GW1-2021-01694_Well Construction - GW1_20210329

WELL CONSTRUCTION RECORD(GW-1) For Internal Use Only:
L Well Contractor Inform.lion:
)OHNNY BURR I4.WATER ZONES
Well Coctm me Na PROM 10 DESCRIPTION
nrn
n. n
A - 3098 n. n
NC Well Cior.clar CedlRrarga Netiber Is.O1JfER CASING Poe malWue4 web OR LINER If ark
GEOLOGIC EXPLORATION FROM ro ...L. THICKNES MATERIAL
0.0 a 1 38.0 It 6.0 h` SCH 40 PVC
Compa.y New 16.INNER CASING OR TUBINGItemheamalrlwrd-
2.Well Constraclion PersalN: PROM TO DIAMETER THICKNESS I MATERIAL
l.nrMl at7dkale.ell nwsarvrnnn trmriu(r.(l/f.('turn,.9me form...rml O. n, la
3.Well Use(cheek well usi n. n in.
Water SR 17.SCREEN
PPN Well: FROM TO DIANIMIL-1 SLOTSIZE THW"ISS MATEMAL
❑Agncullural OMunlnpal public R n. +
OGcabermal(Heating/Cooling Supply) ORcudenbal Water Supply(single) fL fn In.
Olndustrial/Commercial ORaidenbal Water Supply(shared) M,GROUT
oirrigation OWells> 100.000 GPD rai I TO MATERIAL I EMPLACEMEMMUIRM&AMOUNT
Non-Water Supply Well: DO n• 38.0 R rclnwmamorm[ SLURRY
®Monitoring ❑Recovery n. It
Injection Well: n. ft.
Recharge OGroundwaler Remedistim
19.SANDJGRAVEL PACK Ua A
OAquifer Storage and Recovery OSalmnty Banner FRO.1 TO I MATERIAL EMPIACEMEM AIEfHOD
❑Aquifer Test OStunnwaler Drainage R
❑Experimental Techndogy OSubsldenc:Control n. IL
OGeothernlal(Closed loop) OTmcer 2EDRILLINGLOG atbehaddidowdsheahllmeesu
OGeothermal(Heating/Cooling Return) OOtber(explain under N21 Remarks) nand A DEscwImDN rw.r smd. wlvmehitqn,sent see,rw.
0.0 R' 6.0 rt ORANGE/RED SANDY CLAY
4.Date Well(s)Completed: 03/10/21 Well IDN BR-2 6.0 R• 38.0 R' GRAY PWR
4 Wtll Location: 38,0 R' 100.0 It GRAY ROCK
GENERAL ELECTRIC R' R'
f
FwWiy/Owam Name Facility iDl(ifagim6Y)
1223 FAIRGROVE CHURCH ROAD SE HICKORY 28602 A. It
Physical Address,City,and Zip n- IL
CATAWBA i 21.REMARKS r^ gUttit
Crxuoy Puce ldenrilicNMn No (7") OPEN HOLE II'11Or 3i,
f
5b.Latitude and loagilucit in degreesiminules/seconds or decimal degrees:
(ifweli field,aro karats is .flievmt) 22.Certification:
35042' 39.51" N 810 15' 32.34" W A4e 16A"a 03/18/21
6.lRsre)t1<weIbs): CPtrmucat or OTemporary Squinot ofCanif d Well Contractor Dior
By ngnrn Phisfwmthereby,wify rhrthe erll/s).ns(vere)rmun Od,n.,e Ase,.nlr
7.Is this a repair to an existing well: OYes or !9No /3AA'C'ACOH' G1Mur1MNCA('02kC.0200 Well Coeisvw,-.coa ,&and tlmtavAi
1/Phu u a rspoir,�ll.m anuxn.eft roronurrlon h�umouon mnl r+r✓vin the nomrr a/rhr ufrhu neorrl bar Deere yoride✓ao oche.ail ouar.
rrryrr wxkr 12l rrmwes srrnon w mr rhr hark uflhis fnnr.
y.Site diagram or additional well details:
8.For GeoproberDPT or Closed-Loop Geothermal Wells having the same You may use the back of this page to provide additional well construction info
conRruclion,only 1 GW-1 is needed. Indicate TOTAL NUMBER ofwells (add'Sm Ovef in Remarks Box) You may also attach additional pages dnecessary
drilled 24.SUBMITTAL INSTRUCTION'S
9.Total well depth below land surface: 100.0 (h)
Pb.mnhV✓e.vlLNiu W/JeMlur/',/�.em/rianrplr-S�2O0'oN l�f00) Submit ibis GW-Iwithin 30 days of well completion per the following:
13.0 24s. For All Wells: Original farm to Division of Water Resources (DWR).
10.Slade water level below top of<asillg: Ih) information Processing Unit,1617 MSC,Raleigh,NC 27699-1617
lfvorrr lerrh.ahmr rasenK u.e-.
11.Borehole diameter: 12-0/6.0/7.875 (In.) 246 For Injection WO :Copy to DWR,Underground Injection Control(IUC)
Program,1636 MSC,Raleigh,NC 27699-1636
I2.Well rnMtruction method: AUGER/AIR
24c.For Water Su I and O •-Loa Geothermal Return Wells:Copy to the
p c.ease.,many,cable.dues push.nc.7 county environmenla eat epanment o I county where installed
FOR N'ATER SUPPLY WELLS ONLY: 24d.For Water Wells roduriR over IDO Soo GPD: Copy to DWR,CCPCUA
Permit Program,I I akigh.NC 27699-1 k I
Uv.field(gpm) hl<Ihod of test:
l3b.Disinfection ype: Amount:
Fenn Gw'.1 Nonh4mlina Dr w wntofenvrrwulwnwl Quality-Divisionof Water Resoomcs Re...,166-2018