GW1-2023-00830_Well Construction - GW1_20230113

WELL CONSTRUCTION RECORD (GW-11 For Internal Use(h ly:
i.Well Contactor Information:
Kelly Grant 14.WATER 2RNES
W 01 Cnntrsclm Nuns Knees
m rea aWr1ON
R. R.
2730-A
Nt well('r,µ.ectm(:mdiuum Number - IS.OUTER CASING fsr val-raw wens OR WNER fo able
Cacraflarlrillln LP JAN 1 20Z3 111O"t m -- - -"t"N^r" nncRNa;sx htArrn,Ar.
-- 9
Cnmpny Nnne
16.INNER CASING OR TUNING
2.wen CoaetrucDnn Perini,e: PER EPA AOPROVAL mad TO MAMRE,t nn(TI a MATmWI.
LLn all appL<ohb hwll rmurrvrnon prrnrlb fl.e.U/C.Voveo�dYaa. rari." Hel
3.Well Use(check well care); n. n. is
Water Supply Wen: 17 SCREEN
mm TO NAMEM trs)T M7Z T11K71F[1S MATEIIIAL
'�Ag"cuhurai OMunicipal/Public R. R.
I(kothrnnal(Menting/Cooling Supply) ❑Reaidrnnal Waice Supply(tingle) p, p• In.
,indu tr aVI ommcreial OReeidmGal Wucr Supply(sherod)
IS.GROUT
711m uon ❑Welle>IW000 GPD moat m ATEIDA,. Ea1PACEMcwr elEnroD•AteaJer
NOD-Water Supply Wdl: R. ft. ( E a L
RMoodering ORtxotay n. R.
Infection Well:
❑Aquifer Rah n. n.
^+gr ❑Cnoundwaty Remedinti(in
OAquifff Srorac and Rani If.SAND/GRAVEL PACK r sbN
S erY ❑Salimry'Banner rnoM 70 dUTWAI. _ I EMPIACIrI MCTIgD
❑Aqudcrlml ❑SlormwaterDraitisge
❑Etperimenul I echnology ❑Subsidence Control IL R.
❑mithermal ICloaed Lnop) ❑Tracer 24.DRILLING LAG ftmi eh A"tbom bores if
nr.-hcnnal fnwtin ('hill Rearm) 00d cr a Iamundm Mil Remark.) "clat ro DeAC'11t►r10N .eh"AeN sMa...a ssa
n. A.
4.Date Wells)Completed: -a? Wen IDN S4 a-,73 ft rL
Sa.Well Location: n, n.
Fornmr Banery Turn n. IL
Faxilvy0 rrr\nru Iealny iUr.lit.11rliubb) R• IL
305 E US Highway 64,Lexington,NC it. R•
Physical Admrt.q CRY,and Zip n. ft.
Davidson 21.REMARKS
(+"•nb' e.rcel la<noLo.ru,n Nn IPIN) IJp Oax VL
Sb.L.alirude sod longitude In depres/minutes/secnnds or dechrsl degrees:
I hrwell f.I'L roe IavAwy n suRccm. 22.Certification:
7 (_9 qq (o.9z S I61ySl8 • q7 W
b.Were)the well(s): -Permooent or ®Temporary Siamlme efCmified Well Conlmc..r Des,
oyfigneg rib/our,1 hrmhv rrrllfy Ihol tM hwrl(f).m Maul rvnrnw-M u a.wdahce w.A
7.Is this a repair to an existing well: ❑Yn or (Jflo I5ANCACa2C.dIWor ISANGICU2Co..WWa Cw.�r Sm.Aum rau.,.,y.,.
III&''�u"tall,till ow(mm�well<o,.wnan aArmhanun ad,rWaO,IAe.alure o1 the of Ab record Am Ire,prwdrd h rAr hwll o.r..
'"',.ndn.l r rr..ork,"a—--the Ark 4do,/n^•
23.She diagram or additional well deco W;
K For Cimprobe/DF1 or Cleaed-Loop Geothermal Wens havuig Lie same You me) use the back ol'thi,page to provide•dJuroiul .dl.,WIm,I.v,nm,
Cono rucures'Only 1 GWI is needed. Indicate TOTAL NUMBER of wells ladJ'Soo Met'In Remarks lk+t).\ou nwc abo umoh rldmona:ryg,, i tx�c..0
24.SURMfI'TAL INNTRVCITON%
9.Toul well drWh Is In land surface: (O(7
en.wdn/nr.ern tin an drha,pd4/r.evl o-.,hnytr 34v 21)0'onn7rp/aD') In.) 6abm1,this(:W-1 within 30 days of mash(onpktiuw Iw,In,fairewfae:
Sbtic worst level below top of adng: /J 24o. For An Wells: thigmal harm to WIotoo oI Wnle, Nev,ume. (U\YR(10.
1I.Suck
at,slaw blur. '• II M) Inftirmallan Pnicc.eing Unil.loll NLS(',kaklgA,N('_iouv-IoI I
It.Ibreholc diameter: V Ib•) 34b. For Initetion Wolb: Copy iu DWK, UnderytounJ hua:wm I.ontnd(IUO
proamm. Ihlo MSC.kalelgh,N('216vv Ih1A
12.Well construction method: Sonic l4r.Vol Water Ro d mJ 1 qrl w l'wlbg med Ito...WWh:t 1 . Io the
I r e sager,rosary,ohk,dues*r k nc 1 - -P M Y
ctAtmv rnruunrrhmwllroeTt riinunl o-ri�ii-iwtliv wRnetnw
LLNsiofecnoMr)p,:_
UPPLY WLI-Id ONLY:
lid. o Watt We 11��r alma svt�hfp$('upy lac DWR CCPCUA
l SI@dW O1lM: I'ormu ngmu, + 1?.i5(h,Qa alE i. TfiTT-
Amaunt:
Il.rm f W-I Nunh till-nnnnmew W 1•awauatlnnrs,p.wy•ihvusa of W.I.New+me, ReehN 64.2814

20.DRILLING L04G(attach additional sheets if necessary)
FROM TO DESCRIPTION(color,hardness,soil/rock type,grain size,etc.)
0.0 ft. 0.5 ft. Concrete
0.5 ft. 6.0 ft. Dark red brown silt,soft,dry
6.0 ft. 8.3 ft. Brown silt,trace fine sand,loose dry ,
8.3 ft. 10.0 ft. Gray to white silty sand,loose,dry '
10.0 ft. 51.0 ft. Light brown silt,trace fine sand,soft to medium stiff,wet
51.0 ft. 57.0 ft. Dark gmy silty sand,some gravel,loose,wet
57.0 ft. 59.0 ft. Dark gmy medium sand,some silt,
59.060.0 fl. Blt ek and white Gneiss
ft. ft.