GW1-2021-06625_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: ��
D.T. CHALMERS, JR. � j�% �FacwATERZO To
FROM TO DESCRIPTION
� I
Well Contractor Name O ^ TR ft. ft.
4146A �C� / vltl$ rt. rt. I
NC Well Contractor Certification Number �1C+G I�15:dI1•TNER°rG1$tNG:OR�i1`.UBINGY eothermalrclosedlloo
�OtV,310� ���L!0(\ FROM TO DIAMETER THICKNESS MATERIAL
CATLIN Engineers and Scientists' 0% 0 ft. 5 ft. 1 SCh.40 PVC
Company Name fi6rOlTCERTCA'SmG'fo mulTi-c'a�wells Olth7INEB f.a icatile
FROM TO DIAMETER THICKNESS MATERIAL
2.Well Construction Permit#: N/A in.
List all applicable well permits(i.e.County,State, variance,Injection,etc.) rt. rt.
ft. ft. in.
3.Well Use(check well use): tSCREFN
Water Supply Well: FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
❑Agricultural ❑Municipal/Public 5 ft. 15 rL 1 +.. S
lot010Sch.40 PVC
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ft. ft.
❑Industrial/Commercial ❑Residential Water Supply(shared) M8XGIC0
FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
❑Irrigation
rt. rc
Non-Water Supply Well:
®Monitoring ❑Recovery 0 ft. 0.5 n. Bent.Pellets Surface Pour
Injection Well: ft. ft.
❑Aquifer Recharge ❑Groundwater Remediation f108AlvIi/GRA'"`VEl] At;K [a IicaMe
❑Aquifer Storage and Recovery ❑Salinity Barrier FROM TO I MATERIAL. I EMPLACEMENT METHOD
❑Aquifer Test ❑Stormwater Drainage R. R.
❑Experimental Technology ❑Subsidence Control
0.5 ft. 16 ft. ; Natural Backfill
3203D RA..GTtG.atfla'hradditiSnafth"ee'Wif necessa rvl
❑Geothermal(Closed Loop) ❑Tracer FROM TO I DESCRIPTION color,hardness soilfrock type,grain sis etc.
❑Geothermal(Heating/Cooling Return) ❑Other(explain under#21 Remarks)
4.Date Well(s)Completed: 06/16/21 Well ID#: P4-TWO9 ft. fL
5a.Well Location: N�
Facility/Owner Name Facility[D#(if applicable)
ft.
MCAS CHERRY POINT,CHERRY POINT,NC 28533
Physical Address,City,and Zip
CRAVEN
County Parcel Identification No.(PIN)
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification:
(if well field,one]at/long is sufficient)
34.90778312 N -76.8899135 W 9/29/2021
Signature of Certified Well Contractor Date
6.Is(are)the well(s): ❑Permanent or ®Temporary Bysigning this farm,l hereby certify that the weals)was(were)constructed in accordance with
15A NCAC 02C.0100 or 15A NCAC'02C.0200 Well Construction Standards and that a copy of
7.Is this a repair to an existing well: ❑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 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 SUBMITTAL INSTRUCTIONS
can submit one form.
9.Total well depth below land surface: 15 (ft.) 24a.For All Wells: Submit this form within 30 days of completion of well
For multiple wells Its/all depths in dr(ferent(example-3@200'and 2@100) construction to the following:
10.Static water level below top of casing: NM (ft.) Division of Water Resources,Information Processing Unit,
Ifwater 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 ofwell 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&Infection 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-I North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised 2-22-2016
f

WELL LOG CATLIN
Engineers and Scientists
ztaoat.oa SHEET 1 OF 1
PROJECT NO.: 218041.04 STATE: NC COUNTY: CRAVEN LOCATION: CHERRY POINT
PROJECT: PIT 4 (72GW50) AREA-LNAPL LOGGED BY: S. C,HASTEEN WELL ID:
DELINEATION DRILLER: D.T. CHALMERS JR. P4-TW09
NORTHING: 4280911 EASTING: 2632565 CREW: C. FUTRAL
SYSTEM: NCSP NAD 83 USft BORING LOCATION: T.O.C.ELEV.: 24.82
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: Dry WELL DEPTH: 15.0
DEPTH BLOW COUNT OVA LAB o o SOIL AND ROCK WELL
0.5ft 0.5ft 0.5ft 0.5ft (PPM) s G DEPTH DESCRIPTION ELEVATION DETAIL
0.0 LAND SURFACE 24.8 0.0
0.0 TOPSOIL 0.0
0.5
Direct Push 51.5 M I 1.0 23.8
(SC)-Dark tan grading to dark gray and black,Clayey
SAND
2.0
v
Direct Push 26.2 M n
4.0 a.o 20.8
(CL)-Gray,mod.plastic CLAY
Direct M 5.0 19.8 5.0
Push 60.8
(SC)-Gray,Clayey SAND
6.0 6.0 18.8 _
(SP)-Gray,vf.to f.SAND with day lenses
Direct Push 102.8 M
8.0 8.0 16.8
8.1 (SP)-Light gray grading to gray,vf.to f.SAND 16.8
Direct with HCO
Push 933.0 M
of
oa -
El
10.0 '6 Q
U
Direct 553.4 W
Push
12.0 -
Direct
Push 561.5 Sat.
14.0 -
Direct Push 274.4 Sat. 15.0
16.0 16.0 8.8 16.0
BORING TERMINATED AT ELEVATION 8.8 ft in vf.to
f.SAND with some clay lenses
1"PVC Well set to 15.0'BLS.
1
Bentonite Pellets Native Backfill
l