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HomeMy WebLinkAboutGW1-2022-01292_Well Construction - GW1_20220112 WELL MNSTRUGTION REcd, (GW 11 For 3atEtaal Use Oaiq: L Wen Cow actor rnformagom -��- (_ . S R t h-i y r�.. irt.wer�ttzora:s. Wen c*=M=W x= _ - F&OM TO DFSQtPIIOx 3 5 3 xc Wen cam6wceffifi=r",b= 1,0D R /y!/(J,; 15�OIIIEBC'AMG 5o<''mo>beise��ietts ORL1Nffit.' .ew:._ - /�,,,�,�� 11.�s•✓ d +—) �V+- E7tOM 2n D7AD� �'DLS4 ti�we�.r m. D6 IIa18R'GLSQQGORTQreQtG "tliQmiI ?�w'y••. y{�•_• 2.Wen CotntrucKFonPesmit#:�Z/ (�.Z 2/ !� Pat1M 'm 1 area Zia ONc7p$=b(e Ina aerao=ff=Pff=ftl We Co+mty Stoaq T�mim aq ueJ .�r R R `�l/ m, 3.Well ilse(che&wen user -- water S WeL. _ Supply 1SZCit81�Td. -a.; M'sik �r.�;. . s'4x"t'' ;ti?r"` f�• dt:' ::. PROM TO DTAMSl� SLOrs= DILMUL OMimicipal/Public R R '(� m. _ ^ dust-MSlommazial SM*) O a W/y LTatr�rS}� R .W*(fie) Ob R m Noa-waterSapplyweEL L.1 •� OW t0i/�WV .rP��'• 'a�1QV1'�••�. .•...•::�wL F. �.'-''�:ro:�..R��I>'t;ti�.i:::�: ::• acza�rrx�ison:.►�romrr O L 3 R &r ORewvety R R V. Injectionwdl: IL H DAgaffcrp chmv ❑GmtmdwatrRemedfedon DAgm£aSta:aV god Recovetp IISalmayBa=kz MUM 140/GRA43EPA MelMxrAL l7AgaifcrTest OSW=watcrDramap R R OB MfinenWTechnology OSuEddenceControl R R OGeOleanal(Closed Loop) OTracet =ZOtDBILLiNGIAi' ailieehi3ditio�LLsLeEb '" t,. r '�,• OGeob=alMeaW*CoolmSReuuo) 00dur(explamunder#21RcmWM) PEOM io $ R 4.Date Wel](s)Completed: — A-z— Well ms R & r Sa.Welt Lolafion: - R R r►aW? ost� - R R Al • Faa7ity/OwnerName ��,�(�y��k) fy � g 1'tysicalAddCiW.CO=LsadTp / ► `� R R n ' ,� JAN12 .1129 5h.Latitude and longitude in degreestmmutes/seconds or decimal degrees: ' 22.Certification: ��✓ � L as a�. lY •� �N: FAD 33 3 3 w - ;,�;. /—� -z� • 6.1s(are)the wdl(s): HPermaneat. ror O'Femporary S'gmune of , Dam I 7.7s this a repair toatteasfiagweM- OYes or �''��S�f�++ilhaeay«,�yrinrrhenrd(sJ�h�J�arnae�eaDiaozvdanorviti, j • Leo ISAN=02C.0100orZUl CSCOZC.0200]VeZCavasuwmSnmdw*anddiarago py Iflhlsisargalr�IIaibmwnllatbg6rmasfarrma3aglabrllx�maoroftle ofrJds�smvdl�bernpvvvfdadm8ie's'r�ornv xPno�oidsr 2l> ksseeeton aroa fliebecYgjrfas fo ax 23.Sift db gtlm or add clonal well details: S.For GeoptvbctDPr or Qosed Loop Geothwmal Wells bzftthe same you may use to back of this page to provide additional v4 ooatuedon mSo O coastntetion,catyIGW-1isneeded.3adie3teTOTALNUZOERo£wells�,'1 (add'SeeOvefinR=aftBoxlYoumayalsoattaehaddi�elpMuifamemay. drMa- v 24.SUBMITTAL DUMUCTiONS I 9.Totalwell depth belowlund 10 0D' Z� fe) 1 Forrrdarpfs,.sIIrSaaadgrla�j l �g�00'� �0p) Submit this GW-lwis>un30daysofweIl completion per the following: 24a. For All Wells: 10.Static water level blow top of easing: V d t (fe:) �fio=to Division of Wabr Peron (DWR). Ifwnterteaoltaabo�,ems[r�pse +- im onPmcess UUnk l.WM5C,Ralchd NC27699-1617 ]L Borehole diameter. {m.) 24h For Iniection Wells:Capy;W DWR,Un&Mm d 4ect m Camtol Tip PmStam,1636 MSC,Raleigh,NC 27699-1636 .. 1(2.�=�on�°d° �t7 24,ForWaterSnaah+and Ovea-Looa Geothermal ReturnWellsCopytothe ie pmb,eee `':. ooimty eavaoumeulat health eotmty ms�m 'eel FOR WATER SUPPLY NLY: 24d.For Water Wells mduckg over 1 000�00 GM.Copy W.DWJR CCPCE)A 13a.Yield(gpm) V Method of test_ MMI U°PM,1 lI MSC,Ralei C 999,l 61"1— 13b.Dish6edon type: v Amount: 5 d✓ 0 Faon GW 1 Iim&Carolina Depwm=ofFze=oeoml Qmlity-Dbisiou of WamrRrsrneoes Revixd6-&2018