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Home My WebLink AboutGW1-2021-01647_Well Construction - GW1_20210429 WELL CONSTRUCTION RECORD For Internal Use ONLY This form can be used for single or multiple wells 1.Well Contractor Information: D.T. CHALMERS JR. SID F OWATERZOYOES DESCRIPTION Well Contractor Name 4146A NC Well Contractor Certification Number VnK 15.INNER CASING OR TUBING eothermal closed loo )MCess�n9 FROM TO DIAMETER TILftSS MATERIAL CATLIN Engineers and Scientiftt wasedlo 0rt. 1 a. 2 Sch.40 PVC Company Name 16.OUIER CASING for multi-cased wells OR LINER if applicable) FROM TO I DI.a.MIf II:R TIIICKNESS V\IERIAL 2.Well Construction Permit#: N/A (t. List all applicable well permits(i.e.County,State, Variance,Injection,etc.) ft. n. in. 3.Well Use(check well use): 17 SCREEN Water Supply Well: FROM TO DIAMETER SLOT SIZI KI\I ❑Agricultural ❑Municipal/Public 1 rt. 11 rt. 2 in. Slot 010 Sch. 40 PVC ❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) rt• ❑Industrial/Commercial ❑Residential Water Supply(shared) 1&GROUT _ FROV TO Al A 11_.MI EMPLACENIEM A11 MOD& VAA A-N I ❑Irrigation 0 ft. 0.2 a. Portland Cement Surface Pour Non-Water Supply Well: ®Monitoring ❑Recovery 0.2 rt. 0.5 ft. Bent.Pellets Surface Pour Injection Well: It. a. ❑Aquifer Recharge ❑Groundwater Remediation 19.SAND/GRAVEL PACK if a licable ❑Aquifer Storage and Recovery ❑Salinity Barrier FROM TO MATERIAL EMPLACEMENT METHOD ❑Aquifer Test ❑Stormwater Drainage 0.5 e. 12 X Medium Sand Torpedo Sa id ❑Experimental Technology ❑Subsidence Control m. rt. 2&DRQ LING LOG attach additional sheets if necessa ❑Geothermal(Closed Loop) ❑Tracer FROM TO DESCRIPTIM(color hardness.soil rock type,want size etc ❑Geothermal(Heating/Cooling Return) ❑Other(explain under#21 Remarks) 4.Date Well(s)Completed: 02/25/21 Well ID#: MW-01 m' (W 00 � - 5a.Well Location: rt _2O John and Joan Munden Knott's Island Facility/Owner Name Facility lD#(if applicable) � - rt. 129 SOUTH END RD,KNOTTS ISLAND,NC 27950 Physical Address,City,and Zip 21.REMARKS CURRITUCK _ County Parcel Identification No.(PIN) 5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification: 1 (if well field,one laOong is sufficient) 36.508415719 N -75.908403209 W 3/8/2021 Signature of Certified Well Contractor Date 6. Is(are)the well(s): O Permanent or ❑f enrporary By signing this form,1 hereby cerujy that the well(s)was(were)constructed in accordance with 15A NCAC 02C.0100 or 1 SA N(AC 02C.0200 Well Construction Standards and that a copy of 7.Is this a repair to an existing well: O Yes or ®No this record has been provided to the well owner. If this is a repair,fill out known well construction information and explain the nature of the repair under 421 remarks section or on the back ofthis form. 23.Site diagram or additional well details: You may use the back of this page to provide additional well site details or well 8.Number of wells constructed: 1 construction details. You may also attach additional pages if necessary. For multiple injection or non-water supply wells ONL Y with the same construction,you can submit oneform. SUBMITTAL INSTRUCTIONS 9.Total well depth below land surface: 11 (g,) 24a.For All Wells: Submit this form within 30 days of completion of well For multiple wells list all depths in different(example-3 a200'and 2@100) construction to the following: 10.Static water level below top of casing: 2.62 (ft.) Division of Water Resources,Information Processing Unit, #-water level is above casing,use"-" 1617 Mail Service Center,Raleigh,NC 27699-1617 11.Borehole diameter: 8•25 (in.) 24b.For Infection Wells ONLY: In addition to sending the form to the address in 24a above,also submit a copy of this form within 30 days of 12.Well construction method: HSA completion of well construction to the following: (i.e.auger,rotary,cable,direct push,etc.) Division of Water Resources,Underground Injection Control Program, FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center,Raleigh,NC 27699-1636 13a.Yield(gpm) Method of test: 24c.For Water Supply&Injection Wells: Also submit one copy of this form within 30 days of completion of well 13b.Disinfection type: Amount: construction to the county health department of the county where constructed. Adapted from Form GW-1 North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised 2-22-2016 WELL LOG CATLIN Engineers and Scientists zzozzs SHEET 1 OF 1 PROJECT NO.: 220225 STATE: NC I COUNTY: CURRITUCK LOCATION: KNOTTS ISLAND PROJECT: KNOTTS ISLAND LOGGED BY: COREY FUTRAL WELL ID: DRILLER: D.T. CHALMERS JR. MW-01 NORTHING: 1018203 1 FASTING: 2908684 CREW: TREVOR MIZELLE SYSTEM: NCSP NAD 83 USft BORING LOCATION: CORNER OF S.END RD.AND BURLANEY RD. T.O.C.ELEV.: DRILL MACHINE: CME-550 METHOD: HSA 0 HOUR DTW: 2.6 TOTAL DEPTH: 12.0 START DATE: 2/25/21 END DATE: 2/25/21 124 HOUR DTW: N/A WELL DEPTH: 11.0 DEPTH BLOW COUNT OVA LAB o o SOIL AND ROCK WELL 0.5ft 0.5n 0.5n 0.5tt �PPM) S G DEPTH DESCRIPTION DETAIL 0.0 LAND SURFACE _ oo_ 0.0 0 1 ASPHALT -- 0.oa 0.2 4 0.5 ' Mw 01 2.8 M (CH)-Gray with orange mottling,Sandy highly plastic 1.0 q 3 3 (1-2) CLAY V) (V J. 4.0 (SW)-Lt.gray to gray,F.SAND. Slight HCO at 5.0-7.0' BLS 5.0 z ' oa 3 s 2.7 Sat. o 11 ti t 10.0 10.0 (SC)-Dark gray to black,Clayey F.SAND. (MUCK) WOH ' z 2.5 Sat. 11.0 z 12.0 12.0 12.0 BORING TERMINATED AT DEPTH 12.0 ft EJPortland Cement Bentonite Pellets #2 Medium Sand 220 Old Dairy Road ATLIN Wilmington, NC 28405 (910) 45452-5861-5861 Engineers and Scientists www.CatlinUSA.com April 13, 2021 North Carolina Department of Environmental Quality Division of Water Quality Information Processing 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Re: North Carolina Construction Record Knott's Island 129 S. End Rd., Knott's Island, North Carolina CATLIN Project No.: 220225 To Whom it May Concern, CATLIN Engineers and Scientists (CATLIN) recently constructed one (1) monitoring well at the above referenced site. Attached to this letter are the completed North Carolina Well Construction Records with associate Attachments for the above referenced site in Knotts Island, North Carolina. If you have any questions or require additional information, please feel free to contact us at (910) 452-5861. Sincerely, Sean O'Neil, PE Project Manager Enclosures CATLIN Letterhead_ILM Well Construction record Boring Log ENVIRONMENTAL CIVIL GEOTECHNICAL Wilmington, NC i Raleigh, NC i Washington, NC i Atlanta, GA i Charleston. SC