GW1-2022-08300_Well Construction - GW1_20220822

WELL CONSTRUCTION RECORD For Internal Use ONLY:
This form can be used for single or multiple wells
1.Well Contractor Information:
:14.WATEiUONESV gar.
D.T. CHALMERS, JR. FROM To DESCRIPTION
Well Contractor Name ft rL
4146A rL rL
15
NC Well Contractor Certification Number
`;INNER"CASINGrOR�TUBING'other 3f!rcc13sedzloo
FROM .TO DIAMETER I THICKNESS MATERIAL
CATLIN Engineers and Scientists . 0 rL 21,1 1 i..l Sch.40 1 PVC
Company Name trlii.;OUTER'GASINGr form lfi-cn'"°"s'ed wells yoRlLlN-M4,t�a iicadle
FROM I TO I DIAMETER I T}IICKNESS.. MATERIAL
2.Well Construction Permit#: N/A rL rL in
List all applicable well permirs(i.e.(.ounty,State, Variance,Injection,etc.)
ft R in.
3.Well Use(check well use): REE3 �'�
Water Supply Well: .FROM I To DIAMETER I SLOTSIZE I THICKNESS MATERIAL
❑Agricultural ❑Municipal/Public 2 ft. 12 ft. 1 i in. Slot.010 Sch.40 PVC
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) It, ft. !in.
❑Industrial/Commercial ❑Residential Water Supply(shared) fs cxbuTY
FROM I TO MATERIAL En-PLACEMENT METHOD&AMOUNT
❑Irri ation
Non-Water Supply Well: rt. ft.
❑Recovery rL ft
Injection Well: ft. n.
❑Aquifer Recharge ❑Groundwater Remediation 1 i9..fSA'W/GRAVEL\Pt�CKTifa l cattle
❑Aquifer Storage and Recovery ❑Salinity Barrier
FROM TO MATERIAL -IPLACEMENTMETHOD
FL ft.❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control 0 fL 12 rL Natural Backfill
_r, . x �:
20.reDRIU1lINGiL'OG
❑Geothermal(Closed Loop) ❑Tracer FROM TO I DESCRIPTION color hardness soil/rock type.Knun size etc.
❑Geothermal(Heating/Cooling Return) ❑Other(explain under#21 Remarks) ft. ft.
4.Date Well(s)Completed: 08109/22 Well ID#: TMW-02 rL ft �� O
rL ft S
5a.Well Location: ? �.
ft IL , �- 6c,*r.—o
NCDEQ-SILVER LAKE RD. UST N/A -
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Facility/Owner Name Facility ID#(if applicable) �O
5002 CAROLINA BEACH RD,WILMINGTON,NC 28412
Physical Address,City,and Zip
NEW HANOVER N/A
County Parcel Identification No.(PIN)
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification:
(if well field,one lat/long is sufficient)
34.14989 N -77.90351 W 8/10/2022
Signature of Certified Well Contractor Date
6.Is(are)the well(s): O Permanent or M Temporary By signing this form,I herehv certij,that the well(s)was(were)constructed in accordance with
15A N(AC 02C.0100 or 15A MAC 02C.0200 Well Construction Standards and that a copy of
7.Is this a repair to an existing well: O Yes or ®Nci this record has been provided to the well owner.
ff this is a repair,fill out known well construction information and explain the nature of
the repair under#21 remarks section or on the back of this form. 23.Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8.Number of wells constructed' 1 construction details. You may also attach additional pages if necessary.
For multiple injection or non-water supply wells ONLY with the same construction,you SUBMITTAL INSTRUCTIONS
can submit one form.
1
9.Total well depth below land surface: 12.0 (g,) 24a.For All Wells: Submit this form within 30 days of completion of well
For multiple wells list all depths in different(example-3@200'and 2@I00) construction to the following:
10.Static water level below top of casing: (R,) Division of Water Resources,Information Processing Unit,
If water level is above casing,use"+^ 1617 Mad Service Center,Raleigh,NC 27699-1617
i
11.Borehole diameter: 2.25 (in.) 24b.For Infection Wells ONLY: In addition to sending the form to the
address in 24a above,also submit a copy of this form within 30 days of
12.Well construction method: DPT completion of well construction to the following:
(i.e.auger,rotary,cable,direct push,etc.)
Division of Water Resources,Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center,Raleigh,NC 27699-1636
13a.Yield(gpm) Method of test: 24c.For Water SvpDly&Imection Wells:
Also submit one copy of this form within 30 days of completion of well
13b.Disinfection type: Amount: construction to the county health;department of the county where constructed.
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Adapted from Form GW-1 North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised 2-22-2016

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CATLIN
Engineers and Scientists
WELL LOG 22021.4 SHEET 1 OF 1
PROJECT NO.: 220214 STATE: NC COUNTY: NEW HANOVER LOCATION: WILMINGTON
PROJECT: LOGGED BY: Cf EUTRAL WELL ID:
SILVER LAKE RD. UST DRILLER: D.T. CHALMERS JR.
NORTHING: 1473771 EASTING: 2331772 CREW: TMW-02
SYSTEM: NCSP NAD 83 USft BORING LOCATION: SW of Fomer UST Basin nearest Silver Lake Rd T.O.C.ELEV.:
DRILL MACHINE: Power Probe METHOD: DPT 10 HOUR DTW: NM TOTAL DEPTH: 12.0
START DATE: 8/9/22 END DATE: 8/9/22 24 HOUR DTW: FIAD WELL DEPTH: 12.0
DEPTH BLOW COUNT OVA LAB o o SOIL AND ROCK WELL
0.5ft 1 0.5ft 0.5ft 0.5ft (PPm) Is G DEPTH DESCRIPTION DETAIL
3.0
0.0 LAND SURFACE 0.0
0.0 o1j0.5 (GW)-Asphalt and Gravel mixture >
a
(SP)-Brown to tan,F.SAND
r -
Direct N M D 2.0— _
Push
3.5
4.0 (CH)-Lt.tan with orange mottling,highly';plastic CLAY
with slight HCO
Dark gray from 7.0-8.0'BLS with moderate HCO
SOIL:
Direct NM TMW-02 M
Push
(5-6') o U
oa
0 0 _
N r -
U
8.0
8.0
(SW)-Gray,F.and CSE.SAND with very' faint HCO
Direct Push NM W
?'o-r
12.0 i-;r 12.0 12.0 12.0
BORING TERMINATED AT DEPTH 1210 ft in F.and
CSE.SAND
Direct WATER:
Push NM TMW-01 Sat.
i
aNative Backfill
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