GW1-2021-07792_Well Construction - GW1_20211102

Form
WELL CONSTRUCTION RECORD(GW-1) For Internal Use Only: Print
1.Well Contractor Information:
William M Wiggins 14-WATER ZONES
Well Contractor Name FROM TO DESCRIPTION
(NCWC) 3470-A ft. ft.
ft. ft.
NC Well Contractor Certification Number
15.OUTER CASING for multi-cased wells OR LINER if a livable
Mid-Atlantic Drilling, Inc FROM rt. in.TO DIAMETER THICKNESS MATERIAL
ft.
Company Name
16.INNER CASING OR TUBING eothermal closed400
2.Well Construction Permit#: FROM I To I DIAMETER I THICKNESS IMATERIAL
List all applicable well construction permits(i,e.UIC,County.State, Variance,etc.) Q ft 118 ft• 1 2 1O SCh 40 PVC
3.Well Use(check well use): ft-
t ft- in.
Water Supply Well: 17.SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
Agricultural �Municipal/Public 18 ft. 28 ft. 2 i"• .010 SCh 40 PV C
Geothermal(Heating/Cooling Supply) Residential Water Supply(single) rt• ft. in
Industrial/Commercial Residential Water Supply(shared) 18.GROUT
Irri ation FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
Non-Water Supply Well: 0 ft' 10 ft' Cement/Bentonite Mix Hand pour(outer casing)
x Monitoring IDRecovery ft. ft' CermnV%rtomfteMix Hand pour(inner casing)
Injection Well:
ft.
Aquifer Recharge QGroundwater Remediation ft.
19.SAND/GRAVEL PACK if applicable)
Aquifer Storage and Recovery OSalinity Barrier FROM TO MATERIAL EMPLACEMENT METHOD
Aquifer Test [3Stormwater Drainage 10 ft- 13 rt• #2 Filter Sand Hand pour
Experimental Technology Subsidence Control 16 ft. 28 ft.
Geothermal(Closed Loop) Tracer 20.DRILLING LOG attach additional sheets if ne
cessary)
Geothermal(Heating/Cooling Return) nOther(explain under#21 Remarks) FROM TO DESCREPTION color,hardntas,soii/rock tyM&rain sae,etc
ft. ft.
4.Date Well(s)Completed:7/30/2021 Well ID#MW-6R ft. ft.
5a.Well Location: ft. fr.
Brunswick County Landfill N/A ft. ft.
Facility/Owner Name Facility ID#(if applicable) ft. ft.
172 Landfill Rd NE, Bolivia NC fL ft.
Physical Address,City,and Zip ft It.
Brunswick N/A 21.REMARKS
County Parcel Identification No.(PIN)
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one Iatflong is sufficient) 22.Certification:
34.043886 N -78.258514 W 8/25/2021
6.Is(are)the well(s)EX Permanent or Temporary Signature of Certified Well Contractovoor Date
By signing this form,I hereby certify that the wells)was(were)constructed in accordance
7.Is this a repair to an existing well: Yes or XINo with 15A NCAC 02C.0100 or ISA 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 on 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: 28 00 24s. For All Wells: Submit this form within 30 days of completion of well
For multiple we1Ls ltrr al/depths ijdi/ferent(example-j�1200'and 2 rQt 100') construction to the following:
10.Static water level below to of casing: 17.39
P g (ft.) Division of Water Resources,Information Processing Unit,
!(water level is above casing,use" 1617 Mail Service Center,Raleigh,NC 27699-1617
11.Borehole diameter: 2.0 (in.) 24b. For Infection Wells: In addition to sending the form to the address in 24a
12.Well construction method:
Hollow Stem Auger above, also submit one copy of this form within 30 days of completion of well
(i.e.auger,rotary,cable,direct push,etc.) construction to the following:
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 SunDly & Infection 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-I North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016

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Wood Environment&Infrastructure WELL NUMBER MW-6R
wood5710 Oleander Dr.,Suite 110
• Wilmington,NC 28403 PAGE 1 OF 1
910-452-1185
CLIENT Brunswick County Government PROJECT NAME MW-6R Installation
PROJECT NUMBER 6228-21-0146 PROJECT LOCATION Brunswick County Landfill
DATE STARTED 7/30/2021 COMPLETED 7/30/2021 GROUND ELEVATION HAMMER TYPE
Mid Atlantic DrillingCONTRACTOR-_Mid Atlantic Drilling GROUND WATER LEVELS:
DRILLING METHOD HSA AT TIME OF DRILLING —
LOGGED BY B.MABIE AT END OF DRILLING —
NOTES SAMPLE TYPE —SPT
w o
EL
Lu oz� ci a0
Lu�- o- O m j C6 < MATERIAL DESCRIPTION
WELL DIAGRAM
Q Z W U? C�
0 Casing Type:PVC
CL CLAYEY SAND,(SC)dark brown gray,fine grained,moist
0
K
0
U
W
ix Sc .,.
z
O
F-
D SPT 2-6-8
z 5 SS-1 67 (14) 5.0
° SILTY SAND,(SM)dark gray,fine grained,moist GROUT
J
J
Y
U
SM
z
D
a SPT 44 2-1-1
10 SS-2 (2) 10.0
o SILTY SAND,(SM)orange brown,fine grained,wet
J
J
W
w SAND
o SM
z
in
N SPT 2-3-5
15 SS-3 83 (8)
15.0 BENTONITE
SILTY SAND,(SC-SM)orange brown,fine to medium grained,wet
0
F Sc- TOP OF
o SM SCREEN
18'-28'BGS
SPT 100 1-1-0
20 SS-4 (1) 20.0
LU
SANDY LIMESTONE,[Castle Hayne Limestone]Cemented with
W n:0 Shells/friable
o'
IL
_ 10'SCREEN
w a WITH SAND
o PACK
SPT 33 2-1-1 .
� 25 SS-5 (2) 25.0
Q a: SANDY LIMESTONE,[Castle Hayne Limestone]Cemented with
:b Shells/friable
a
2
a n:0 BOTTOM OF
LLj z SPT 44 7-8-1 c WELL AT 28'
W 30 X SS-6 (9) ..
30.0
Boring terminated at 30.0 ft due to refusal