GW1-2022-07635_Well Construction - GW1_20220817

WELL CONSTRUCITIO. RECORD For,tttow.1 Usc ONLY:
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2:Wei!'Gtntt orit fortttation,
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Rich Lemire KltOM . 10 pKKVMQX
wow tor4rjaorName ft. ft.
ft, ft.
2593A or'
FROM To DKINWT
NG Well Comreetar Ccnrftcatibn TFamtier
;pt#:t'F.1t. a' inuttl eased; ci Ott"tdP#Rit a 'tie ti` 3.
F.R TtI1GK!'r5S' MATERIAL
SAEDACCO Inc 0 f4 14.5 F.L. 2" ht SCH-40 PVC
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YRORT TO DWMETER. THICKNESS VMATRtntAL
2.WW1 Cnnshttt tion Pennit tr tt.. fu
t o all a,wu wblr wro&,.d s f+.a Crnrnrv,sawk,'.v rir^v-,1 d[4 ew-j
3 well yse(e well rise):
1�r' tcrSat►pt� Cll ffto" I t)IANIFTER StArrsir7. . TfA(X%'M'TI MAT TAL
IDAgricidlurai DMunicipamtbtic 14.5R• 24.5 ft.- 2-i 4 010 SCH-40 PVC
clexti entlat(Heating Cooling SiTphy) ORt:sidentat Water Supply(single)
ClindustritUCommcrcial Olkesidt:ndat Water Su sharcxl
( TROM' To MATERIAL< EINVIAC'f MENT 11tE 100 AM ,T
OWgstion 0 ft. 10 t4. PORTLAND POURED
lion-aster%ppiy Well:
6�>vtonitnrn : Ottecosr � ft, tt,
injewon well., tt ft..
0Aquifcr Recharge Whoundvm,we Rcowd4dion
OAquiferStorngc inn 17a:0
1,Cry 0sahnity Bariicr ;r` xtAT rant,. tcstat s;1u 1T?txTitOn
12 A. 25 ft. SAND #2
C]Aquifar Test OStomsts-tta fhai nags
A. ft:.
Cl"ndmcnt tl Timfinologs' 0t ubsi4ncc 6otrot
itf 3i _ Tait` wdolaa
nFeROCftthemul(Closed Lwp) bTmcec be a(t*ab(r.w_oro_
e tn�riru ,4*.
octodtenllaltlteatin Caol Retun) t74ther(evx einntulertfaI Rematltsl 0 fi. 20 ft: BROWN SAND
20 A. 25 ft:. PWR
4.DiteWCRO)Cllomplaeil: 8-4-2022 WdlID#MW-LF04
fG- ft.
Sst lltrll"Catillm (t k
VENATOR iL (t: q-
Factl4;0t NncrTtamc facility 11)0(IF"plicabte)
ft,: � ft. r
5910 Pharr Mill Rd., HARRISBURG, NC, 28075 (L ft —
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CABARRUS BENTONITE FROM 10*-12, DINQiBOG
CesrtAj` ParcCt3datdtf�atibn.ivb,fPL'•;l
5b,l.sitfmdc and L. nyftttde i.n dec lmlmtt secansl'or d imal; c r r am.; 2 Ccrtii"rcation:.
of wen Ltd;OTC 1*16 lii:sr�ttet-tu> ss
N W 4~4- > 8/5/2022
Sitti 4f Ccnii. wcl[Caatractoc - Dam
6.Zs(it*)the trefi(O., WIRennanent or...ElTdoporary. sr rtirt A4L tfiJn 1 ltertbt ees. .ikd the awlt ewhv)tw7grezeted wr wvo,dWwx
idift 15A NCACOK.&W Rr`13A:Rr6l C 02C.020 MY COftomeffm SoWivds etrt(I jkw er
7.Is tlti a repair io an txh ing wtlt;: 7YEA i t tibNo rr rl+ltlr rormw tits firm j-uv fwd 1*i*r av11 medrex
If ild tr t+lovir.fill tx+.krm,w uall tougl1wrion 1,rfu1ta06a at:d i tyilniu.tlu tuuure of Jhr
r[pi6ir wtdrr 2l rtRnkrkkSertfarr M tar dx bkrk of llria fiirin: -23.SttC dlagr8m:ctr 8441tional well.detAk
Yon mat use tlit?`ltack of&61 to tsio(3tte a'•tdditiotlat 1re11 Site deWIS Or AwAl
$::�ttrnl)f�'6f-�Y4flg{�NSf!!iC#it'fl:-1 Sti11CLi4tlt1etF111�+. �',Q1JA18}`a`ti99.Iltta�hetltti381.QJ1'1SS&rt�;
l�or iituftf :t>;fe rto»or ro vt• arrayliqwy wells 0)VI 1`nfdt 04 wme cottstrukd6n ran i nt� A l I1 C t iT(170NS
ase3niiratsr/rimvi .. _ . .
9.Tntaf ado dgttl►below land srtr[ate 24.5 (f,) 242.For Alf Welts Stibrttit this form within 31t Cloys of cYiitglfdiOti of well
For atrrtfttptr tir11t list toll iftifts ffdiJferou(e+xm�f�tr 2t?n'atttf,2 )tNJ) cominiction tp the foIttm
to.Stetie Wuter the lteldw.tap of cusin c 16 _(tt.) ifivision of Water Rcc4ure ,Inhtrmafibn Pry tesfanR itnit,
Ijii�tter trrrl it c t"r rx+lm,r+.e 161711fa1t SetsiCc Carter.Raleigh.:,NC 276g4m(,17
t1.11orChnk diamCttx 8.25^ (( ) 24b Bnr tniection We1tc ONI. :ln addition to sending the foil to rite address in
24a aWVe, also'Wbnnit a:Copv of this form within.30 days of Completion of hell
12.Well COIMTuctfon►i{ethod AUGER Ct"wiction to aidToTfou ink;
t;.e.`,atte:r. ,y. ,nlc'diner push
DNlsion of Wafer:Reaoarcea,:IItadergi�und tujcctiati Gontrvtl.Pto�ram
FORNVATt R Sbt'PPLY WELLS ONLY. 1636 Mall Seri'fec Ginter,Rirbei);1r,�iC.2]699=i636
13a Yield(gl►m) 'Method,of test
' 6i WAteesp tpi &1wection��'ellS:
Also subnut one crop) of this fonii aitbin,Zti days of Completion of
13b.brarnfixtiionttroez AmobnN_ s sell Construct an to the County hcahh department of itu Cottnt<'sa'ttGt=
constttictt�
Faun Gn`-1 NwiftCamliw Vgwnwitt of Emimiuix nt and Na4ml Reowms-Phis Ion of WalciResptiloes An[scd:Ay�uSt 2tii3