GW1-2022-06994_Well Construction - GW1_20220725

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WELL CONSTRUCTION RECORD Ful httu'nal Use Only:
1.Well Cofilr•actor Infnrni)atiun:
lrif!•�J°.�� !' {�1' rt rs�ro ;J�, 1.7.WATER ZONE'S
\1IF
'cll('utrt,aU,•r\atnc -
L—t
NClhrtlCanot,iturtl•n,fic.1l;,,n%uinhc, I 1 � r- "`T i ��'.t3�':-rPr'Ii:•'.-.'l' .'•.� %-i `
15,MITER(:ASIN(;(far multi-rasctl tvclls)OR LINLR 011 app icahle)
ru _ IT)I\SIG:rI•:ft i '1'It l('hRIC55 At.CfLKIr\I. j
It. --_ in.
16.INNER C'AS1NG OR TIMING(geothermal Bused-loop)
2.Well Conslructjun Permit r. _
PKUtI IO DIA�I F:rER I rIIICI:NPSS \14'1TRI:\1.
I.;<r uli app1,z ui,h u','ll;•a:;:rrr;hr.n i!••rnnn n, (W !'rtutn.N,'a •. I,n r,nr, rrr 1 �) fl. Imo _'_ t�-'.�- in. i`-' ��L..` ! �p-C
3.\Nell Use(chC•cl<trell usc)t It. ❑. n. 1
N ater Supplt Well: 17,SCRELV _ —FROM Fit_ 1) N1111C'II Fi il-(YI'tila 'fill(:I:\'1Cs> ' >t tl'Pl'I tl
i-----�---'\crtculuual �[9unic ij,al!Puhlii fl. ut. v n c
Gcnthertilal(l leatin):I_u:lin¢Supitlpl �Residenu:d\1'alrf tiu},pl•I --'=---
li
lndustnal!('nnunerccti �Rrsidcnlcll\Valet�u),I,Iv(sharcCl) -J --_
IR.('ROUT
Irngatiou FROM _ru t).tII'MIA1. I taiI,I_\('r:alr:NI All:rnul,&n,twrvI
-
:Von-\Voter Su1)pl) \\'ell: �, ft. 3 .• i"it. :'�1'c:.y- t i� H,j t-`�o�f��J••).
- :h•lun,u'rltt - - tt-ear -{ ig-'-) _-- �-- --i
I G-l'c^ar /`tla tom. I
Injection\\'ell: _�-� � -- T '�xLr�j-- ---.-51_e_ L�/-�✓ �=�-i
1 ft. 1 ft. 'I[.e6 f C I�U r.P-"i-a✓:JAY c !
\quiler Rerhatec f(amind%,;ucr Ren c.iiation L — C P.a.-L•C r
19.SAND/GRAVEL r:\Clt fit a, liable)
AyuiferSuuaecandhc,'"arr\ ❑sillinilt Isomer FROM I at•\rt:IZIAI ha1PIA([;veNralrnu;u---
4\.IuC I csl ti[urnt%% ::ct L)ram:t_c j �' li. I It. S/o c-y r ��� �� .fir<' / �-!•''•1`I
l�.perntemal T'ecjutoi", , O�Subsidcn.e+-annul i -n-j--- p '-- ����I
i6coli mill I( Ic„e\'•l,,-ari El'Tracer 20.DRILLING LOG(attacl additional shock if nccessarv) _
I FROM Tr) nlJic`Itll'l'I ON it to r.ha ral, sniVrn:1, in
C othrrnal;ife.ain 'i r.eRcalml Dotllcr(CV11i1111IlIl rri_2l Rrnnirks!
rt. r- o ft.4.I)alc\\'ellls Coot)leted: S-"-` Nell 1Dr; I J 1•.J,re :..�r-v,,�e>-iT Cje,
3a.t\ell L!,calion: !J I't. �-' It. ,0 ----/--y
f�..�dVg U«t^ S`4��j-�:�•,t,S" �I_��� 1i. ft• �,� �` n ��'�r' ..y"- rU f�''`- .
QE PVE
21.REMARKS -- 1-- -- -- - - --- --- ---- -
- —Irelo+'+x�en P►o4ar{v111tJ llM--------=
--
jh.Latitude and longitude in tic ret•sJminuti>iarcnntl..or decimal degrees:
%!!,yell lill ww 1,10"llt 1,.nlfu iQW! 22.Cel'Iilicalio K:
. 13
irrn ) rt Qart ure ul('cililicd\\Nil Cmuracto6, .Ltre)the vellts)� 1u --
------ -----
„..
poi
lip xt ly this finer 1/rrrrl,; u,;rfr rh,u;ir< .:, .v u•,i. ;u,•:/..... . .v. ..•
7.Is this a rrpail'It)an e.\iain t\ell ❑Ye> or No uiu;U.1 S(';Ir u'( nlutrn 1.; VC,lr'n;, n r;i'r:,:.r.:, ::.• r,
!!fit!.:,d: rnr n„n,...,,� : .., ul,.',Il.i • a1:n ottlfbn, :r/r! .n.i r'/'r' ,:.fill: nj:iu, runt n1 tiu�rrrc!;r fur.1�:'r• .,,,..,1 i Inr:_.:n.,
23.Site diagram or additional well del:tits:
X.For GeoprohvID11I nr Closed-Loop Geothermal\1'cHs iititntL the same YOU utay use the back of the,pa c to 1)nxui adchuontl tc 11 cue dl ul ,:en
�,nc,truciunt,uni% (TV, .,n;eJc,i In.�,c,,:� ell \i :\ o i, cunstnrCtlldetail;. Younta`. 1vtge ifacccssarv.
Chilled.
_ ---. -- - -- - sut3,IrrTnl,INSTRUCTIONS
9.Total well depth helot, land surface: _ � -� lll•1 24a. Fur All Wells: Submit thle Gun; %%itiur, 30 days m :nmi IC:U,w
1;ant!tin(,1,-,rrlhlrv:rtlr/•-pU`r,,l;:Li!r::�rt:��-,.rrrq�r',. P .•
construction to the lolbnvine-
10.Static water level below(up of casing: � � Ift.) ,
Division of Water Rc;nurccs.Information t rnccssinr,Unit,
1617 iNhil Service Center,Raleigh,NC 27699-161 7
1 I.klorehole dianleler; -(in.) 241). For Injection Wells: In addition to sendntg tltc G,mt tit ihi.a..,n.
ahc,ce, also suhr.ti! unr.op\ of the, G'rm ,,:hrl III;I:!•;o- of t m,.Pleliorl of%vrll
I2.\Nell construction mctl)gtd: runsu MCI iI'll to the t„Ilotcme:
Division of\Voter Resources,Underground Injection Consul?rv-')srn.
FOR I'll St'1'1'1.\"\\•ELLS ON*],): _ 1(>36 11ai1 Scrvit c Center.Ralci h.NC 27699-I0:)
13a.Vii•ld tgpntl Method of test: 24c. For \\'ales•Suoaly & Injection Wells: In addition Io :call the• Ihrr.) t:,
the addlvss(Cs) ahovC, also :,ubmit one cop) of this loon within 3t day:, o!_
1311.Disinfectiuu type: :\nwurtl: culopiviion ul %tell :oIlsuliclipil,IT, the C!un11v health dch;uttltcnt Of the COuluy
where cousinmed
i,r,nt Ca\�i Nor\;t'u•:ini.:trrP;:ntr.,,r..,„1_m.t7,.,r!rrntal t�rtram:.f)t,rwn:"i`.\,tr:r Kc.ourec., F.:•r:c:.:-_'�;n''