GW1-2021-06618_Well Construction - GW1_20211007

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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. 1
FROM TO I DESCRIPTION'
Well Contractor Name 0 U
4146A \\Cj -�;at��� ft. e
NC Well Contractor Certification Number QrSiGe�;OR W< .WINNE2GASING�ORM)BiNG eothealal closed loo
\�`o��'J7kO\ S' FROM TO DIAMETER THICKNESS MATERIAL
CATLIN Engineers and Scientists 0 ft.1 5 rt. 1 Sch.40 1 PVC
Company Name #16 OiJTER'GA$ING'fo'r�ulii-*cas`edwdl...... fiNER f:a icable
FROM TO DIAMETER I THICKNESS I MATERIAL
2.Well Construction Permit#: N/A ft. ft. in.
List all applicable well permits(i.e.County,State, i/ariance,Injection,etc.)
ft. fl. in.
3.Well Use(check well use): &7TSGREEN
Water Supply Well: FROM TO I DIAMETER I SLOTSIZE t THICKNESS I MATERIAL
❑Agricultural ❑Municipal/Public 5 ft. 15 it. 1 in. Slot.010 I Sch.40 1 PVC
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) u. n. in.
❑Industrial/Commercial ❑Residential Water Supply(shared) W BSGROiJT
FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
❑Irrigation ft. a.
Non-Water Supply Well:
0 R. 0.5 n. Bent.Pellets Surface Pour
®Monitoring ❑Recovery
Injection Well: ft. fL
❑Aquifer Recharge O Groundwater Remediation f19:fS"AND1GRii�'Fd3fPAGK il"f.a icaMe
FROM TO MATERIAL EMPLACEMENTMMOD
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stornwater Drainage
❑Experimental Technology ❑Subsidence Control 0.5 ft-1 16 ft. Natural Backfill
COTDRftll!NGIIYW artscchVdaitional�h`e"eWif,necessa
❑Geothermal(Closed Loop) ❑Tracer FROM TO DESCRIPTION color,hardness soiVrock type,grain sine etc
❑Geothermal(Heating/Cooling Return) ❑Other(explain under#21 Remarks)
4.Date Well(s)Completed: 06/16/21 Well ID#: P4-TW19
n.e. S �O
Sa.Well Location: C
Facility/Owner Name Facility 1D#(if applicable) Ile V
ft.
MCAS CHERRY POINT,CHERRY POINT,NC 28533 O
Physical Address,City,and Zip
lZtjRE117A'RKS . §
CRAVEN
County Parcel Identification No.(PIN) r pv t'
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification:
(if well field,one lat/long is sufficient)
34.90829411 N -76.88932549 W 9/29/2021
Signature of Certified Well Contractor Date
6.Is(are)the well(s): ❑Permanent or 00 Temporary By signing this form,I hereby certi/b that the,rel/(s)was(were)constructed in accordance with
15A NC4C 02C.0100 or 15A NC4G 02C.0200 Well Consiniction 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 miner
if this is a repair,fill out known well construction information and explain the nature of
the repair tinder 921 remarks section or on the back of this/orm. 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 mulliple injection or non-wader supply wells ONLY with the saute construction,you SUBMITTAL INSTRUCTIONS
can submit one form.
9.Total well depth below land surface: 15 (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 cr 00'and 2@I00) construction to the following:
10.Static water level below top of casing: 9.54 (ft.) Division of Water Resources,information Processing Unit,
lfwater level is above casing,race"*" 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.e.auger,rotary,cable,direct prish,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
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CATLIN
Engineem and Scientists
WELL LOG 21a041.04 SHEET 1 OF 1
PROJECT NO.: 218041.04 STATE: NC COUNTY: CRAVEN LOCATION: CHERRY POINT
PROJECT: PIT 4 (72GW50) AREA-LNAPL LOGGED BY: J. WILSON WELL ID:
DELINEATION DRILLER: D.T. CHALMERS JR. P4-TW19
NORTHING: 4282811 EASTING: 2632737 CREW: C. FUTRAL
SYSTEM: NCSP NAD 83 USft BORING LOCATION: T.O.C.ELEV.: 22.78
DRILL MACHINE: Power Probe METHOD: DPT 0 HOUR OTW: NM TOTAL DEPTH: 16.0
START DATE: 6/16/21 END DATE: 6/16/21 124 HOUR DTW: 9.5 WELL DEPTH: 15.0
BLOW COUNT OVA o 0 SOIL AND ROCK WELL
DEPTH 0.5n 0.5n 0.5tt 0.5ft (PPM) LAB. s G DEPTH DESCRIPTION ELEVATION DETAIL
0.0 LAND SURFACE 22.8 0.0
0.0 ' TOPSOIL 0.0 0.5
Direct Push 0.0 D (CL)-Dark brown,Sandy CLAY _
U
2.0 a
o -
v
t -
Direct D U
Push 0.0
4.0
Direct 0.0 D 5.0 -
Push
5.5 17.3
6.0 (SP)-Gray,vf.SAND
Direct 11.0 Sat.
Push -
8.0
Direct Push 350 Sat.
-
o> -
oa -
10.0 B Q
�t -
= U
Direct Push 65 Sat.
12.0
Direct Push 6.8 Sat. -
14.0 -
EL
Direct 3.3 Sat. .
Push 15.0 _
16.0 16.0 6.8 16.0
BORING TERMINATED AT ELEVATION 6.8 ft in vf.to
f.SAND
1"PVC Well set to 15.0'BLS.
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Bentonite Pellets Native Backfill j
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