GW1-2022-05197_Well Construction - GW1_20220531

WELL CONSTRUCTION RECORD
nis forinqu be owd ftir4ngleci muhiplquct1s-
t.W' elu6ntraaorloforotation:
14-AVATER ZONES
Robert Miller FROM TO 0),tiCRIVYI(N,
W01 C94rdd I 6rtfanlq;
2675 ft. fl
NC.Well CdntmaarCcrfiWtja�nNitz6cr 15.OUTER CASUNG(for ajolikaged vi&0 OR'M-T.R fir-ap fl h1c)
FRONT- TO. I Mck"M, T,1,r1,1.t.,
SAEDACCO Inc 0 fL 381 fL 6 11 in. 1 ch40 Pvc
Coiqany Nonw M.ININERVASING OR ckllstd-IrAip)
FRO,Nru----1 To I DIMM"Ek- I THICKNESS' I ATATERULL
ft.... I
3.
17.y(.RILEN
Water Supply Wdl.,, FRONT I TO DrANTETCH:-1 SLOTSiz$ -FIMCUNESS I MATERTAT.
OAgricultbra) 4unicipal/Nbfic 38- fir 4i1. ft. 6- ­ K 0' .62 Sch40 Stainless
MCgothenna I fReatingtCooiing Supply) 011esidential Water Supply(single)
01ndustrial(Conintcrcial Miesidential Watu Supply,(sbarcd) IS,-GROUT'
'FROST , ITO. NTATrRUI.- I ENTPLACEAWMAYMOD&.01OUNT
Ej hfiftation 0 ft. 321 (L Portland trimi
Non-Watir Supply Well:
ft.
[1N10nit0FiPg Mccomiy fL
InjPCI1011 Well: At.: rL
EiAqu.i(cr*qb1'rg'a' %`-Ila Rcillcdiition 19.SAND:GPtML PACK fir applileal)ky
'FROST' -To Nlvrmtrm,
IiA ie6vel3• nsalinity Eanice
'ft-
351 53- fi, Silica Sand 20/46
1'.0 ft, ft.
ocintilIx-i TPM Q id c� S11b5CnCC onim
Pvcdr. - .1n RI I
30:DRMLENG'LOG(attach ad4ffliomil sbtds if pec"stiry)
QQLp!k1n"(f-jgsed Loop) oTracer jiLN w�gm FRONT,: To DMCIUPYJON"(mbrilr
ElGeoffienna I'(14eathko,'Cooling Muni) EiOtlter(-explain inf&r 921 Retnaiks) f4 to
fL rL
4.16att,Wcli- C60 d(ed:',3/5/22 AVj1l]D#EW-32
ft. 1E,
NA"ANIell LAVatiodi
M fL
Fadfl[ty]DRtitappjjcal�,O: ft, MAY 3 1 2022
1248 Bill Hall Rd, White Oak, NC, 28399 ft.
. 'fQJOl3
21. -►REAIARKS'
Cumberland Three feet bentonite Seal from 321to 35,
llprcO lklmlii`e ifionNo,•(PIN)
5b.I 4tifilde and Lonkitude in de or ,decimal 4 cgreeg gmcihn1nutc�1sii,6n.ds '.'dec' 14 2L Cerfirteafloq-.-
2/17/2022
MA-rummit or. '.oRtuporary
h%,aigw;q.aft fdj.I 1"orrhy L-Velify t(jor I;w
ivith
,7.Uthis a reivaii to an i:.ci-wftng Nvell-' EIYLs or MNu ccoy hfrhif rea;4 has
23.Site dia;r mor.addltionAl witidetaits:
You Maymse=1 back of this Nge.to'f&,J6:additi6nal Avell site-4"g or i4ii
iaik'You inay ah—o�Itach additional pates ifincessary.
8.Number of Wells constructed: coustfuctfoik de
For m,4,1pre vv'�k-1t'vrve j4Ar,ivW1s,0jVLY i6r1i rhL,.xffme
sulAufft talc 8111INUTTALINSATC9TdN8
9.Tivi-A ive.11depth wrfacen- 531 tam Fnr All W`Mn .Subtitit,tUs hhnnitbilt.30 days.of'conWPe666of iMl
Fir#Qj�pje)V"Oh,1?.�r 3@200*aM 2@ IM7 consWidioii to ik foftowi'fig;
10.Static water level klawtop of casing: Divisida of Water Rtisourceit,Informatidn Unit,
Jfit,ime-level am 11+ 147 Mait'Seff' irr i2iaicr,RAleH,i,NC 276991617
11.Borehole diameter:10 24b.FnrTnW.f1a W0SPNLY. In,addition to sending ft form to-the addrim in
010 09
246a6&e-also S)ibtnit a,copy of this-fann witlfin jO days of completi6n,of%, ll
12i'MMI'construction method: sonic tb-t[0 fbllowinlp.
'Division of Waur Resj6urces.IJudergro.und lnjeifidn Control Firo-m!",
FOR.WATER SbIPPLY WELLS L ONLY:
Y; 1636 Atail Service Center,Meighi NC 27699-1636
-i4c.For Writer Supply&Injection Wells.
134�Vidd(OT) Aldhod dft6t•
Also subtAt one cdpy of ftfafni within 30 days of completion of
'134.Akinrbetldtltypi�� Amount: %Nrcll comraniction:to the c6unly�caltfi-depaTtIncuf of the coiinfy�whcrc.
comstmacd.
Nhonh Carolim Depmmat ofEmironmcni,aid Natural Resources-Divislofi of\AlhlcrR=owcm 'to 1.Revised AugList 1.