GW1--05440_Well Construction - GW1_20230821

\NELL CONeSTIWCT1ON RECORD[GW-11 ° Far MOW CPR 014_
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N 1 t*AT PR TONIEll
Ora FROM rn
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4605-A, i�- it ' R 3 „-
)a: Cma.na asa6c.at.?at.i. 3 i' it 7a IL , 1.
N,Wt9 POO*WM end Pomp Co. to rx.T�R CASINO aF.atesaw OR LOOM w
Is" tonaArs rtactO+es IS,tranu
dergtav•!Montt l G tr a ia ,r-c E tv
Pto casrrm wttTauv;_ ..u,,...1 LAVA c ..Va�ia 31
Oor II) MAItTtnn „ MAMMAL
tata6 orgibatilreinittorsotaamiagraostarrkaOliC.'O utaarkr4tfranaae.1 R ft. la. F
9.Welt rare(rltee'lwarlet9 IL IL is j !1
'\\n:rr Super 4� It.SCREEN --__-. 1,
FROM 10 MANTEL-WI -r. LOT 1 I RIATIRiAL
:2\_n.ul iral: 0Nlumciptd Public Itn. • n.
a .. ., ,-Trial klksalitapeochog Stipph) tiesidentinl Water Supply(single) rt. R , -..—IR_.. .I ,
•, s Commercial
.C cial ❑`Residential Water Supply(sham!)
N.GROLT
OWells>100000(iPt) tltOM 10 i 5LAUUB11.L 6tlnatcomirr!mime aAYITo\t.!
\.,n-\Pater Suppl,Well: / R R
ZniaSt:tot:n ❑Rceoven• R R r
Trajection Well:
R R
.:•iyuif.r lecher a ❑(iroundv ater Remodiation
19.SAND/GRAVEL PACK Of appltohtt)
Cloy Stemage aml R‘vowrY ❑Salinity Barrier FROM TO MATERIAL tSIPS.ACt)>itaillll0111 t
Q:l luifer Test OStonnv atmr Drainage R R
7.:Exp nmentsl Technology Subsidence Control ft. R — 1
:Geothermal(Closed Loop) ❑1 racer 2t1.DRILLING LOG(attach additional theelai(atraatrr7l
_(;ti:h rural IHeating Cooling Return) OOther(e%plain under 121 Remarks) FROM TO oFsraQtro tt.ttalasi�rdarttt>tr Waft doe.dab
0 R 2 'L Fop Sod
1.Dane\%eli(s)Completed:r- / ) `Z 3 vt'e11 io# ,Z it SG R
S.I.\vcU Location: $-U R y((f-n' C?/Gnt rE Rcuc ~
R ft.
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=., ,l.,-,/j h. n' n' AUG 2 1
cr Name / Facility De(tfappttcablc) ?o�3
•n
fr
-:-..._� Ca 1�aa•y.andZtp n' rt. G Endo
21.RENIARKS t.11r'a ��
Used steel hardened drve shoe
Ct1+.[ Parcci!drnufsanon No(:'IS)
eb.I.atitwit.and longitude in tkgrttslnlinutes/seconds or decimal degrees:
:.c!tt r rig s,,.:'.f.te tt) 22.Certification:
.5.c104-c5o2 N —745. 519)1 w _." 6—,r_2 ?
Ft.Istatrt the s etl(s): L"Pcntament or ITemporary Sigma. n[ r„ntr CUE
(,ystgnttt"e OHS form.I Inrchv COI 17-1,that tlr,.4140r011011rpdsa1ra/1a.re.ti.ls•rti
'.h tbla a rttpltle tit as nsisluyC welt: QV es or CNo 1 i1 NC.1C ar.0100 or 151 WC.ic'OW.1C01 alit Cato.iaaiwrersond ya a,9,
"elta..r itakiiiiMttlr.tlt a seotrraannaaai 11 a wut asjdmn the nature ty t)n gig.,rceord has bcrn Innis(.-I to die sad'aremr
•ap,o.smite IV.emtvltrtaree*aosth&itwtlrkrakiefrean 23.Site diagram or additional adtledils:
•
I'or Geuprulie!IDP I or(iuwd-Loop Geothermal Wells having the same You mac use theback of his pap a pt[tsid ai�triti atelaaaritstlpas info
;.em Lat`ica:,ugly l Gl'(-1 is n;a;d,al indicate TOTAL NUMBER of wells (add'See Oval in Rasnalks Bore).tat may als,'Amidtuiiiosl posit
4tJ6at: ,- _ 21.SUIIMIITTAI.INsrR1'tTlONS
!t URA wall displk lteivatkindG[ surface: (/0 tit-) Submit this G\1'-1 tsithin 30 daps of well ewnpiettan per the rat6nsthg: i
dp..dfreM wig,g*. .4.0.4 half rerat(ca rntple.4200'aid 2:0)1 tar)
!
7 21u. For All Wells: thittimd form to Lhvi,ion of Rats g&i,airees NN►R).
In water�vd btlwt tupurc raw:_� �' (rt.) Information P;o:.,sing('nit.1617\ISC,Ral:i0.\C 14-11f17 i
6' 21h.For injection Welly I.Copy to DWR. ..T^,said Molise Qaa ial((OC)
II.Ir.rhok dl.utatar: t limo Prolgram.'oho t1SC.Raleigh.NC 2-o taF+
Rotary F)- i
12.V.all eumlestetlott etsthunl:_ 24c.For Water
tiuWth kind(pen-I a op tienthertui itetuni. eagyaagie
county tnviro tmnta h tlth 1I,.0 Rrvttt t m,,;,gut}*ham / i
Ii]It WallaSI.1T1.Y vtiF1.1.•1 tl'41.1' 21.1.For ,tore Wegs pradFrii�o%er mow Gra [
Blow Pun n Pnxrwn.hil t MSC./12.. t.\i "%vr,run
—C�Y 4 {
iii¢
U .1baM py Method td n,r.- ---
136t.wtlrrttalar viva HT" Amount.
lisos'ari•..t. ta.ticatlr.Otasonaa.t etrammounassalgest al-Damanv to as.,t<t;.,.,„t..:-