GW1--06500_Well Construction - GW1_20231013

•
• rr suer•--...anno 1 MN—11U N KLUIRD(GW-I) Forhiterftal Use
L Weil Contractorlofermatien:
Ricky Corriher - -
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24 1� Ter -
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NCWeR C tiomNumber i' G
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Frank A. Corriher&Sons Well Drilling, Inc. - -- -~: - - _--
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CompanyName
....3R =2.Well ction Permit n: io ---- ----_ _ —
Iiaan /1e(j construction Pvmiri'�WC County, :�,•a,�c..•-- - - -----
M.3.Well Use Variance,etc) +1 a' I -. 1/8 m' SDR 21
(check well use): nialralilWrellariMilrengni
Water Supply Welk
• 1 � '" TO mass 1;;r.J c -� is
DGeotheartal ft. ft. m•
�_
( Cooling Supply) W he- . y(ink) R R
mat Wafer Supply( _ __
• Cl nigatIDA Non-Water -- [Mons 100,000 GPD i! m • ----- ---
,ek { �.rn. way
Wv, . ..� r ORD:oY 0 R 22 Beribonite Hole Plug �axomrr
Injection ft. IIIIIIIIIIIIIIIMIII
ClAcir4fir RechargeW OCT1 2.023 ft - ft.
-vyilkais
DAgaif rrTest rj:e .�':�L ijS : ,
• 13ExpmmeatatTerbnology °Subsidence Control ft $
DGaoal(Closed Loop) CITmee CIGeoilienwl
(H oormgRsnmm) OOthar(e:plain•umix#21Remarks) -llirli �'. ,,* ,4_"'""'--- --��3"_-
4.Date Well(s) q g )3 . � �et.
Well DM aG R O s
3a Well n: ©] c�f o91 ® $ � � l f ,
dame F3 IDlFCsfappBeab,. -IMO
ft.
7576
C-611240/) fnlir? . e 4,,,'q lD j e R ft.. y,=dr" •
ft. ft.
Physical County .
aSit.Latitudem longitude in_ a
aegrees/minutes/sorals or decal degrees: i
Of weR SM.350 f N 806 ---,(7 7 6 w OF
-4-
6 Is(are)the wel(sk or ..
6lac,rw 23
t7Te�rary Nell Coat ,I 1 DoLe
Hy *is oertifr that diexoll(s)ear(we e)coartneeadmacaardaseenidi
. ��t Isarepairtoanemtingwell: ClYes or 1SA1VCdCO 00 NC4CO2c.Qloo Weil Coam n axe Itatacogv
is a>spat,A out known wail construction natoniation lord piaj thenature oldie afnhissecwdkw been Pineal te the, all~en npair tattier CI rare;b seen=orm the back oftkisforn,,
S For 23.Site •dlzgram or add welidetail=
ebelDPT or d-beep l We9s the same You may use the back of this page to provide additional weilcoosnuction info
cansintetion.only 1 GW-1 is n rd d 1 Tom Nu s ' (add See Ovef.inRemarks Box
).'Wei may also attach addlionalpages ifnecengy.
9 Total well depth below land surface: p`ce: 6- `�' THIICITONS
For wells&taidept s if Wawa( WOO'and (ft.) S`ubmatt is G�i-1 within30 days
2(�1ao) of well coffin perlbefoilowiag: .
10.Static water level below top of casing: 140 (.) 24a. For All Wens: Original £I cmn M Dsvi4 of Water R
fnf un atioa Processing Unit,16171u1sc,Rateigb,NC 276'99-1617
Ifxva3kadfsabae triadic,use"+' � '
1L Borehole ameba:61 0214 24b.For Injection Wells:Copy to DWR,
iz Wellme<hoa:Air Drill -�1636MSC,Raleigh,Nc 27699-1636 Control I e. 5; tronapush,etc) 24c.For Wafer Sst�ly cad
Geothermal Return Well=Copy to the
county environmental health depatto t oftbe county where installed
FOR WATER SUPPLY WELiS ONLY:
130.Meld(gam) Air Pe:mii Program,6124d.For Water ells prodnewe1 Iov�100,000 GPD:Copy to DWR,CCPCUA
Method of t MSC,Raleigh,NC 27699-1611
13b.Disinfec6on typ Sterilene Automat 3 •ey S
FormGW-1
Noah Carolina Depatne=of Envittaurentat Quality-Division awn Resources
Revered 6-6-1018