GW1-2021-06260_Well Construction - GW1_20211123

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WELL CONSTRUCTION RECORD(GW-1) For Internal Use Only:
1.Well Contractor Information:
D.T. Chalmers 14.WATER ZONES
FROM TO DESCRIPTION
Well Contractor Name
ft.
4146A ft.
fL ft. i
i
NC Well Contractor Certification Number 15.OUTER CASING for multi-cased wells OR LINER if a livable
CATLIN Engineers and Scientists FROM TO DIAMETER' THICKNESS MATERIAL
0.0 fL 5.0 ft. 6 i° Sch. 40 PVC
Company Name
16.'INNER CASING OR TUBING eothermal closed-loop)
2.Well Construction Permit#: N/A FROM TO DIAMETER THICKNESS MATERIAL
List all applicable well construction permits(i.e.UIC,County,State,Variance,etc.) ft. ft-
in.
3.Well Use(check well use): ft. ft. in.
JNon-Water
ater Supply Well: 17.SCREEN
PP Y FROM TO DIAMETER:, ISLOTSIZE THICKNESS MATERIAL
Agricultural [3Municipal/Public 5.0 ft. 25.0 ft. 6 1°'' slot o.olo Sch.40 PVC
Geothermal(Heating/Cooling Supply) Residential Water Supply(single) ft. ft. in.;
Industrial/Commercial 1J Residential Water Supply(shared) 18.GROUT
Irrigation FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
Supply well: 1.0 ft- 3.0 f`• Bentonite Surface Pour 1001b
Monitoring Recovery ft. ft.
jection Well: fL fLAquifer Recharge DJ Groundwater Remediation19.SAND/GRAVEL PACK if a livableAquifer Storage and Recovery Salinity Barrier FROM TO MATERIAL EMPLACEMENT METHOD
Aquifer Test I3Stormwater Drainage 3.0 ft• 25.0 ft• #2 Medium Sand Surface Pour
Experimental Technology Subsidence Control ft. ft.
i
Geothermal(Closed Loop) Tracer 20.DRILLING LOG attach additional sheets if necessary)
Geothermal(Heating/Cooling Return) Other(explain under#21 Remarks) FROM ft. ft.TO DESCRIPTION color,hardness,soil/rock type,grain size,etc.
4.Date Well(s)Completed:1 0/28/2021 Well ID#66PR1 33 ft. ft.
5a.Well Location: ft. ft.
MCAS Cherry Point N/A ft. ft -
Facility/Owner Name Facility ID#(if applicable) ft N6V 2 3 zo2l
Site 4075 System B, Cherry Point, NC fL ft
Physical Address,City,and Zip fL ft. INFORMATION
28533 rQ J, N/A 21.REMARKS
County Parcel Identification No.(PIN) Outer casing has an additional 2.0' stick up above land
surface.
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field,one lat/long is sufficient) 22.Certification:
428,874.643 N 2,630,930.634 E 11/02/2021
6.Is(are)the well(s) x Permanent or Temporary Signature of Certified Well Contractor Date
_ - - By signing this form,I hereby certify that the well(s)was(were)constructed in accordance _
7.Is this a repair to an existing well: 13Yes or J3No with 15A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a
If this is a repair,fill out known well construction information and explain the nature of the copy of this record has been provided to the well owner.
repair under#21 remarks section or an the back of this form.
23.Site diagram or additional well details:.
8.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same You may use the back of this page,to provide additional well site details or well
construction,only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells construction details. You may also attach additional pages if necessary.
drilled: SUBMITTAL INSTRUCTIONS
9.Total well depth below land surface: 25 (ft•) 24a. For All Wells: Submit this form within 30 days of completion of well
For multiple wells list all depths if dierent(example-3 tt,200'and 2 a 100') construction to the following:
10.Static water level below top of casing: 12 (ft.) 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: 1 1 (in.) 24b. For Infection Wells: In addition to sending the form to the address in 24a
6in H.S. Auger above,also submit one copy of this form within 30 days of completion of well
12.Well construction method: 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& Iniection'Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b.Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-1 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

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CATLIN
Engineers and ScientistWELL LOG s
zteo4t.os 1'8SHEET 1 OF 1
PROJECT NO.: 218041.06 STATE: NC COUNTY: CRAVEN LOCATION: MC AS, CHERRY POINT
PROJECT: 56GW07 AREA RECOVERY WELL LOGGED BY: O'DAYNES WELL ID:
INSTALLATION DRILLER: T CHALMERS 66PR133
NORTHING: 428875 1 EASTING: 2630931 CREW: &FOWLER
SYSTEM: NCSP NAD 83 USft BORING LOCATION: SITE 4075-SYSTEM B T.O.C.ELEV.:
DRILL MACHINE: Diedrich D-50 METHOD: H.S. AUGERS 0 HOUR DTW: 12.0 TOTAL DEPTH: 25.0
START DATE: 10/27/21 END DATE: 10/28/21 124 HOUR DTW: N/A WELL DEPTH: 25.0
BLOW COUNT OVA M L SOIL AND ROCK WELL
DEPTH LAB. I o
0.5n o.5n o.5n o.5ft (PPM) S c DEPTH DESCRIPTION DETAIL
0.0 LAND SURFACE 0.0
0.0 z (ML-SM)-Brown SANDY SILT 0.0
6 1.4 Sat. t'o �.o
10 9 (SP)-Orange Tan Fine to Medium SAND,Poorly
2.0 GradedQ.
0
to
7 0.7 Sat. s.o
3.5
4.0 (CL)-Gray Sandy CLAY
5 6
7 5.7 W s.o
6
6.0 6.5
7 5
(SP)-Tan to White to Gray Fine to MediumSAND,
6 3.7 Sat.4 Poory Graded w/Sandy CLAY interlayers at 8.5-9.0
8.0 and 12.0-12.5,Strong HCO from 10.0716.0
2 3
4 21.0 Sat.
5
10.0
3
4 4 629.3 M
7
12.0
2 s
6 156.8 Sat.
7
14.0 0;
2 oa
z 4 223 Sat. o a
s
16.0
3 3
6 20.3 Sat.
6
18.0
2
3 3 14.0 Sat.
5
20.0
1
z , 13.1 Sat.
3
22.0
2
5 12.8 Sat.
3
24.0 5 7
NM 16.7 Sat. 25.0 25.0 2s.0
25.0 BORING TERMINATED f.SAND.AT DEPTH 25.0 ft
Portland Cement Bentonite Pellets a#2 Medium Sand