GW1-2021-07496_Well Construction - GW1_20211116

PrinE; toirt
WELL CONSTRUCTION RECORD(GW-1) For Internal Use only:
1.Well Contractor Information:
Justin Marlowe I wATUZOMM
WeltCoetra"Nemc FROM I TO Col
R. R
4452-A
IL
NE Well Contractor Certification Nmnber IS.OUTER CASING fir mufti-tend wells)08 L NZR a
SBME,Inc. FROM .9TAMaTsre MCKNISS MATERIAL
ft, Fir. d.
Company Name
LWen Construction PermR .Not applicable VROM To�t9VNBdtCAS>rIGORr]nIAM nEk eottter I IMCKNESS MATOOAL
Ust all applkabk"wil WrldaNedox penvdir('Le WG Comt►y,gate,Variance,etc.) 0 ft. 25 2 . is t�Ow.1- PVC
3.Well Use(cheek weD on): M IL Is,
w*rw Sappy well: 17.
PROM I 7'O - tNAME78i GTE TpICKNBSti.� MATERIAL
Agricultural QMtmicipalIPublic 25 (L 35 ft. 2A � VA10 Sch.40 PM
Geothermal(Heahng/Coohng Supply) 01tesidential water Supply(single) IL ft,
hulustrial/Commercia► QResfdentiat water Supply(.hared) IL GROUT
hT1 atiOD FROM TO MATERIAL F.Mn ACEMENT METHOD h AMOUNT
Nw-WsW Supply Well: 0 R• 17.1 ft-. neat oemant T4rW@ pipe;-42
M�itoring Recovery, n rL
Injection Well: .
n. IL
Aquifer RechargeGroundwater Remediatiaa It SAIeDIGRAvIt,! C1[ k
Aquifer Storage and Recovery QSalmity Barrier FROM TO MA ]EMPLACEMENT METHOD
Aquifer Test DSwnn mta Drainage 22 IL PT IL R2tdtersand PM
Experimental Technology DSubsidme Control tL IL
Geothermal(Closed Loop) QTracer 2a DRUAMG Lac attach additional sheets trnecessa
FROM TO DESCRIPIION�eaor YMwta pa/nek ate
Geothermal eatin lira Rehm Mother lain #2l Items" FROM
R 10 R {dish-brown.tight brown,Ma staid with slit
4.Date Weu(s)Completed: !!/5/2021 We111D0 CLF21-13R 10 % is Reddish-brown,fine, sand
So.Wen Location: tit ft' 35 R Reddish-bromIn,fine sandy silt
Duke Energy Not Applicable iL ft
Facility/Owner Name Facility W#(f appllable) ft. ft.
8320 E NC 150 Hwy.,Terrell,North Carolina 28682 rL (L
rbysial Addms,City,and zip ft• ft•
Catawba 461803426350 �,21.REMARKS
County FIN)Identification No.(PIN)
W Latitude and longitude in degreWminntes/seconds or decimal degrees:
(if well field,one kttiong is sutTuient) 22.Ce]d8eatlon: Ir f i:G I JON
35.619019 N -80.976044 W %, O%770NPR0CE INS UNl7
41 a,
6.h(are)the well(s)MPermanent or OTemporary ='Ir*g
ofCertified well Contractor Dat
this form,l hereby ceWfy that the"well(s)was(were)consoucted in accordance
7.1s this o repair to an existing wen: ,13Yei or DINO wUh 15A NCAC 02C.0100 or 1SA NCAC 02C.o2o0 Wea Consnuetlnn Standards and that a
ljthir&a repair.ftAout k~well consmwflan Injar"tdtlae and eaplaln the nature of the ropy ojthis record has beer;provided to the noel!oxner.
repair vitder 1111 remarks secdon or on rhebgek ojthts form. 23.Site diagram or additional well detail:
L For Geoprobe/DPT or Qosed-Loop Geothermal Wells having the same You may use the back of this page to provide additional well site details or well
construction,only I GW i is needed. indicate TOTAL NUMBER of well construction details. You may also attach additional pages if necessary.
dritlod:VA SUBMITTAL INSTRUCT[ONS
!.Total well depth below laud surface: 35.3 00 24s.For All yens: Submit this form within 30 days of completion of well
For—hiple-Vs list all depths(('d{fjerent(example-3(y200'and 2@100) construction to the following:
10.Static water level below top of easing: 17 Division of Water Resour
ces,Information I'mcessing Unit,
Iji"oterlewel to above casing use"+" 1617 Mail Service tenter,Raleigh,NC 276".1617
II.Borehole diameter: 7.5 (in.) 24b.For Weedon Wens: In addition to sending the form to the address in 24.
3.25"Hollow Stem Augers above,also submit one copy of this form within 36 days of completion of well
IL Well construction method: construction to the following:
(i.e.auger,rotary,ablle,.dQect Push,etc.)
Division of Water Resotr ves,Underground[glection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Men Service Center,Raleigh,NC 276"-1636
13a.Yield(gpm) Method of test: 24c.For We Supply A Injection Wells: In addition to sending the form to
the addresses) above, also submit one copy of this form within 30 days of
Dab.Disinfection type: Amount: completion of well construction to'the county health department of the county
where constructed.
Form OW-1 Worth Carolina Depanniod of Environmental Quality-Division of Water Resomoes Revised 2 22-2016

