GW1-2022-10633_Well Construction - GW1_20221128

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FROM TO ntentt?TER TfIICt.XFM MA TRTA1,-
SAEDACCO Inc
0 !t. 5 h. 2" it, SCH-40 PVC
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Water Supply W01:• FROM to 0f.m'- :sta> 'S1101 SW. MArFiRtAI.
5 tt. 15 ft, 211 W .010 SCH-40 PVC
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0Cms€ttr�ttr4ti eatir4t,0)Oting Stipp) Mtsidential Water Sup�h,fsingiej (i �
Cf6uhistrial C©rr uietr al DResidential t4ater'Supph(sivamd) tR;dROtIT . ,
6ROJr TO MAMMA. E111 ItTti A AMOUNT
C)ttri 'Cwn. 0 ft, 3 (U PORTLAND POURED
'Non-W7ter Supply Well:,=
ft.
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pAgtiifCi i cst CAtomt vCt 1)tainE&c
ft. ft.
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t7Geatlletutai(Aeatiui; aotit7 ketunilr 00thetit siht[sttdrr#2-I itettl8tf,5i tti 5 h. FILL;GRAVEL ROCK SILT SAND
10 ft. SILT;CLAY MOIST
4.i1'at'Welt(s)Gompletc): 11-4-22 V1+cli)DkM�-iRn. 15 ti. SILT,CLAY MOIST TO WET
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Shell Gas Station
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fr, rt: L
202 NC-9, Black Mountain, NC, 28711
Phys+cal ritldtz s C t.and l is 7'21
Buncombe BENTONITE SEAL 3 TO 41
('"manly 1>arce W-11wif(cn)1011 Nn:t11114-4 1 l prt?G � Ura
5h'.I atidrde snit I ijntittrtie in ttv+t�retaJtnnutifil5ecfn�ts nr ttrCinial tc,nrcni 32.(:trtifetatifib:
(ifu tit;10d,rare i joligifi
l3' B.ri a n EYII n 11/11/2022
Signrtwof Ct4tii'ed VWrli Centractar' Dxc
d.is(awe)the nell(4 Xtpenulnent or CTemli6rat►' 71r a srfn) ar4i;krmr,?hrrehii`C'*e4y brat OU,irrlti'a Wrts()"'ro j cxtotwered ier cierOt4mrr
worth 1_U AWAG flM,01 M tH A 5A.VCAC ti:C'.026014101 f=ws1rookut Comfetrg Z idt rAAnr a
7:h this a rrepalr to an t"ft wdl. or K M) twfl m. Mr r,
ljrht.",0 rep4r.*t'#k*Oi k/or rwow Trout g'st to it rtrr'wn re rf 4le
;>Vlflmdrr!>t_ icerl'V W40 tar rvr dw btw*nfrh sfora+. 23.,Site diftra or add tionitt sv�$l dettettc.
Y'txl ntav use the,back,of this pdjo to pro)lde additioltal ttell site mails or well
8.Ti ttttternf ells rbrisfrtntetl: l consaucdon detills, Yw nval�atiach additional pages if jWessaty,
fr.rWi0iiPkA+ifx iPcxirarerviesYtrcr,rettplra';itst7��!kzrirli rite,
rrmeegtrstr+tcri4Ar,,t. cerrr
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9'Total tt ell dhittir bCitttri;iRttd Sttiface 15 (ft:3 24a.!'nr It 'elis: Stibutit this font tititltin eft.days of co of tsxli
1,ern (it trxctli lr,r rrfA�+roc#�s fdtf ie*err sea rent to <t 2(k)er tcA 2 t !r> co r4tniclion to the folloaine:
1f1:Shillft water level WOW tdp of Wiitg: Uiti 6i6n t f V4'rter lti sfiu ryes.tatr►rtrtatiutt!'ir�tescini;tfnits
;(wort.r^Ytr Ai Y>tcr.'e r rsliax;test'" 1G17 Slail-Sm iec' rtrtcr I2ittCi„r.iYC'23GJrJ=.t617
11,t3nrt7rolc di�mctct-8.25" On.) 21U.Ei,�t gn MWU ONLV; in adtliflan to sending rite f4rtn Teti the aitdtess in
2#3 above, also s6b0itI a copy of this 10irm Within lti 0-s of Completion of well
12.Well eah fftw ion jsxt'iltod: BSA tontlntction to aloe t'nllowing:
fie.auprr.rotatf•.v-6bit.dord pussk t*r Vhvhlon ofWater Itesduroes`Undcrgoand l'tj.MIloti Golitrbl Proglg Atn.
Olt:tii'ATE tBC�PLIYWGri,LS'O�Lt': lr3frStailSer'tiee;Center...Raleith.XC2'�(iz94 3(r
13tr l'idtt tupni"t l►t ttaA'gf test.- 24c.For Water.SRl►plr&1njcthtn'Watst
Also sitbnvt oft Ccgn, of ibis fQntt/tiitlln 3Wd4jat�Coillp etionof
13G:Ulsittfixfign(ape-,, Awkin/ heitlth dcitsttnrrm <i'the minty tr irctc
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M•cll constnrnian to thc'Cormn
tonctntctrd_ ;
Porrrt 1%hwth Caroliita Depwo it of Etwirontrtrtr mid N nura)Resourers-Divislott of 1Yswt Remia(m ficrk,:d ALVzt NJI19
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