HomeMy WebLinkAboutGW1-2022-10674_Well Construction - GW1_20221128 WELL.CONSTRUCTION RECORll
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`IJ:.WATERZONFS .
John Eisenman FROM- 'M DESCRIPTIOV
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FRONT TO I DTAMTEit' TTQCr,MSS NTATERM.
SAEDACCO Inc
Cr";1AjNan%.,•. -1ii:1NNFR CASlNG'0R-TUBING.4'LAtiem►A elused-loii"-,,
FRONT TO Dt4STPtGR TMCKNiESS MATERIAL
2:W0t'CUn:iti*fi6nPercriit#; 0 RIF 8 ft. 2" !% '� SCH-40 PVC
leer atdl app7ira6lr rscN pramitX fee:Cnuntg.'Sta:c,lrpriamrr,fi�yerrir�rtr J
�:Wcll;t�sc_(chcclin�cllasc)i� t r17:5CRtl;N .
Water SupplvWei,h FRONT- TO DiAMY.T£it SLOYSIM Tn1CKI SS N1ATMAt,
r1ttgTicl nual. Cll4ItInICIpaUI►ubA1C S ft: ig ft: 21' tq O10 SCH-90 PVC.
®Geoiknnal(Heatidg7Cooliii Stipply3 Mesideittia[EYater-5uppi}'(single) fi• ft. -in.-
®industriaUComntcrcial Mcsldentiat Wotcr:Su .18;GROUT. .._
PPiS'(s117red'}' FRONT -To. MATERM -ESlF1.ACENMNT3tMOD&AA1OUN1T
❑iri anon 0 'ff.- 3 ft. Portland Pour
Nna=Witter Supply WOO,
6ahlpiiitriring pl gcyctg
,Injeellon Well:
�IflQlfif¢fRCGhitr>,'C 0(.ipufWv:ttcr RefiWi-tl0n t9zSAND1G%tVEIi PACR'tlf• l ilic:ibfe —
:"FRQNT TO - NLITP,RPAL RUP1.ACIMIF,VTM"11On
ArlijnifciStoragc;tli�ltccaicq'- la5almity Bamcr 5 R. iS ft, Sand #2
13AgikciT6t- ❑StoiTriiiatcrRrt iiaoc f�• ff. j
❑T XPCOmca.631 Tcrohnofogy. 17St1bsidclicc,Coutrpl
�2nli/RILI:BIIG'I.OG7allacti eddiiional slieiYsif neecssairvl
OGci:iltgmaai.(Closed Leap} ❑T�oer FRONT To DfsStiRTPT10\votor.hartlnca,uilFn>tk n 4h.<k I
❑Gootliciiiiai aiinglCaoUngMutn? ❑toter.(eAplaiumuier#2IRetuaT6s)
.4.bite4Yet!(e):Completed;'11-1-22 rdlllPjtMW-11t 4
-u Well Iaicatuto -A- f4 V Li
Mills Cleaners It,- ft,' ! UN
Faoflity,Qtv ms ocrNa FaciliijlDk(iEapplicnblc} `
ft, ft lnO, ,r s
1305 Skyway Dr., Monroe, NC, 28110
Plgsirulxiddiess:Cit}'_andZiP �2titl:tifAltt;S' ,
Union Bentonite seal from 3-51,
t oaruty Parcel 41:111ificallon No:(PIN)
56. ilcOveilminutaAceonds ar decimal dcgrcrs: 22:CerrifecntinD:
(if.Yc1I TiCfd;otr faiflol>f is'sultSckru)
N AV . • r- - " ' _11/6/2022
51gmnlrC of-' :k �f _-" •• :—•_ BAG. .f �+' ;�xii.. _
6.I9(40 IhC Tva(S}t MPcrntauettt ,or 17 FCIItpOritt} 11t ylCrii�i .,rhu fgi; :� 4; (u','hv �x�b wij i rs,l. ixjrsliucle�t Gr,mg'orrlanCr
iidrh`!SdaYGICOZC.<x 1�:nC +: �iC:!1200tfi•NCo►sfiverionSraraiardstvidAara
7:Ls thix a npnir fo an es stin;;n'elld ❑Yitsf or 'ENo rcryirofrlrlrirc iirfhies bran jiM1*hd Mi M1171er
ff tlrls:rt'a rY�xrlr,fill w.vt krapil2a ti'eftraruliucrla�a l,Vorrrrarlon roir/4:r�lahi rbn rulru�a ajAia ;' }� -•
refitfr•rcirrlerb'?1'iivnIIr�ts.a�rlranptavidicbruLpfdurfornc. - .`Z�:SttC.4litif;i'BRt�OCiLddiliatlIIl\!'CII11Cfilit.4:
Ybu may use tGe;bacl;of this pap Ia;ptovide addidotlal%vell site*Wls:or*1611
S.'INuntberof Yells euustmitted: 1 Comhuction rtetails; You asap aW attach iddiiimml pages if necesSjmy
kor makinle bdeciMn ar rrMl-u�r�r sirpnJj'1refls ONLY irJrli rho.aaatecoestnrrreou,;youau�
sutrurir Dire form: - SUBMITTAL iNSTCTC_TiONc i. .
9:Tut.d will deppt 6etow land surfacIei 18 ([f.) 24L Bor All Wellsf Sub»tit this farm willrin 30 days of e6inpteii6p'of Well
kwJwihipkl'dls list irlldepiki1fdifferent1eT4mrple-JQ2M'and.20100) constmdtiontolhcfolloniq-
11J:Static ivater.lei'el below top of cashir. MvNiun of Water 116ource3,'Inft►rnfationPraces3irig Unit,
ljiiwrry tc'v�11vuLai'u caifng rue"+" 1G17 Mail.Sitv'ici!Q( tcr,}talrio}YC 2769J-IG17'
I;
li:Borchole diameter-6° (in) .14b:Fnr lr LW led Mjh ONLY: '•in addition to Sending the fomt to the address in
24 aWo( also submit a.copy'of this fotti►within 30 d3�S'of.Completiott of W01
12:Well'eonstructiou method:Air eattstntClion tu follawingr
(LC.311g`Cf rolas?'.:Cobtc,`.direci pasl4cta} -
Divhlron ofw'titer.1i06urce's,jUndf6rpmuuf!lpj lou Control.Prograni,
FOR WATER SUPPLYWELL.S ONLY: 1636 Mall Sen-icc'Cenfer;Raleigh,NC.276"-1636
D3a,"Yicld( ini) hYctliod of
test; '-4c,.FUr Water Sutmlc&'fn_iee for .Wells,,
AW subniit'orao'eop}' of this fanss witbiR,3()
daysofcoutilletiott.oP .
13b.bislnfeetiau,gpe Amount: well dwisimction to the cahrity'hcalth dcpaTtmont of the cobnly u'licre-
constructed.
Funs G1ir-1 Konh Comlina Depaitmeiu.or Ea imwmntf and STamrsl Resources-Division oP Wafer E;ieK� Revised August 2013
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