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HomeMy WebLinkAboutGW1-2022-05164_Well Construction - GW1_20220531 WELL CONSIMUCTION RECORD Fu*I'11VCnW1U'TwON LY: This form can bc,used-finknrlcar md1lip];wiffls, I,-I WellOntractor Infortnaploft: 14.1VATER ZoNks Robert Miller FRO.111 TO motn'TION %1 01 CorRr,Idortsame, 2675 NC.Well conwamr ecrtiwation Niu&& 15.OUTERCASING wens)OR LiiVER:UL Sch4O Pvcle) ' I TO, I DbutIETER .1 T11 CKNE"!20"eab FROM TO: ft. 9 MATERIAL 55, f, t. 6'. SAEDACCO Inc I 16.1NNFR,CASING Oft 1BING'(teotherinal closed4wo) �Oal �_10 _ELL%1KTER TMCI-29M MATEMiLL 2,'Well CuRstructio"=Fc mit"; R. /ill 4,11 -11arlafyce,lty-dcn ex.) f4L ft. irr 3..Weiilts'c(ChieckweO use): 17.SCRttN Water Suppl�y Well: FRONI 'J''To I 0rA.LtFTFFt 51.OTS17Y. I THK7KNVS%- 1­,%xATrRtAT._ Mgd'cu.11mral 0Muni6pa11P1tbJk 55- ,ft, 751 ft.. 6 0' .62' Sch40 Stainless R. ft. in, 06-cothennal fficadog/Coolipg Sitilply), ©Residential Water Stippjyjsingle) 1011nduvria.VC,Dntntcrcial MesidentialWitcr Svppb,(shared) is:GROUT FROM •10. MATERIAL I-EMPLACEMENTIMMOD&AMOUNT El Irriftation 0 'ft; 49, ft; Portland trimi 1:3tvttfnitpring, CORscp►rrp R.: ft. Injection Welly 1jAqu'ffCr-liC'C1h6Tgi DW,idinAll"altr Reimcd1tion 19.SAN b4RAVEL PAC (if applieW41 10 51ALTMAI Rupt�FROM­ A"AlwN MT11013 Q,kq Sal r rif�rSto�age-a Rccovi�iy 13 .,1n1tvJ3iiflc' IlAti"'Ific"i-T"Cit 13.Stormmat4 66fiiagc 52 ft, 8 b ft, Silica tnd 20/46 Ill perinic Plxhuolpgy. [IS145 dcncec6i4rol 1G.'PRI1.LENG LOG(914juh ad4filiorO shm3if FWw'"ryl 0G.eothennal(CIostd Loop) IlTracer FROM 1.TO DESCREFlnON(tolor.Nird6eii.mAX'mck t%K.'Piiij sic,cit.) Meothennal(11ea1itqpraot[ngRatunw 001her(emplain unjer#21 Retuarks) 4A4tc Welts]Ctntip1ctcd: 4/11/22 cI'IIDYEW-55 71_— sa,N1!F1l,1A)CAti0n: MAY 3 2022 nictlity,bunpr i4ou'po fictlily IDN 6(ppjknble) ft. rtffiformdu�, C"C �,q Ljnil 1248 Bill Hall Rd, White Oak, NC, 28399 @L.vC-V-F-!uk;! PlIvikid rlddic3r,City.,and t p 2 1:REMARKS Cumberland Three feet bentonite Seal from 491to 521 county P�PmC3]*jOric.11ion No,(FIN) in de ­� J c�slsi' ' ds "-#c ifit _gmcs�Tiniit. n iF 22.Certificatioq- N 2/17/2022 emll-d"44- Date Is(are),the -xPernianctit or .131ethporary By st'gi#ng JhLi fqnv,I frereby rerrify r?uqfijr wax,fwety)comimeyed ire-aqcoA*wce law 15A Nctic KCAC.rX,0200 Well CnilatrTictia r§rdrpdardsanid tW'j,tr I_4 11y" �7.h'thbi a reilairta oil 1�..nting Nvelk EIY#--N- .fir- � 'ENo -ropy, f61s:h a rypil r,TA a im rr 11V Ivell awwn irfica brfprimay.1 w i and twp?a h i r1j c o i j i to re of rite i2l rtwa s Jtun a i-M ft,e iiaek qfmi.,farm. .23.Site diagrams or additional well Retails: You utay tige_tl Wck of this 0&,to Of&vde additional Ivell site,4eols,or*ell 8.N ninbdrof wells konsltru*d: 1 cons(tuctiowdelails,,Youvay A14afiacliaddi664pagdi if flacessaly- tor TtIMONS 9.Uial well.deptlibelow laud surface: 80' 24it. Poi•All %Vilh '_Qobndt this fdrin urithin 36 days of-conipWonof W-611 Fpr"#fji:9P1e wvll 0isr V.fhefr4d ffdWVFeA0 cxaf.npfe=3@21PT CTIM1,20 IPO7 to IlLefolloviin'AD-1 10.Static water level,beloW top ofcasi4W,� (W Divlsitni of Water Resourceli Inffiratitidn.1iro'cesiing Unit, lfwater level;s 4havi wtog are Idliul"Servicet e.r;,P_ilcigh,NC276994iiI7 1I.-Borehole diahigter.10 24b.Far-h ifee.lion 3W 19 ONLY:, En addition to sending the form to 11w address,,in 24d a6ove..also qibn9t a.copy-of thh,fan piths 30 days'of completio'll of kv ll 12.I'VeIrconstrite-tion inethod: sonic consimitioll 66 Ilk"rbllo%i•Ilg. ctd.) 'Division ofWitq 4csdurcc4.Utidirgound lukdion 6ntrol frogram, FOk%%ATER SbTPLY NVELL56NILY.-" 11636 Mail Service Center,RaileighjN474t99-1634 14c.For Water Wply&1njcctto'n Wale:131;Vfdd(gpnt� Alcthad'aftes- AIS6 sub6ift om C60y of this fanin with'ift,30&VS of,Completion of .13h.DlsinfeL4i n typ4�! Nvcli constnictio'n t'o'lhc county licqlth department of ihc.coiinWwkm 0 Am aunt: constructed. Revised Aug=201.1