GW1-2022-05156_Well Construction - GW1_20220531

WELL CONSTRUCTION RECORD, Earfr�ernnler�,tarrt�:
This,form can bc'usdd ftri..singte Qi multiok-wctls'
1`.Wclt<Co11'tl:tctorTiifartilation:
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Chris Ruffer PROM .YU I OOKIIMON
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FROM. TG DTAMETER- - THICri.IM" AIATERI.AL
SAEDACCO Inc tG, fL ta.
trta trij'1t crw t A RCA 1'IxTG OIt`TL10 G- 'okhennaf etustd400it
:FROAf TO WAMUTE& fitrCMF,SS AMTERt.1L
2.4VCltbMtructFtr 0 ft. 60 ft: 6 _p? sch 40 PVC
tiu lds�cplicr,#rJevrieHpr rfitffi3(rc.Ciurnru�.3Futu-'tnrlrtiicV.11li detg rc°%°
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water 3npplywcll:. 'FROAV VTO DIAMETSSt. S(.0TS17% Tiilmmss' AtNTRRF.m.
[� uttiiral 0Mttiticipa'M' lilic, so k. 70 (t. a in o2o ss
C36cotherniat Q3eatin fiCooling Supply); DResidenti.Tl Water Supply(single) 7i fr. i
t lndustriaUConuiferciai I3Rcsidcn6at ltrator5upp6;(sltaictf) I&GRFROAT -- Tar NTATERML U rMPLACENTENT INFMOA AAtOU T
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lion Water Supblg Well:
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57 ff. 75 ff, Sand 3
i�Rtlnifci Test l$tornncater Uta140.f"c
ft.• ft.
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:I)titt.�Velt(s)CaBiplct�il: 4-20-2022 _YeIiID#EW-25
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Chemours ft;. ft
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1248 Bill Hall Rd White Oak, NC 28399 Cumberland C, ft. t€. .a aZOG
White Oak, NC, 28399 P1tvs- 1,Xddre'sst5t} nrrdZip 73isRrAIAf€rS
Cumberland 70-75 is a 6in SS sump
C!ivafY 1??1rr tcl9wtiCe r4i(,n Np,.[t�l 1)
ti.T�Ititirctc and,l,tfrptzitude in dq
pv"irntkd onldg or ded M"adfictrixsr 22.Cettificatuid:
raiSt4fi t`eettlr ixr�ltii7dt�nis;srcffic:>~sit) �r r�
1\ �j' _Chr U_ G1 4-20-2022
Si;,muim,or-&ff€cat Vrtl Canerrctoi fte
6.1S taa a tlle.\felt }t MPerfii rent far .0TRfi or'dry, B .x•pn, ihit;qrm I'Ircreb y rcrf` A-(4,11je u�el xJ wsai ere cynvtnreted in-aexewdsnre
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Z1Z I A NCAC'62C,Ol00.or.ISA A101 -02C.,0200 l eff Cpiratrrtcrio i Sraratardx and Maj a
F,Lip thts a nl€Air to an e?d tingvellf OYes .iie Mo. rod,of this,, trr rdh as tnchlu3mitW in'iho Iirll my irr,
.{fafaa v dr,v ripe;Ii,#Pf t-Mr. ecv u431-cvaaasnr wvj'MM' of rturaf cvf awl e4,irahi she-oware Pf rpe
rt� 'wnii�aa F rt iw tks:irriiiia 0 ra¢jr&bewl'o,J"dliNfOrMe 23.'Site diagratwor additional well details:
Y611►ua} use Ilie bactaf was page to,'provide' additional well site details,or well
�.I+i€ttuhrrpf iti'elts iuitstractctad: 1 ainstiuctEnr€deiii�s. Ya�u:i€><�y aTr�.g;attac€i:rddiu�hpab�s,if uacessaky.
fiaraiwrt�rd�T�tral��ar-e�nr�r�vati`psatFp�i atiitdl.lta�L}'irfrFi rFfe.artlN+iivrastrarrsFuar,��ar.c�rra .
.sa yidta ,;fa,rin• . . - R.CTBM TTA f24'CTUG3T(Hn..
.Tofiil ctiilclltlibeta laaii,sirrlryc . 75 (t1, Zla. For All WellK ;$ub»tit this frgrrii rtiEhin.3f�days of conrptetipk cif elf
fortrebZri nh=ctPrlFcrivtd�artyd(fire�K�ti+r Pc= t 'tra,rl� �°1 � c n5thictioiitOatofa}fauing;-
10.Static water level belovr top of casing: (ft.) Divisiu u of Water k�,ou r 6,lnfurmsktion,Prdixming Unit,
if-4uieeIt,vd t,taLraiEu tvra>ra,- +' 1617AlAit.Sen•icc Catifci#,Itaici Ir IiTC 27699-1b17
IL Rsrcholc diainetei.10 in (}o} tab. nr�iij� aii-�cfla 8Nf Y In addition to sending(lie fomi to the address in
34aabbce.alS6,= Ilbutit a:copy of thisJartn within 36 da}•s'of'6ns0etion of well
13 bi,clt4mustme.tion`inetiiad: sonic c instructloei taalt follotiistg:
(ic.:snger.r+aiaq cable"dish gust ctc.) -.
Division of WaterResaurecsy tuderground t6jecilon Contr6l Piv"—I,
FOR NVATERSUPPLY WELLS'ONLY. 1636 Alai[So-Tvice Center,Raleigh,XC27699-1636
13.%"lim wo Nlethod'oftcst:
2Sc.Far Water Suepl�dre fnrci:tffiu Welts:
Also sSnbf rt Orke aapyr of this f6in vvitbin 39 days.6f cotiftrletiofi.of
'13h.Disirifcctioil,typC Amounte, INI ,cotrrsiconsdtction to the-county�c9ltCi doparitnent�of�tlrC�t(Tunl w1➢re
l�nti t-[ NoInhCarolinaCi. rtmrirt:ofEtrviiarmscr8anddames]Resour€ts-Divii Ion ofRratcrRes t Revised August 20)3
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