HomeMy WebLinkAboutGW1-2022-05158_Well Construction - GW1_20220531 i
WELL CONST UMOl'RECORD '
Far NLl':
Thfs-forni can be owd for, in to or-nti�ti(i7c-ut lis.'
1`.W�ll.ContraciorLifdrluation:
toAVATERZONES
Chris Ruffer Fttdht,. "ttk pFCtttpuidN
willCraiaitimorNam'o (t, (t.
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4223 A
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NC..Wc]]Cdrftmcloi Ccttiftwt!oan diurticr IS:.OQ7 ER.CA Er�]G tro ntatli es lM rce►ls1 OR LiNt;R ltf's aTicabk�'
FROM TO DrA,METER THIGh.'Y&SS ` I xkMr;�t..
SAEDACCO Inc ft_ (4 in.
Ccirrah;ur}:t5(�sr+e �:t6.INNER"('A:�I1a]G'pFtTLaSINI`rt�+athea�nsslrlcf,:d-loii ° -
'FRMT Td DLUIETER- I THWFNESS hrA1MkL
t*Cl tomtrt Ction#}milt k 0 R.. 23 ft,. 1 u! Sch 40 PVC
f.ut trff r,{illrnbfe v ctl rrritz,(ex.'Gaunty%1u? -lrnrfarwe,I fecdon efrj
3'Wll;i3sb(chcclw;ti 11 rise): 17.SCR!_EN.
Water Supply We]E:: FROM LIFO ,nLti\tF:TPEC SGdT$t73; Tt#1"-NFSS' I ATATF:RCAt,.
1Jt't$tiettttittal 1JlvfniiicipaI.ymlic, 23 R: 33 ft: `i 4 Alb Sch 46 PvC
ClGeothennal atin ri. itr. pia;
� pl�vlia�'�ttlsply}., tdiR�siifentiat Water
13hidusttial£F'ommerciai ORtsidcatialWiterSupppiv,(sbared) 11`'GRQUT v.
,FROAr ' '-70. AJATER(AC- -]EAIPUCENTE3TIFMIOD.&A'ATUDNT.
t7ltii ntipn 0 ft.' 17 (L Portland Tremei
).Ron Water SupDjy Well:
Gl�#onit4�n� COIteco�'ery� ft. rt�
Irtjectitai Wett:
Agttrfcr'1{cchar,-,e EdGnrotundg(nter?tciRetliation 193AN11-GILWEL PACs:f;r a alicab1e),
'F'Rdli'' it) tkiA'iF Ft4tL k41Y1 i F 1rFiT NkTitdn
nx{wecr..s?t6Ptgenipt{ ov,c-'4 080ni(}�B't7r3eP� 20 - rt:. 3�3 ft,. ..sand z
❑:AgvifeiTcit CiStvmm itcr Drt ti j;c. ft. ft.
pE.�;.timcnttilTta;hnp�,i�,}c RStibsidetiset~bt:#tpl
20.-,DFULL) G L0 Gtaltach adititiowal ik-C4s if reeecs5nul'
C1G:xrittentu►l(Clusei�E oqp) OTracor FROM 70 ol4r. wi<r dc.1
❑ titltcattal tooling DOtlter(-,xphi tiund6r#21 Rewadis) te. rt
ft. (C
4.Date'4A'ill(s)Cnp1,pjdej: 4-19-2022 ,{Ve1l1D#OW-34
See GA.0 s notes
.,a'� 7 �m
�:r:�4rt�1 I.,t►e:rtiainr (t, � e•�„ � . .,.,,....
