GW1-2021-06624_Well Construction - GW1_20211007

WELL CONSTRUCTION RECORD For Internal Use ONLY.
This form can be used for single or multiple wells
1.Well Contractor Information: Q�
D.T. CHALMERS JR. FROM To I DESCRIPTION
Well Contractor Name
4146A e. e.
NC Well Contractor Certification Number process U - Q R,G, S1NG76R1TU$1NG' eai6ermal.clnsed too
�fi�0f1'3tlo0�� cl'!On FROM TO DIAMETER THICKNESS MATERIAL
CATLIN Engineers and Scientists n�NR Jew 0 ft. 5 a. 1 Sch.40 PVC
Company Name G6TOUTERGASING for"�m`ulti-ca wells OR1I$NER�iGa icatile
FROM I TO DIAMETER THICKNESS I MATERIAL
2.Well Construction Permit#: N/A
ft,I n. in.
List all applicable well permits(i.e.County,Stare, Variance,Injection etc)
ft. R. in.
3.Well Use(check well use):
10 iSGREEN
Water Supply Well: FROM I TO I DIAMETER I SLOT SIZE THICKNESS MATERIAL
❑Agricultural ❑Municipal/Public 5 n. 15 ft 1 in. Slot.010 Sch.40 PVC
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ft
❑Industrial/Commercial ❑Residential Water Supply(shared) �18YGRODT
FROM TO MATERIAL EMPLACEMENTMETHOD&AMOUNT
❑Irrigation
Non-Water Supply Well: ft.--TO
0 e. 0.5 n. Bent.Pellets Surface Pour
®Monitoring ❑Recovery
Injection Well: ft. ft.
❑Aquifer Recharge ❑Groundwater Remediation MWTSA"15DTCR�KT'fa ie b1'e
❑Aquifer Storage and Recovery ❑Salinity Barrier FROM To MATERIAL EMPLACEMENTMETHOD
❑Aquifer Test ❑Stormwater Drainage n. rt.
❑Experimental Technology ❑Subsidence Control 0.5 rt. 161,1 Natural Backfill
r2011)121171ING�LrOG ar tfachwdditionalshl�`eee fnecessa
❑Geothermal(Closed Loop) ❑Tracer FROM TO I DESCRIPTION color,hardn77 soil1rock type,wain size etc.
❑Geothermal(Heatin Coolin Return) ❑Other(explain under#21 Remarks) o. a.
4.Date Well(s)Completed: 06/16/21 Well ID#: P4-TW08 n. n.
ft. ft. S �O
5a.Well Location: �N
ft. R. � P
Facility/Owner Name Facility ID#(if applicable)
ft.
MCAS CHERRY POINT,CHERRY POINT,NC 28533
ft. ft.
Physical Address,City,and Zip
W-1?tREMTI21GS
CRAVEN
County Parcel Identification No.(PIN)
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification:
(if well field,one lat/long is sufficient)
34.90769454 N -76.88989856 W 9/29/2021
Signature ofCertified Well Contractor Date
6.Is(are)the well(s): ❑Permanent or O Temporary By signing this form,1 hereby certify that the well(s)was(were)constructed in accordance with
1 JA NCAC 02C.0100 or 1 JA NC A('02C.0200 Well Consiniction Standards and that a copy of
7.Is this a repair to an existing well: 0 Yes or ®NO this record has been provided to the well owner.
lfthis is a repair,fill out known well construction information and explain the nature of
the repair under 921 remarks section or on the back of this 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 ONLY with the same construction,you
can submit one form. SUBMITTAL INSTRUCTIONS
9.Total well depth below land surface: 15 (fit,) 24a.For All Wells: Submit this form within 30 days of completion of well
For multiple wells list all depths in differcm(example-3@200'and 2@100) construction to the following:
10.Static water level below top of casing: 12.2 (g,) Division of Water Resources,Information Processing Unit,
if water level is above casing,use"-" 1617 Mail Service Center,Raleigh,NC 27699-1617
11.Borehole diameter: 2 (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: DPT completion of well construction to the following:
i
(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&Infection Wells:
Also submit one copy of this form within 30 days of completion of well
13b.Disinfection Amount: construction to the county health department of the county where constructed.
type:
Adapted from Form GW-1 North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised 2-22-2016
i

CATLIN
Engineers and Scientists
WELL LOG 218041.04 SHEET 1 OF 1
PROJECT NO.: 218041.04 STATE: NC I COUNTY: CRAVEN LOCATION: CHERRY POINT
PROJECT: PIT 4 (72GW50) AREA-LNAPL LOGGED BY: S. tHASTEEN WELL ID:
DELINEATION DRILLER: D.T. CHALMERS JR. P4-TWO8
NORTHING: 428059 1 EASTING: 2632570 CREW: C. FUTRAL
SYSTEM: NCSP NAD 83 USft BORING LOCATION: T.O.C.ELEV.: 25.16
DRILL MACHINE: Power Probe METHOD: DPT 0 HOUR DTW: NM TOTAL DEPTH: 16.0
START DATE: 6/16/21 END DATE: 6/16/21 124 HOUR DTW: 12.2 WELL DEPTH: 15.0
BLOW COUNT OVA o o SOIL AND ROCK WELL
DEPTH 0.5ft 0.5ft 0.5ft 0.5ft (PPM) LAB. s G DEPTH DESCRIPTION ELEVATION DETAIL
0.0 LAND SURFACE' 25.2 0.0
0.0 ''' TOPSOIL 0'0 0.5
Direct Push 37.5 M 1.0 24.2 =
(SC)-Dark tan grading to dark gray and black,Clayey
SAND
2.0 _
Q.
Direct Push 47.4 M
4.0 4.0 21.2
(CL)-Gray,mod.plastic CLAY
Direct 24.6 M 5.0 20.2 5.0 =
Push
(SC)-Gray,Clayey SAND
6.0 6.0 19.2 -
(SP)-Gray,vf.to f.SAND with clay lenses
Direct 40.0 M
Push
8.0 8.0 17.2
HCO
Direct Push 382.4 M
of
oa
10.0
�t
U
Direct 263.2 W
Push
12.0 12.0 13.2 =
sheen and staining -
Direct Push 427.8 Sat.
14.0 =
Direct Push 595.1 Sat. 15.0 _
16.0 16.0 9.2 15.0
BORING TERMINATED AT ELEVATION 9.2 ft in vf.to
f.SAND with some clay lenses
1"PVC Well set to 15.0'BLS.
i
Bentonite Pellets F-1 Native Backfili
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