GW1-2022-10413_Well Construction - GW1_20221116

WELL CON TR1UC`i ION RECORD Far,I��nutl trs,oNi�^
This for¢i can beuscd f4r-4t glc of multij4 we is
i. k'C1I-Co#itl:tctorInform ation:
Ir.�►ATER�L[I�NT..fi
Brian Ewing FROA1: TO, 11FSCRtF11O\
wo1ICoGtirrcivTmairle,
4240-B ft ft
NC,Wdl Contractor_Ccnjficatiosn Nftw6ci 15.OUTER CASING ttni�mviltl eaacd�ieF1s1 OR
fl LINEtfa Fcahk=
FRONT TO ft" THIGiN AJTER TAL
SAEDACCO Inc fL 4Tia C irntanY-Nanw M INNER Cr'RNG OR;TUBING` ooa76ermai elurw: 4o i
FROA1 TO ntAMETEFL THWKNESS I AfATERTAL
,WcilConstrvr;i011PC#7t1i$ ': 0 R. 29 ft; 1" SCH-40 PVC
Jr'rr uil ajgi7icrrhJc�x rll p�rmrtz(ra:C'ounh,Strirr;-Ynrinerr.7ryerdcgl cu:)
3.V1 clt Fist{chal..rrcll asc); 17.SCREtN
WaterSolilrly Welk. � FROM I;711 nr ,%tFTFR.. 5tOTs7. 7HK-hNrS5 Y NIATFRtAt1..
0Agitcultnra! I:Munidip*_htbliC 29 (t: 34 f{. 1" iu: :010 SCH-40 PVC
tiGeoEhetmal(HeafineCooling Supply). bResidentialAVI(or Supply-(siDgle)
❑feu[astuaUConunercial DResidential'WaterSuppi-.(slmed) FRONT ROUT°Tn nrATsat rr EarFLressrF-Nra rnan aro r
❑Irii"i#fion 'fC. ft.
Non-Wafer 5u j jply W,011:
ft.. rt
M Janitonng.. C7RccOtirr}
Injection Welt:. ft. fc.
a Aquitcr Rccharge E1666d5i-a'10 ReTucili;lliou 19.SAN 0,1MkVEL PACfilr u a1160M,
'� �G•ROar' tiv ntAtF°rCrS1, •FtttPl.,1c'�irvVTHltrinrr
QAgtirfcr-Storageaixll{c,Oycly Gl$7tinih B'Uricf 27 R: 34 ft. FILTER SAND # 2
i7Aiitfei lest f7Stommatci;t3i in l;c ft. ft.
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❑Gtlieniaul.(t,losett Lou li) ❑Traec'r ';FRONT. Tt} UFscRAeTlOwrcabr,#artirdxtscutnrcrr x� ,re,tict
❑Geodlenlydalealing-CooIiDEReturn). 00dwr(t:!p6in=der#2tRf:tnad%s) 0 it, 15 ft, FILL SAND/SILT MOIST TO WET
15 ft,, 34 (L MOIST TO WET SILT/ CLAY
4.Date.-wW(8)Cdpiple4et): 10-3-22 'Well INA2TW-D-01
f4 ft:
+a,W111 I.arcnttctud ft. ft. --
_...
Seymour Johnson AFB ft; ft �a
Faatltly,1&ncr Nmw Factliiy IDN(j(aypljcatgl i) ft IL lJ Y 1 °J ��
1050 Wright Brothers Ave., Goldsboro, NC, 27534 ft, ft. I
F1i;s'xilrldd�ss.C.i •.anaZi72 T R r r,U R OK
�_.. �•���r^. '•�l,rta
Wayne BENTONITE 25-271
C tgtYb• Nme]lklmilifyplipn No,,(PIN)
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N «' ��GI _ 1NI 10/4/2022
sigmtorc of Ccitifrcd W e'II Cants^tar. Ddic
:Is'( th tii'ell(s). l'C7nS]nenl 't7P -1SITetilpUCffr;P lY.r�b a lrn hi f,farm I uerehj eve wfljx)vvs- Y.wnt eorwrifeied Ge.ucea xlm,rr
Ivial f5,t NCAC QZC.Oio4 or.I.9A IVC tCOZC.0200 lYetl OJrbtre+ctlorr Storufrrrcfs ixrirJ rlai r n
7.Li tith a repaitto ati exhitingn'elli �l5°�v or LINO "V-y 6frfih frs�iiYi Tarts_h�eat'rrr+zrirFcit irr`ifar�irlt t�w;rrr,
(#,rt'i+s l�u r:�itr,ptl cara,�rccmw x�e71 nxr,-3rarrvietta f+ijcrr»urr,'�r ararf r,il!Prr�trc ffie.rN7rnre t�f the
a tistrumltr�P tvsw t$s i>•eri�ira ricrw ttac.brut.rl"'tltfs nrnr, 23.Site diagram or_adrhtional%!eII details:
lr bu nlay use We hack bf this page to Provide additional well site details,or t"sell
R.Ltiutnticr..of n ells cvnstrnetr d: 1 rnnsiructio#tdeta€€s A'ou:illax alr:auac€t iuidiGonstl paya if ti:ccssary.
For arcritPa€Prr Irr iala�rr,a**rjtui-utirrz r Drp i lru fts OJVLY wJrJi djr'.sama ri rrstructicrr,}c+ar c lra
.cvJ mFisrxae forira. S[AIM1FIJEW,[�TSSTCICTFONS
Ojoiatisetl depth b►,la»vlans surface: 34 (ft:) �;,a. For All:S1rc11+„Sr bfidt dii." fdri within 36 tlay=s of cons lotion cat 1i`el[
Fa3rrreaidn?pJ,psc.R�1r'3rtald'�gu�s't,�d'�,'urraitf�trrra�i€-.,'{e'_'tJd7"errufZ'�tahry canStnrcti9�C4ihCt�ICocvina;,: - .
10.Static wAtcr leVel L'OW top of caslit a (10 Dit'itiiun of Water Roiau r► eii,Informatifin PracerSinK Unit,
Itii�rr'e+t t{r el b rtLaik r s to 'tua"}` 167 htait S"T'ice Ccntcr.:t2 ticeph.�1["27G99-IG 17
11.Rorchc►Ec d!>;inetci:2.25 tab: n n r�;j�IEg ONLY: .Fn addition to sending liVr fom7 to iliaadder in
'24a aboc@,alsi3-submit a.cop.V of this fanii ti}ithin.O dabs of Completion-of%til
12.Welfcnrrstructiou nwthod: DRIVEN c`onsttnctloti tn'the ftil]etviilg:'
{.c s"ger.raraq cntalr•dtmit hash:etc')
1I€ hiou of Water Resources;VOdcrground Injecfien Con"I F rogriom,
FOR NVATELR It SP`LY WELI$ONLY: 636 MA Seri ice Center,Raleigh,We 27614.16U
13,l e1d(tgimj Method Of:tcs;. 24c.For Water Supply&1R cctfon 1rV`cltsE
Also silbnlit o 'cop}•.of this forul within 30 days of completion of
1 bisinftitimpn, it -- _ _ Anfount:•
mcli constitrctii ice the calmly beah dcpanmm of khc-counh•:eslrctc-
co#jstnlctcd.
Pann GAM t 0.0 CarOina Mpaunsnt o.f Em.irojimeni and Vawral Resources-Divi's Ion of Rrater Rw_a,Ut» Remised August_V 1.1