Chemours (t; ft, MAY 3 1 202
Fsai7ii}aia tiicrAlitnae facaitplMd(4pFllcAible) R (t
1248 Bill Hall Rd White Oak, NC 28399 Cumberland C, ft., A. MOG
White Oak, NC, 28399 P1¢suS`Aatshi Cif andZip' 21_Rtn1, tta '
Cumberland
G4=ittiLv I?arcet tda9nyfcc,9ii9�Np,,(P1t�)
Ali.;i ttltacic and t.tin tttttd ,iu.tl c3/mittutcslscco, 6 4r ecimaI i1qg1•i sc 2x. crt ratirrif:
+itt`ia>rlttttt.'airi;ir�'tr�ti�3s,�tctfic�nt) /''��-y {�
}Y _ChP'Irv,'Ri.lI'' 4-19-2022
5rttnc afCectifiedWC11'atiau dr Dane
C Is(Afer)the-well(s): -XIPLrtt ancitt 'or .oTempotary fly r.`nin roar:rrrm f frerrfr.cerfl Pliaa;flee ivrlf s isas, ;
S b f 3 f? () j`yrerc)crniunrefed frrlweor&mce
ii*4[SA JVC tC 02C,010.7 ar.1JA NOW P-C-0200,M11�'..aitatructfatSrandards rind that d
7.blhN a tiepair to an exr:at ng o,ell:, ElYes, or MNn et�,�r.a;tfifs rrefimT lira t ern flrnl rrl.rd ro'_if,�;rr.2 i ncvtrrs,
.�t1,$is dr n i off iaurb, aT-dtrex,�s»ircvfdq'&tAwniv n)t eildegrtPa )111)e turraarr of q1e
i�;",iraoi�:a dnI tti- 23.Site dhiy)ram or additional H'€ll details:
You nia} use tip back a£This page,to pros!ide addi6irnaE iseli.si[e.der 3its:4r isP11
S.Nuttiberof ixvlls cdustructM: 1 canstntctiotl deii ils You:tiiay also atiachaddi ona pages rf necessary.
Fvarurarfatf+7r,trti4�rkur.i*€rarvruvarersa�sJ�wits_i)NL}'iSP.tr,rliasrrastarurrs}t<nrllwr,.}�tvac�rn
sy,vatr ar•,+�ari<t: -.. .. . $E]BN111 ALDMETG`ONS.
9:77otalwv11 l€pihbclari Iagdsiufne 33 ([t,p 2tw Ivor A11 Wall 'Snbriiit this iami within.3b ays;.df comgateticiti dE%�e11
Fear a+ratlrF,i*Ja*>ifdt'lf3ta7fF't fuf 'ittfl e.tiait�,Tiranafe xRf 2tki'enw':?, f $ C9nstiiictt`ona0`thdf6AowinE,., -
If).Slade wafer 14'i'l'l iitluu'trap_of casinw. VL) 11ii<•isidrn of WatOr Reiaa ke t,iafurinafititili>ft)tersina�Milk,
Ifwd erla=k�W h-Vhot!,t4i iu tie IGI7 htat�5crvicc Cpitcr!•itileigtir iC 17G93,IG17
11.Borehole diameter:6 in (#u) 24-b:Eor in fadIa i HAg 0NF Y-,-In addition to sending lb:fumy to tlte,addtess in
246 abbo Q a'W solituif a copy of dds,fumi Witbiei S6 day s,of cai1 ple idit of a0l.
111VOfcoiistrtictiiouinethod: sonic eottsEltictir3l►tm,tlr fpuo%i*ig_
(ic:aaige6uia' •.cnble:.dii1edpustf,etc)
Divisiriu of WaterRcadurce,Underground Iujectiou Cantralkrirgi4 n,
FUR NVAT E RAMPLY,WBLI S ONLY 16361 NIail Se rc'ice Center*Ruleit lr,iT 17459-1436
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13- i4eld{ rm) Ictlind nftcst Vr-Ft*Wat&Sti �plv.Yc�lnicctlon'Wells:
Also suborn one,Copy of this forth ivit int 30 days of"completion of
13b 01 tifM-tinn.typ : Amount: wall camtntctii n"to the count} health d440meilt.iaf the cotmtv.whcrc
e€anstnieted�
Fonu, liT-1 Not1h Catalpa M-pailaxticof Etwitaan etu w dNara al Rewumes-Diltifiioa of latcrRezuen heviscd A4ust 1-013
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