shenandoah Ave., Ciarlotte, NC, 28205 ft Ft
21.RLMARKN
Mecklenburg 12710204 Temporary injection ooint. through DPT tooling
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35.210533 \ .-80.801887 ,\ Brian Ewing 1/27/2021
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1%this a repair to An C%ktin¢.dl: '\.r nr
. .. :!,Sitr JiA¢ram nr Additional well drlads:
!sm m:n us, Ilk'ba.4 of this TNIcc I.' pro..de:iddm.,ual well snc drl.uls ,, tt ell
X.SRmher of wells nlnstnrctrdc 1 :cyst noel l on Jel:u ls. It ou it I.., a1, 1tiacb'iddla nal V..tds d Ill t,
. . + ., SLIINILHALINSTI'('IIONS
9.Total well depth bell IAnd surface: _ 19 111.1 24A. For All \\ells: 4lhnnl thl, It m. ath,1 :II Li%. of SnIF'I:m.nl of .tell
t •, ..I.",,I, :.,I . „ , a,, ,I ,"• _ cons[mzl mo m I he lot lo.,Ino
In.SlAtic wAler Iesel below tul,of carin.: I]l.l Dkioui of Il Ater Resoun'es,InfolTluhon I'mcessing 1 nit.
11.Bon huh•Aimnrlrr.l 5" tin.[ 2J6. Fur h iscliun NrlIs ONIA: ,.Oda lu it to srl xhne it,loon 11'11'c nddll�,it,
ua alxn r. .da, snbn•h a n'pt of lto> Inuu .l illun d:os of .ougdcuuo of well
12.Nell om M1lrfiun nlelhnd: DRIVEN ;omlmannl to Ile lollownn:
Dis hiun of\1 Ah•r NrMw n'rs.I ndrrgnnnul Injrdinn Cimino[Pmo-nnl,
FORM %TFR Sl PPI\ ,\FL1 c OSI \: 1636 NfAil Smice('enter,Raleit:b,\( 276m) I6N,
13a.\idd(L'RIIII \frthoA of I'm 2U.For Nater Supph X Injectln Nell,-
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13b.DiAnfection hlie: Amllunl: t\cN couvni:unn In [be couul\ Iwallh dep,mncul of the xunn ul'cra
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