387254_Well Construction - GW1_20100909

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NON RESIDENTIAL 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#(if applicable)
SITE WELL ID #(if applicable) AMW - 16
3 WELL USE (Check One Box) Monitoring Ni Municipal/Public ❑
Industrial/Commercial ❑ Agricultural E Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 8/26/10
4 WELL LOCATION
Tram Road & Bennetts Bridae Road
(Street Name Numbers, Community Subdivision Lot No Parcel, Zip Code)
CITY Mt Olive couwTY Duplin
TOPOGRAPHIC / LAND SETTING (check appropriate box)
❑Slope EValley ❑Flat ERidge ❑Other
LATITUDE 35 0 5 41 6200 DMS OR
LONGITUDE 77 ° 54 27 1200 " DMS OR
Latitude/longitude source 3PS Dropographic 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)
DD-
DD
Facility Name Facility ID# (if applicable)
Street Address
City or Town State Zip Code
J. Clark Wriaht - Davis. Hartman. Wriaht PI I C
iv Contact Name
^ 209 Pollock Street
Mailing Address
New Bern
City or Town
( 910 ) 514-2828
Area code Phone number
6 WELL DETAILS
a TOTAL DEPTH 12.5'
NC 28560
State Zip Code
b DOES WELL REPLACE EXISTING WELL? YES ❑
c WATER LEVEL Below Top of Casing 10.68
(Use "+" if Above Top of Casing)
NOE/
FT
9 " eT
R,.
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
7 CASING Depth Diameter
Top +3 Bottom 4 Ft 2"
Top Bottom Ft
Top Bottom Ft
8 GROUT Depth Matenal
Top 0 Bottom 1 Ft Grout
Thickness/
Weight Material
sch40 PVC
Method
Tremmie
Top 1 Bottom 2 Ft Bentonite Tremmie
Top Bottom Ft
9 SCREEN Depth Diameter
Top 4 Bottom 12 5 Ft 2" in
Top Bottom Ft in
Top Bottom Ft in
Slot Size Material
010 in PVC
in
in
10 SAND/GRAVEL PACK
Depth Size Material
Top 2 Bottom 12 5 Ft Coarse Sand
Top Bottom Ft
Top Bottom Ft
11 DRILLING LOG
Top Bottom
/
12 REMARKS
Formation Description
See attached
RECEIVED _
SEP 0 9 2010
Information Processing l ►nit
DWQ/BOG
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C WELL CONSTRUCTION STANDARDS AND THAS.A COPY OF THIS
RE :' AS BEEN PRO:�E� TO THE WELL OWNER
SI
8/26/10
FCE'TIFIE. ELLCONTRACTOR DATE
PRINTED NAME OF PERSON CONSTRUCTING
Submit within 30 days of completion to Division of, Water Quality - Information Processing,
1617 Mail Service Center, Raleigh, NC 27699-161, Phone [phone]
O C T 1 4.eC't2`P09-1 b

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KORNEGAY ESTATE
1677 TRAM ROAD
MOUNT OLIVE, NC
AMW-16
Dnlled by Applied Resource Management
Logged by J Zuncich
Date 8/26/10
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2 - 4
Medium brown/ orange, very fine to medium grained sand, slightly
clayey with some brick red mottles No hydrocarbon odor
Low
HA
5 - 7
Light to medium gray, clayey sand to sandy clay mixture with brick
red mottles No hydrocarbon odor
Low to
Moderate
HA
10 - 12 5
Medium gray, fine sands changing to tan orange fine to medium
grained sand Possible very slight hydrocarbon odor
High
HA
HA - Hand Auger