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HomeMy WebLinkAboutGW1-2022-03408_Well Construction - GW1_20220315 WELL fQN TRIMMON RECOL Gw x1 For�alUse o>zly: L WeU Contractor Info dome �rtaox h WenC C'Gt law Rzor�s. F80M To -'ir�ox• ISO .3oD Ncw�cN� fL sxoMU[EBCASiNG fm�"nmin`ened;:F>Es OR7�D;It r:._•_. rest � �reL �P®D'N®e R ft is 2 W,eHCo D6IIII�tBR'CA.SaiGORT�IIQG " staQmit w�;>.. ,�.._.; asRvctloaPermftS: (�c� raonc To ZLsaaII app8�ile,.eII do per(R�L� Corday.snmc v�imr�eu� �. g fj R SD 7 �oaous ess�rs% 3.Weil'Use(eheeikwea user O i �' ►Z• ffi Water Supply Wel. �JS7-skim �. s;SkyyY•xa,>At�y J a. .a .✓ F80M OAgricuhtaal 02+ftmieipai/Publi TO .; areaffi�is STOTsltE MATIItrAL O fL is GeothemId(Hea#*Coohag Suwy) Water Shy(fie) MtW Water fl on dls>100 000Y( � Ow •IE'QtOITf�•' :r;r. sue,i i�':'a_�tr :::` k= ' N—o"i=rSapplyWeII: GPD FROM zo: iMAMMILL XMXwtZMMrrM=OD:.urouxr qMMft=9 23 DR at r e�� Injec6oa oAquiferPteebatge ❑C=undwaterRemedie'm $ . DAquifcr sndR-OVc(Y Dsdh;ryBCe= A9 FROM TO MAMMM Tyr. MtEffmD OAquiirrTest OS�omzvraterDraivage >� 4L Olbgm m181 Technology O uEddeoee Control OGw&=al(Closed Loop) OTtaca :Zp,,DBILLIldGIA(` sltii]tia0ditia®iLsLrs"tiif j er. �. OGeoffi smal @e-8NM .00liaBRenrm) OOther(atpl k=dcr#21 Remwb) FaoM $ t 4.Dstz Wetl(s)Completed: �-!0 ,ZZ WeII ID# fL Ss.Weil Lofation: k fL ft. ! Faa7ity/OwaecN®e FacftIDO(ifgVHcabie) $ , tL 7 y.. ti.. � Parcel SleauSaoioallo.(PBS '•`,` .ti. n Y" 4 3 Sb.Latitude and longitude in degreesemmnt wseconds or decimal degrees: MA R (ifvnU field,one IWIM a �i) a _ 3� .. 22.Certification:N b ) ' 6 Xare)the Wws): ermaaent br OTemporary I Z T"� S eII Dme 7.b this are Casa > BydVdfsftfam4JA-by-nfyd—hew4s)was(&we)omarrr�dbrca�vd==v , pair temingwen:- oyes or mho 15AN=02C.0100-LUJVCtc02C.0200)rrffc „sWZIV*ffldZhMraMpy lj isargalY,�IIori�m�rreIIomavuctlarbrJarmoslmeaadeprobrrheameosofrhe off+isas+madh=beoep vWdad:v*evrdamw. .?qx&WxUrtrllaaamdss=ff=*ran rhebarkofzFz&fw= - 23.Site diagram or ad&donal well defti1r. 8.For Geoptobe/DPT or Qosed Loop Geothermal We&having the same You may we the back of this page to pro4ide addidoad well c=&ucd=hXo conshtu.`ftM only 1 GW 1 is needed.3adic3te TOj'AL NUMBER ofweils (add'Sez Ovee in Rcmadm Box}YoumW also attach addiliond pages ifinewy, daRed: 24.SUBMITTAL MMUMONS , 9.Total well depth below Ind smftm. 3 2 0 Poi-=&PIC was AWaffege•y4be,aleamp9:-3@2po1md2@ZM () Submit this GW-I within 30 days of well completion per the followhW. 10.Static water level bdow top of eat 6,o 24a.For All Wells: Orig-mal fog to Division of Wafer Raswuees (DWR), If+ teoattr�oWeaat '�ae�+-( ( ) btIM&MP=c=ingUnit,1617M5C.RaldSkXC27699-1617 1L Borehole diameter. I� {m,) 24b:Rol Infection Wellx Copy to DWR.Linde imuod]Weed&Comtol Mq "� /� Pm$am.1636 MSC,Raleigh,NC 27699-1636 11 Wel contraction method:__l'S O�a — /•� ,— (L,—-ion able,daeftynsh,�) 24c.For Water Suvpk and Open-Loop Geothermal Retorn Wells:Capyto the ' ootmtY eavommental health epaut Imes couoiya iaslm i-ed FOR WATER SUPPLY WET.LS ONLY: M&For Water wilk do ' over 1 GPD:COPY tO.DW1%CCPCf7A Permit hv8MM'.l 11 MSC,Role' C 1 11 ]3a.Yield(Ypm) I D Method of test: 13b.D shfiction type: Amount: FoursCrW-1' NoehCMDN=Dcpau=ofFavfim= di Quality-DivisionofWaarp= ar Revixd6fi2018