GW1-2022-09191_Well Construction - GW1_20220930

WELL CONSTRUCTION RECORD For ll:tcrimlUscONLY.-
This form can tr used fix sim=:h or atultlplc wdis
1.%Veil Contractor Inforvnalion:
M WATtR ZONES
Zach Thompson ! FROM I it) DEKTttP110N
\\'Cll('ro+4racier N.Ink
ft, A.
4478A ft. ft.
NC Well Comrtctor Cen ificat ion Nutnbcr 15.OtITF.R CASING(for nlul i tiastsl sveRs3 0R LiNF.R'if"a rkahk
FROM To mAatFTFa Ttnt'KnFSs MATERIAL
SAKDACCO Inc 0 h, 19' ft. 2° in. I Sch-40 PVC
CuntgKun Nance 16.INVER CASING OR 7•UBIfYG{ mthetmalalused•fbnniv
FROM TO D[s�tFTF.a Ttltt'K\F.cS \1.4TFRL\L
2.%Veil Construction Permit 9: � ft. ft. as
1-isruArrlpli,-rihle Wellprnnir,li.r.Cneu,l_'.S1um.I niurrr,14erMCn rhr.) a
q fl. fl. •in.
3.Well lase(check well use): 17.9t,RFY.N
Water SupptyW*ell FROM I TO 01A.IM71t SIDYNln; 11HCK%'tKS l MATERIAL
IalVfunicipala4tbiie 19' t. 29' A. 2° in. 010 ,Sch-40 PVC
tSAgrieuhural
it.
hlGeolttem>id(licatintirCoo(ing Supply) IJRcsidenrsul\Nate.Sttpph'(single) (L in.
(lindustrial/Commercial tJResideniial Water Supply-ishtured) aR GROUT•. 1
FROM TO 1.M111At. EMPIACUMENT MET110D A AMOUNT
❑Im'^titian 0 It. 151 ft. Portland CehiEntection
Non-lakater%lq)iv Well: rt. tL
Mmonitoring QRctosrr)-
in ject on Weil:
DAguifcr Recharge LICimnndwatcr Rcowdiation 19.SANDKiRAVEL 1)ACK fit ilkable
FROM TO MA71;RtA1. NJ1PLAt'/:Nr:YT Mt:Tllpl►
❑Agnifcr Storage and Rcco%-cry OSalinily Harricr 17 1 ft- 29' ft. Filtered Sand #2
17Agnifer Tcst 0stormxttcr hairs.gc
• n. u.
0Eyrcrimcriml Technology Otiuhsickticc Control
i 30.DRMLiNG'LOG(ailrach addhionolahreis it nicessara
❑Oeotlerinal((hosed coup) OTrdcer I FROM TO DESCRn'"ON tcubr.twitti.mitlowl,hpr,-rlin 4ri•,tint
I]Gcothennal(HeatinelCoulioe Return) !]Other(,explain uttdcr 021 Renla"o 0 ft. 221 ft. Brown silty sand
22' f ft. 29' U. Weathered Rock
t. I
4.Date Well(s)Completed: 8-3-2022 Well 1DAMW-210 t.
Sa.Well I[A)CAtinn:
Alcoa
S
Fa .lit)tClicrer Naar. Facility im of appii nblc)
293 NC-740 Badin, NC 28009 Stanly County. .
Fin si:71:\ddr;ss Cih.and Zip 2I.RtMARKS,.- nfz)': r 9;0: fa- ,
Bentonite seal from 151-17'
C-aulalt )'arcs)ILL-nitfwaijon No.IPI.VI
Sh.Latitude and Longitude in dcMmrs/minute,0wcnnds or decimal degrces: yL C*cilifrcatina:
(tf'actl field,me 1;Wht%-i6 udticicul)
35.404686 N -80.118723 K utit ofCeni dtFcll Da Canlrrdul "i 8/6/2022
A GZ<4
ly, .
6.Is(am)the Ncll(s): mPerntment or oTemporun• lt,-.titrri,r)•thin firm.1 hcrrhr crrri)v rho;the uwlfrav errs I%ir=rrl Concbu<7rd air w-corelunre
w;dl 1 t h NCAC 022C'010)in'15A aVCAC Off(',l209 I1i•11(-"0w4vw6.'.1 Srnraltuilc and ibil o
7.Ls this a repair to an arxisting well: OYes tar MNo '."pi ni lhi,'rrCnnJ he.l+•rt+prnrid."d to I&s,wll naY,rr.
Jf rbi"lr a Itpur.(1l t,: fngnN well(-ony.rr um)i9f arena tm turd r.t7•Gtin rhr jimult—f rile
reprir urrdr•F21 r.-nulrA.t sn-lirrn or em rhr hta:t 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%'ell
8.Number of wells constructed: 1 Construction details. You may also attach additiotwl pages if necessary.
1(r,rnrdriptr it7irtt'ri;»f G,n/rtt-trrrre'r tupph i 1•'c115 OAY,Y'rritfi rlir!rout rvnSh'ut•rioiq y„a rt+rr
sa6mit onr f.+mr. SSIMNI1,'1"t AL tN-.T�CTIONS
9.Total"ell dtyuth below land surface. 29 (n•) 24a. For All Wells: Stdanut this funn within 30 days of completion of well
Ftrr muhiph•°','1Jx fist all,lrpthr ifrJ(f,•pre•n1 Sr.:rOtnpf<••,;N t?!Y oval LGf l�a�'! eonstruvion to the fbiloping:
10.Static water level below,top of casing: M.) Division of Water RCSllnmes,Information Processing Unit.
lfnviwt lYrr1 i>,r1,wr•co-wig.ose•"+" 1617 Mail Service(:enter,Raleigh.NC 27699-1617
11.Borehole diameter..4° (in.) 24h.Err iniection WcI1cONI.Y:` tit addition to sending the font to ilk'addw, in
24a above. also submit a copy of this form within 0 days of.vntpleliou of %veil
12.R'ell construction method:Air Rotary construction to the following.
t i.c.auga.rolarv.cable,direct push.ctc h
Division of Water Rcsourrcic,Undergranod Injection Control Pr ogrant,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center.Raleigh.;YC 27699-1636
13a.Yield(gpm) Mrthnd of test: 24c.For Water Supgly K Injcetion Wells:
Also submit one copy of this foist within 10 days of completion of
13b.Uisinfititinn h'M Amount _ %ell canstmctinn to the county health department of the county%'here
constnhctcd
Font OW-1 Nonh Catolaim Ucpanincnt of Ern tionnr:nr and Natural Rearurces Un i onof Wafer 4eotrels Raised:\ugust'2)13