HomeMy WebLinkAboutGW1-2022-08615_Well Construction - GW1_20220516 �QELL eONb'rRUGZTON RE ` O� 3 ffO 2- `'`
. .. G�V-1 For h�aai O�aiy
L W Qa Coaeturlafor=tlon: - Usc
well ca=mmrN— a �/ 14.WATFdtZpNES...I y,:
• --�, c�"�'r/ EOM R. To 0$ n�s�aox•
NC WeRCosaaeme CIiacxd= 1 R $
_ '; l .i(�v `�M�Gt.S�iG 1� 4ieIIs OgL�IICR' .r=n._•-.
'} DTADZSiS6 1Z� x�•r►s►�r
2�mftmcd aPramlts. 4 �` g$4RL9OR7 MMG
>�OM - To ,Drs3tsta
zsaau ,�Te„vIImaa ,�2 �MC Co oa�.scae vm m,�aeJ t ' Rftiis TA rt-Iv
3.Weulrise(ehceicweII aser $ tt ;a.
Witrr Sttltply We]t: - •nz :.-x: ;:;�;,.�,��>„��.c,,�•.,�.'w:.::=� ��:�:��
DAg MOM TO nre�Re sLor=
Cal(gcapag/Coolmg SaPPIy)
01/Commarial Wad'SPpl3'(d81e) tt it .�. - •
9 entialWaterSupply(shared) .Ia'.GROQr�.:
Noa-Water Sappiy WeII: 0 7ers>10,000 GPD :rsaou To
mi AL g
Infee(z�on WWeE— CRxovery & g, •�
C1A U fwPerbmge p adnzZErRemediatioa $
yBanfer
�QA4aS`totage and •:'19 SANID/QtAv3LPA
QStomtwates•Draiaage sa�csimvrt�:-
tj
S. g,
C 1Techaology OSnbsideme Con rd
R. IL -1
I(ClasedP) CTraca =20.DBII.LIIIGFAtG
(IGOpffieffieT at haadifi®flihee$'7f 1,. a w..�.
L Rctzd) OOdtrr( under 2l RetnaziCs) lit TO a ,. .� • •em: -•�
4.Date Wetl(s)Cotttpieted: - Z.• .%- Wen IDd
_..
Sa.Wen Lot:afion: .
- MFkffi �
y • Fa�yM#C� n Pray
^ ��) lnfot+n
Zt7f a -lam O� IAam e 5 RdPIWdmI �
p'&`e,,Ck'. Wit 1 OW Tr i - '� &
—Y.]!� / Gv :21.'REDIAIi85;. \:,; .�;`�r;;y:. ••,. :•.,
�1d�azioaNa(PIlQ)
Sh Latitude apd lotgitade in degrees/minates/seeonds or decimal d
Crfa+eIISeld,tax ladloaga swat)
3
6.Nan)the„a(S).. ermsaent' ror 1Temporxry 3 -Sib Si Dm
7.Is this a �'� 5 *1 I d—dwwWs;vw(wvwj Oxa=wdww, ,
ragrirtasaemtiagwe�� OY�s or fto I561YGtCOZC010oarLSdNG4CDZC.O20olPrdCaanmfBaaamly
IfthLrisargalr,fig
o�bienr� �y�y�y+maierp�obirheimaa:oftJie oftiarrscmdhmbmrpovfdodmrhe�rrIIo�niv'7lp iOJf7Q7 17m707�SSiCltOROr=*c&m l.'Ofg&fw L
8.For Geopcobe/DPT or Closed- �•Sift gam or additional wcH deader:
Loop Geothmmd Wens having the same You may are the back of this page to protide additional viell oonstnmdan into
cOMftucftoa,otdyl GW-I is-needed.ladiciftTMALMMERofed- wens (add'SecO7ceiaR=m3mBoxlYoumapaLsorsita&additiooalpttgesif ,
th bdowlaad sm wL- '2 2 d 24 SDBbBTTAL_Il�ISTBUCTIONS
9.Totalwell dep
FosrmlnplsnsIIsRcaIId�rtrla:&+�(—VIe-3@200'4d2gto0) (� Sbbmit9tisGW-Iwidtia30 days ofwencouWkCanpertbefWkwhr
10.Static waterkvel bdow top
(fe)
of 24s. Ror AAllWdix
1frmarladtsataNeoaL�Fae. �0 Original foaa to Divisiaa of Wafer Rasotnoes(DW$
/ btfmmafiaaP:ocessingUni.16I7M5C Rddg6.NC27699-16i7
1I.Borehole diameter. G �Y {m.} 24h Foi Iaiee:son Wel=Copy to DWR.Undwjvzmd Nactiba Cmewlh'V
12.Wen•eonstrQearon method: (<0 l i►„ / '1636 MSC'Raleigh'NC 27699-1636
CLe-Aww,"My.caw&OMFOA ae') 24c.For WaterSn and Ooe_++s
,. �y.` e�acmvaamn•�m
aele� Copyiti the
FOR WATER SOPPLY WELLS ONLY: 24d.For Water Weus du ' over 10040 GPD:Copy WR,W.D CC=A
13a.Yield(Z;* Method of test: Pe mitPtogtmm,l Il)aC, C 1 Il
13h DitaaSeetioa type: '� Amomtt:__ >M Z �✓
- i
FainGWl' )Tw&C=&zDV mmofEnvitoameasalQuality-DivmonofW=rResuases
Ravixa 6 -20I8