GW1-2022-07632_Well Construction - GW1_20220817

WELL CONSTRUMON RECORD For lacnwi tstoNLY:
This.formcen be osedforsitgk or mWtipk wetly'
.well Contractor Inforntation:
Tula
Rich Lemire PROM TO
D►�'RIPrl N
WCH CotTtbCto N-Agm ft. ft,
rc k
2593A
NCWep ComractorCcrtifetation Number 3, or'iiNiastrti " 'flR1ttR;` H�iibR FROM TO DEANTTF,R TM(YWNT-% MATERIAL
SAEDACCO Inc 0 ft; 6 p. 2" io, SCH-40 PVC
Contm'A`rreC' 1d1'.` G01t97tN%`' strlo'rsedtgi'<' » , .
FROM TO I TIHCKW 4MATUMAL
2. Vell Constrvetion Penult
blo trlitr*irable writ pe mtrs tr`_r:Cmraery.SANr,Varintror,frier#04 uw'7
3.wdl ilsc(ctreck ivd]Use)-
lVatcT.strppi�*4A7i11: FROM I TO 01AMPTER' Sid1TSIWJ 7UP('KNM, MAITRTAi
IOA Utturat omfinicipavpublic 6 16 tt; 2^ i'L .610 8CH-46 I Pvc
0C,00theinutl CHeatin000I!ng Si vly) MOM Water sup ity.(Sins tc) ft` L ih
®IDdvstrial/Cotnnterc ai Oltmidential'Water Suppta(shared.)
FROM TO MATERIAL EMPI A(I MT1?J11ETi166 A AMMN-"f .:
Olrr tian 0 ft. 3 ft: PORTLAND POURED
Non•Water.Sappty Weft:. ft
liNfonitorin OReeoxery.
Injection Ivetti ft tG
DA(luiferltccharge OCtroundvmterReawdiation t9 AlD A fit 6►i
OAqudfo Stomp and Rccowry' [1Salinii<-l3arrier Mart Rt itM t► Y,Twrltim
4 ft: 16 fL SAND #2
17Aquifcr Test ❑Stoirnhater tha mgc
tt:
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�2ti:`1f (dt�ch�a tjaii►alatieed'sif" rr
DGtothe mal(ClosedLoop) ❑Tracer FROM' 70 DESCR:OttO�i miar;LiprQneri thirruckt atar:trt
i7C,todwn uai(Reatin Gooli Return) ❑Otter( iti udder ik21 Retnatl+s) 0 ft, 20 ft: bROWN SAND
4.Dite Well(a)Completctl; 8-4-2022 Wal11)#MW-LF03
(L q.
Ss, Wtll I:oc>rthin: ift. aL `L.�U
VENATOR fi; h
Facilii.00owrNamc Facility 1D0 arop4obic} ft. ft ,
5910 Pharr Mill Rd.., HARRISBURG, .NC, 28075 ft, it: r _ e
ith..�rirfi�Ji t�(;'�%�ur-ar.€a:��, Unh
010 lied Address.City.and Zip ,2i:REittARttS 'r
CABARRUS BENTONITE FROM 3-4'
t;,twttt}; t*atCr:t l�ir()t`ir,�tiorS Na,(Pl�'i
Sh.,t.aititadeand l ongfprdc in kgmct�1nti tntes/ cbntfFnrihximul. rtrese, 23 GcrttRcatiirn;.
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8/5/2022
row�m.oeA �-
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6.is art)the tudi(s MPennoucnt :or...oTet Pa
( ) t}' tij s4bv ing r7r r farm 1 herbJry rrrLlft ihi;1 Av r+w 4A o tWr fw rrne)t rt4tnirted Ln.vrt and mrr
iiith 13A NCACO2C.Oi or:15-A AICAC I C.0:00 We#Cortor(rr kw Stmddardi(vid tknr it
7,I:r.tbitS a rvoir.to an.cxisiing wdU OV6 lie COiNb eopy o¢-41,rear i h"la ra;wfeed Tri sfv wvfll mritrr:
tJrhlais a iqi*,fill pru iosen m f the
rrpwir a diio l rMA2*X seer&v,orrM it...brsrA-iif t/dr pruc' 23.Site.diagram'yr additional tt cif detAU-
Yon nab use tljj0 otIM paw id,
o proy9de:tddititii of rill site details or ti 11
>l::? i irrber of ascfk csttttcirtl: 1 sotLstnatiiotttlttails. 3!au_iaa} lqo atlafillditinit3l paita�cctat+rv:
Fur irirrirt It ird k�r or rir i•nr)rar sup[45-ledis ONLY r hil 40 wMe.jv?xrsrructlo»„ter c�r�submitow form, $.ld11!lI1,Tl LINST115TION____C..
9.Tatal eltdepth helmv iand surface. 16 (f1.} tat+ Far All
VVeUa Submit this form within 3tl d t�s of rv>tmtdion at ii 11
,jFor nuditprr,rills list tiit itrXu v r deffer-w(erornp(e-3QZ-0 J'ni&2@ 11wr) CvnStniCtiOlt icl ttr�ft)lloniitR:.
10.Stark waterim-el bdoW top of fa8ing:.16 (rp bl�,6160*f Whet R60urtl,b6nntition,Pftte ianR Unit,
i/riEtaer Jetcl tr vrr rin lrl ase"4 1617 Man Ser►iee Ccutcr.ltnlcil ly NC 176934617
it.BorditiM diameter:8.2511 pia) lib.For inicrtlon wetly ONLY—.L In addition to sending ft form to the address in
246 ibbVe<al€o'subinit a Copy of this fnttlt.uithin;?i► 631 of completion of WWI
12.Welt constmetlon woethod:AVGER eoubtructiontolho' Otto Ling:
dt:c: rrgrY rou+,r_.-ably dimr rah cte f Air!Lcion of Hater Res6urcc e,Utidergr6nDd:InJettlnn Control Ptti►tram;
FORWATERSbP �V.PLYEL S ONLY: 163611faTi 3et�itr Ceater,FWd.gbiNC,276"4636
a Yield(g1►mj Method of tot:
.t'nrWatcr,5
13 24c upy9,�&ln�ectmn;liettC:
Abdo submit one co :af N fcinii isitbin 10 dwsofcompletionof
. trclt CptLSituCiiDn tot11C`COunty leralth depa)tmrru of Itic co utrt)�vr•tecae
tab.bfAinftxtiion .,,.-m „--
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