GW1-2022-05218_Well Construction - GW1_20220531

WELL CONSTRUCTION RECORD For.Intc no]iTsc 0MLY:
This,form on bc'uwd r&.s.fJ191d or rnultipIc.wc[1s-
1'.Well.6utt"Ifto,r fidorimation:
I.J.WATER ZONIS
Chris Ruffer FROM TO
WWI CPrAravror MM, ft. ft
4223 A
ft. ft
NC-Well Cdatrinildr Ccrfifi&floa Nihiker 15 OUTER CkSUNGtra� LiNERlitaonrleahk)
FROM TO - VTAMETEW� THICKNE'—.6 MATERIAL
SAEDACCO Inc fL, ft. to
Conv4"ly N Ilw OR I IBING4 v4Aherinal dusxd4orio)
FROM TO DIAMETER, TIUCKNE
2 * 111..We IlCoristrucfi6n ,Oc 1t1it#: 0 ft. 18 ft, sch 40 PVC
6
rJ5ift111M;ff1-b1"wd1permits, (fir.Cnunh,.,MWP,,Vadatwe.11yertica. Ir
3 se(Check well tisq), 17.SeRKEN
Water Snppljv%Ul U." FRONT' I TO DtAAMTFEC SLOT SIZE T14T(KNFS"- I'TUATERMY,
0 Agricultutal 0 1 Mimic jpaMtbftr i8 'Itr- 28 ft. '6 . 'in. ,.'026 SS
MG90thcfalal(ReatingfCooilng Supply): .011,csidential NV=r Supply(single) rL I rL
13 Industrial(Conuftercial ©Residential•Water SupP4*'(,lx;irod) IS.-GROUT
TRMT TO 35HURRE T-ENT—PLACENTENT13MMOD&AMOUNT
0 lrji• Lion 0 ft. 12 ft. Portland pour
NonAVAtir Supply Well:,
it (t.
Injection Well:
EjAqu1&rI3Cq.ha'rgd MjrovndT-,Iia R'Coldhidon -19.'SANDiGPL9LVELIIAC.*K(ifalilolie:hf)lc-)-
PRON r,H-6. F'111 PLACT-MENT Id F.T11011
15 ft, 33 It. Sand 3
la" iirfcr Test, pilwngiq.
E JE vziimcnial To.-hridt9gy 175absidcricc CoMPI
10.,DRILLING LOG 611ach ad4lilionni sheets if ftce%sgryj
DGe,othennal(q,qsed Loop) otracer ..FROM: DFS(_Ft1Vn01'(c6br.hardtievi,jv1Vnwk sjpc,"grfm Ism%tft.)
ElGeothennal(1ea6qo,�Cooffnp R tuin). 00dier(Implaitt tnider.921-Retninks
fL. ft
4!byite c6nipleted: 3-15-2022 �1�ell ID#EW-3 1
See Goo s noteS4 X_LJ
Sa- ft. fL
MAY 3 1 2077
Chemours ft.- ft.
FUCPhy MY ff#plkable') ft, R.
1248 Bill Hall Rd White Oak, NC 28399 Cumberland C, ft,.
White Oak, NC, 28399 21.R1
Cumberland 28-33 is a 6in SS sump
ColiftLy 114trel ld:nfificjlion No.(PIN)
5b,1,4061dc:mid L. ngtmrlc in degrceshninutcstsecrinlls or i1ccinitit'deo'evs:
22.Certift-a.tion'.,
N
Chris 3-15-2022
-W
'Dale
6.1s(are)thcwell(* ml?erntanent or oTcuiparary
av mgning i�htfanrr_i frerEby irelky)way(werej caminteied h?,acevft&nve
iddr ffit AVCtCO2C.0100or ist Nctc o_k..o'_xq well Conirrriedmi S(and.ards"711d di4ir off
I ls'thlis a rel'isir fi)an ai"I:ing yvell: ElVes .6r M.Nip
23.Site diagram or additional Well details:
You may use tlie'bact bf this{rage io`pfovide' addid6nal well site.det;iil�-Or Well
fli S.Nnuerof Wells c6ustructed: cons(tuction'details."You tnav a6oa'IJ;!C[iadditi6tiaipAges;ifl vr'essaty.
Fa r j ON'hiple ky"v ah-uvirer jAipplyiq?hIONLY i4rh rhe same c4M30r1F4KQJ1,y&jrkvP
9.Total ivelldepih below land svrfkL- 33 24a. Ptir All Walsi Sitinidt this.I farin iii(hin 36 days of cornpleti6ir of Well
For mahgpIr it e ds'hii 44 pry ff dwe ry f;fi4wnp'� 3 @ 0 0- oa 2 @ 1vol wn54inatiOry to I I Le rot 10iyi,ng;
10.Statli%vaterlevel hilow top of easing.- w4qidoi'of Water R606 reeq'Infornia'tio'nProeessing,Unit,
Is vjfvi�e vaiffi:am 1617 Mail Service Cenieir,Raleigh,VC-2769 9-1 617
It.Borehole diameter:lO in 24b.Fnr InfMidaA.H Tic ONLY: In addition to sending-(he-form to the address in.
24daboie. Asa
6§6buift a Copy of this forte Within A'days'of Completion-of W01
12,'WCIU Construction-method: Sonic consitudlion to the rblloMag.-
DivNion of Water Resources,Ufiderground FaJecilon Control ProgrAin,
FOR NVATE9 SUPPLY"%VELIS ONLY' 11636kailScrvice Center.-Raleigh'.NC 27699-1636
24r.For Water Supply,&'Inicetion NVclb--
l3a.Vield kpni) maloti of test:
Also sti6tilit one copy of tlds font within 30 days.ofcoinbletiofi of
13 DisinfectiP11,13 mount -%,,clicanqtnictibuto the coiint3rhca, departrucraof'the Countywhicro,
k. A
Noah Carolina Depaurnera of Environnint and Nararal ReWurces-D,Iv is Ion of NAater Rewuras Revised Atigitst 13