387252_Well Construction - GW1_20100909

F,V
NON '• ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3324A
1 WELL CONTRACTOR
Joseph L Zuncich
Well Contractor (Individual) Name
Applied Resource Management, P C
Well Contractor Company Name
257 Transfer Station Rd
Street Address
Hampstead NC 28443
City or Town State Zip Code
(910 ) 270-2919
Area code Phone number
2 WELL INFORMATION
WELL CONSTRUCTION PERMIT# WM0800934
OTHER ASSOCIATED PERMIT#Of applicable)
SITE WELL ID #(if applicable) AMW - 17
3 WELL USE (Check One Box) Monitoring [1 Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery 0 Injection ❑
Irrigation0 Other 0 (list use)
DATE DRILLED 8/26/10
4 WELL LOCATION
Tram Road & Bennetts Bridge Road
(Street Name Numbers, Community Subdivision Lot No , Parcel, Zip Code)
CITY Mt Olive COUNTY DUDIin
TOPOGRAPHIC / LAND SETTING (check appropriate box)
0Slope ❑Valley ❑ Flat ❑Ridge ❑Other
LATITUDE 35 ° 5 41 5000 " DMS OR DD
LONGITUDE 77 54 ' 25 5000 " DMS OR DD
Latitude/longitude source 3PS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5 FACILITY (Name of the business where the well is located) -
Facility Name Facility ID# (if applicable)
Street Address
City or Town State Zip Code
Clark Wriaht - Davis. Hartman. Wriaht PI J C
Contact Name
oti 209 Pollock Street
Mailing Address
N New Bern
City or Town
( 910 ) 514-2828
Area code Phone number
6 WELL DETAILS
a TOTAL DEPTH 12.5'
b DOES WELL REPLACE EXISTING WELL? YES ❑ NO qi
NC 28560
State Zip Code
c WATER LEVEL Below Top of Casing 11.38 FT
(Use "+" if Above Top of Casing)
cal.,5
7
d TOP OF CASING IS 3 FT Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C 0118
e YIELD (gpm) N/A METHOD OF TEST N/A
f DISINFECTION Type N/A Amount N/A
g WATER ZONES (depth)
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7 CASING Depth Diameter Weight Material
Top +3 Bottom 4 Ft 2" sch40 PVC
Top Bottom Ft
Top Bottom Ft
8 GROUT Depth
Top 0 Bottom 0 5
Top 0 5 Bottom 2
Top Bottom Ft
Material
Ft Grout
Method
Tremmie
Ft Bentonite Tremmle
9 SCREEN Depth Diameter Slot Size Material
Top 4 Bottom 12 5 Ft 2" in 010 in PVC
Top Bottom Ft in in
Top Bottom ,Ft in in
10 SAND/GRAVEL PACK
Depth
Top 2 Bottom 12 5
Top Bottom
Top Bottom Ft
11 DRILLING LOG
Top Bottom
12 REMARKS
Size Material
Ft Coarse Sand
Ft
Formation Descnption
See attached
C V E D-
S[P 0 9 2010
inaluii rrui.,essing unit
DWQ/BOG
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C WELL CONSTRUCTION STANDARDS AND TX -COPY OF THIS
RE ='D HAS BEEN POVIIED TO THE WELL OWNER
E OF CERTIFI
8/26/10
DATE
ph L. Zuncich
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
TMS
Submit within 30 days of completion to Division of Water Quality - Information Processing, Form GW-lb
1617 Mail Service Center, Raleigh, NC 27699-161, Phone [phone]
Rev 2/09
oc r 14 2013

KORNEGAY ESTATE
1677 TRAM ROAD
MOUNT OLIVE, NC
AMW-17
Drilled by Applied Resource Management
Logged by J Zuncich
Date 8/26/10
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Content
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Blow
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2 - 4
Tan brown to orange, fine to medium grained sand No
hydrocarbon odor
Low
HA
5 - 7
Tan brown to orange, fine to medium grained sand changing to
medium gray clayey sand with brick red mottles No hydrocarbon
odor
Low to
Moderate
HA
10 - 12 5
Medium gray, fine to medium grained sand changing to orange
tan fine to medium grained sand Possible very slight
hydrocarbon odor
High
HA
HA - Hand Auger