GW1-2022-02874_Well Construction - GW1_20220228

WELL CONSIRUCTION'RECORD Fdt iraermtil tJsc t3NI.Y:
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TROM TO` PLUUTER• 791CVJMSS NATEMAL-
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FA(iM TO 1 DUMETER; I T0rC KF1% MATERIAL
Groundwater Remediation Permit#WQ0036881 0 ft. 88 FL 1 in Sch 80 PVC
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o f!. 53 1 in Sch 80 PVC
3.W'91 Use{cb MU Well t+ y x
Wafer Supply VVdh _ To I 01AMATER .I SWTSIZK Ilot s A1Ay fii9iAL
C ilk t3b$tallClp@wAlic 68 rL 90 it 1 in h6l old SS
' (Iltai9 53 f. 55 rL 1 in im. 010 SS
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nXootvs gappw Mesi&n ial Weter Sulpb(skwe)
®itbdastrialfd omfliercial Mes�l WaW Swly(sbawd) a
VRAM TO KATENA1 -TAIETHODA AMOUNT,
ai 40 (L 0 R. Portland Tremie
Naa Water 5' ly We111:
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85 ft.. 90 f[. Sand 2
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❑cftdl"gtai(Clow Loop) 13TtoM r"N' 70 o�ctxtrrity�wat.a ��aratrnna �d�.r
❑Geodmnal do l Berttea� ❑t r4 nui t:Ret�rae }
4.Date ell(g) mnl 1-26-2022 3.5 see Op 's not#
54.Well Lnratien:
MOOG FEH 2 7
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1995 NC Hwy 141 Murphy, NC 28906 Cherokee County,
Murphy, NC, 289076 PilsieslA:ddiea5;'Gi4'-WWZ'O ;dt N7 AM* "-,MW' W� I Iter.=. �
Cherokee
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(flweli mid,° 1adJio is tidldeits4)
N VV „ 1/25/2022
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6.h(arse)thewell(s)s M Permanent 'or l='fl'emporary. eigtldtt elrir firm,1 JMreHp ierrdfj rhidt lAr wxld�r/ s(wti+sz)crxnamrcfed ue, ardaciee
addh d SA NCAC 02C Cnmat+tiie Saa�a&V< ,s 00 dwr a
7.fS Ob a repsilr tb im tsistWS well.; �7_is" br MNp rVy Pf iAtst r P j&M V"W jovw ce wow nrrr 047wr.
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repairmaer$21 narks SWAM arm AL-bwk aldds fnrua 23.Site diagrom'or aMdonA weii detalta
You may tise(he leek of ids page to provide Affi6ong util site details or will
8.1ford6orof rills apt • 2 f% tilBCE t1D$et9li5: You may also tiecemly.
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9.TOM WtH depth below i sm1facc 90 fld.) 34a. hr Ail Submit ibis hnn witldti 36 clays of completioa of 11
For mAdple wIls Us►aflkps if dry miO(rxr rJe= 2A�7'Asd 2�tfiJ�1 O tkCtaPn ia"it falllgvagn
10.Stalle:water level below top ofcadngi (IFL) Di ixhiuof Water Rtsqut+Pl,info I"U ba vnwesmug U014
If ruaAer kved is 46mejVditagg use..+" 9617 Nati.Servict CkAber,Raba Nr 27G -tb17
11.Horchok ditnmeter:a in ) 24b.FPI f 1t11 e1La ONLY-'In adddaun to sending dw firth to ft addTm in
24a above also aibmif a copy of::tbis factor wltliin 30 days of=Vletrou of 1 vll
12:Well oD ni bod: Sonic crsos6rucEton to dw itoou viug:
(t e.a mlerp; ble duest posh etc) Division of Water Resornees;IJuderground Id>JJection Control Program;
FOR WATER SUPPLY WELLS ONLY 1636 Mafia Service Cemer�Raltgb NC 27699-1636
33a.Veld( ) A!letbvd of test Eie.For Water Sins d�InRoa f' ',Mb:
Also submR one odor of this forin iv tia.30,day&o convetion of
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