PROJECT: Marshall Steam Station CLF21-13R Well Installation
Terrell,North Carolina BORING LOG: CLF21-13R
212013,Ph.101
DATE STARTED: 11/4/21 DATE FINISHED: 11/4121
NOTES: No SPT sampling performed,
soil lithology logged from cuttings.
CLF21-13R installed on 11/4/21 -see
Observation Well Construction Diagram
SAMPLING METHOD: 3%"H.S.A. PERFORMED BY: J.Marlowe/SBME attached.
WATER LEVEL: 17.12'bgs on 11/5/2021(after well development)
U O
We <o MATERIAL DESCRIPTION w a w
o= w--
w
SANDY SILT(ML)-soft,reddish brown tan,fine,dry,some non-plastic fines,micaceous,dry; 835.
1 832.
834.
833.
4
831.
830.
829.
7,:
828.
827.
826.
1 SILTY SAND SM -loose,reddish brown brown,fine,dry,some non-plastic fines,micaceous,d
1 824:
1 823.
822.
14 _.:.' 821.
1 SANDY SILT-(ML)-soft,reddish brown brown,fine,moist,some non-plastic fines,micaceous,moist to wet. 820.0-0
1 ..
17 . 819.
1 818.0-7
817.
1
816.
2
815.
21
814.
2
813.
2
812.
24
2 811.
810.
2
809.
27.. 808.
2 -
807.
2
806.
3
805.
31
804.
3
803.
3
802.
34
801.
3
800.
3
799.
.- .
37 Boring terminated at 37 feet
i

Observation Well Construction Form
E
E oject:MS F ase 2 Pr
Well In
Boreho
Refere
e s 'b u be , P ase 0
Driller/Company:Justin Marlowe(4452-A)/S&ME stallation Method:3.25"HSAs
Drill Rig:CME 550X Coordinates: le Diameter:7.5"
tart Date:11/4/21 Northing: 686085.92 nce Point for Measurements: Depth to Water/Date:
ompletion Date:11/4/21 Easting:1412818.66 Below Ground Surface 17.12'on 11/5/21
Height of riser casing stick-up above ground surface(ft):835.75 ! DEPTH
Height of concrete pad above ground surface(in):. 6 (in feet)
Concrete Pad Thickness(in): 8.
Ground Surface(Elevation:835.52 ft) 0.0
Protective Surface Casing Bottom of Casing 0.2
Dia(in): 8 ---- .,�.._--Qom_----
Type: flush mount
Backfill Material Riser Casing
Type: neat cement grout Type: sch.40 PVC
Dia(in): 2
Top of Seal 17.7
----------------
Annular Seal
Type: coated bentonite pellets Top of Filter Pack 22.0
Top of Screen 25.0
- eo---------
Screen Type
Dia(in): 2(inner),2.7(outer) Filter Pack
Type: pre-packed-sch.40 PVC Type:#2.filter sand
Slot(in.): 0.010
Bottom of Screen 35.0
Bottom of Sump 35.3
Bottom of Hole o 37.0