GW1-2023-00822_Well Construction - GW1_20230113

VN 17J.11, 1,VNNI MUL I IVN KP.I I)KI) (IL N-I I For lnttRnal l)so(rdy'. �I
I. Nell I owtractor InformaBnn: I
Kelly Grant
WWII CnMracan Name 'E.�. �� A i! T) _fM1raflRTgY
2730-A JAN 1 c 2023 " _"_
aK'Wdl(:annclMCcmJrauonNwnnrt IL OUTER CARING Cr msYFtaMd welh (IR LINER 1•
7 61AM na tlnCR KFAS MATERIAL
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N•ter Supid,writ: 1 EN
MO ro MAMRRw NpTMa TIIICIt ftATgMAL
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(1 lydurinSIAommerwal 7Rmdmbd Wata Supply Ichnfedl I&GROUT
-11T bon ❑Well,n ltMl C)CM(iPD ADM TO AMIAI NMF"CL'WtTAQWO&AMM.v/4.
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11.
A.Date"Him Completed: -,c4 ) 2• Well JD-5-4 D'd S h. R. _.
Sn.Well l,nudOno fL n.
Fortner Battery Tech R, n.
I.0",(,-me N." Iluhty lDI(Happlic•ble) R• A.
305 E US Highway 64.Lexington,NC
PhLaa Adllm..,(1v.and zir R It.
Davidson 21.
REMARKS
t.axrar 1'a¢cl ldenu ficatnn Na(PIN) r•y O2=elf.
5b.Lodmrk and longitude in degreevminuleshtconds or decimal degr•M:
(Irwe11fMid Div.Ini Lmp!.Iumcreab 32.CatiDeadOwl
7fz� h ,'v. �,p , l(,3YG� 1 'Ss W
i.INorel the wdl(U: Permanent or tiltempoinry, Signature n(Cenifmd Well Comndm eye
RY 1(enlate IAu/arm./hrtehv.'rrrlY for rM wlin I.m Darn/roroarrrwl rat arsldwrm test
7.Is this a repair to an minting well: ❑Yes or Ql�*o 11A NCAC 02C 01600 nr!SA NCA(0.(" d:W and('..uvacura Fs W W,,,na,d ,a Ica.
Of A..,a rt(uv.f4r ma blow well,omwnma u1/armaurw an✓rgaaln rM nararr n/ih, f'On,Mcw✓h.1 been(nrn.l kid rat Ile wll,.w,
,glee sal..all rrma,l...ro.m n..v rM her)n/rhi.F+rrn 23.Site diagram or additional we"detulh:
L for(koprobaDPl or Closed-Drop Geothermal Welts having the same You may uhc the back of this page .,pnrvrde addntMnul wall nrvxn..twv.mr,.
cnvimr :i-n,only I GW-I is needed !odi ate toll AL NUMlll.R of well. (KM'Sm Ovice in ftemuV lox l may dvo sua.h AhisnoW falls,.f of aav
dr:''.Ird
/ U.SURh11'1'1 Al.INK"BUl'I IUNN
F Total well depth below land wAocr. .) 0' 111.1 Submit IMr G W-1 wllhls Ib dry.offish a r floe Iwhwl Fm—Ohl'-el"by wr dpah•dwllnnr rr.am/rlr-)(g1M'ad)(gldD'1 I W' 4:
Id.Stok water level hrlaw top of rasing. Jam.qu IIIA 14a, fur All "Vils: tltlµulal Iomr lu 1)"O" l nl y ,Vv, Rc..wuee. HMNI,
!/.arrr b.N nr...r. „me •'• -• l/ Inlurnmbla PnNcvrmµ Unn, Intl MSt Raklgh.Nt ­ow-lbl l
11.Borehole diameter; V (la) 24b. tar llidtfillift\VTIir: Cup,to 11WR• Llminµ..watt Innamon I .vvmi III I 1
Program, Ihlh Mm,Raleigh,NC 27hw ob
12.N'ell construction asM►•d: Som(
6 c aor<c mar,.nhk.4mx,prwh v, , 24e.Rw%si Slepoly and l Mn-1 War/'w"M Wall Bailers N'ollr: I'.Vry In n
wrudY MVRmrmintlaTTioaht�wrtnanl n t ,aunty w IRW
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ml Melhod of Int. wudm . . µ . - - n T
oil type: Amsunl:
form GW-1 Nnnh(ludma Ihp.nnrM of Iflefny.Upmum of Ware,Kenwn.. µe dLlr;a

20.DRILLING LOG(attach additional sheets if necessary)
RRO;\1 TO DESCRIPTION(color,hardness,soil/rock type,grain size,etc.)
0.0 ft. 0.5 ft. Concrete .. _
0.5 It. 7.0 ft. Brown to red brown silt,trace fine sand,soft to med stiff,moist
7.0 ft. 11.3 ft. Ochre brown silt,trace to some sand and clay,soft,dry to moist
11.3 (t. 24.0 ft. Gray to yellow brown silt,trace clay and sand,soft,dry to moist
24.0 ft. 27.0 ft. Brown silt and fine sand,loose to medium dense,moist to dry
27.0 ft. 40.0 ft. Olive brown fine silty sand,medium dense,dry
40.0 ft. 50.0 ft. Gmy brown silt and fine silty sand,trace clay,dry to wet
50.0 ft. 57.0 ft. IGray brown fine to medium sand,wet
57.0 ft.1 60.0 ft. IBlack and white Granitic Gneiss