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Home My WebLink AboutGW1--07106_Well Construction - GW1_20231103 1• WELL CONSTRUCTION.RECORD(GW-1) For Internal Use Only: I 1.Well Contractor Information: • ti).;//i .1./ W;111 b.e r ly . • . , ., . . . • 14.WATER ZONES Well Contractor Name • ---- FROM TO , . I IDESCRIPTION • 3 tg 76 A • . . . . • ft. ft:i 1 . • . NC Well Contractor Certification Nurriber , • - 15.OUTER CASING(for intilti-eased wells)OR LINER(if op Ileable) • K.,--Sc ever e.' br;/t A.:9 .. . . FROM • TO,' . DIAMETER . .THICKNESS - MATERIAL .. . ft.- i. - Company Name ' ' • • . . . :ft, in. 2.Well Construction Permit#:/y/A tEac L.'A• 16:INNER CASING OR TUBING(geothermal elosed-loop)5::>Le -FROM. • TO . . DIAMETER. THICKNESS • MATERIAL. List all applicable tie!!construction PC nits li.e.UIC.County,-State.Variance,eic.).• ' ft. . it. ' in. Per/k infdley 44.1 ei-,;re,ce . , 1 . - 3.Well Use(check well use): ft. R. i: 1 In, • • . . . . . . WaterSupply Well: " 17.SCREEN , r . '. - .' - . THICKNESS MATER' IAL •ClAgicultural, 0Munitipal/Publi FROMc - ft. To DIAMETER SLOT SIZE. ft. .. 1 I in. ' . ''' • ':_. - . • . . pGeOth9rmal(Heating/Cooling Supply) Ogesidential Water Supply(single) it ..- it In... : ...: . - • • - 0IndustriaUCominercial °Residential Water Supply(shared) IS.'GROUT.0Irrigation . 0 Wells>100000 GPD, . • .. FROM • TO'' : MATERIAL'' • EMPLACEMENT METHOD&AMOUNT- . Non-Water Supply Well: - • ft.. ft.- 'I 1 '• OMonitOring . °Recovery . . .ft: ft. ' • • ' • . ' . Injection Well: • • ...-. °Aquifer Recharge . iii te:nulwater Remediation . - - fl. 1:t.• 19: (if applicable) • •. • °Aquifer Storage and Recovery : ', •OSalinity Barrier .FROMSAND/GRAVEL PACK_ ' TO • 'AIATERIAL • .EMPLACEMENT METHOD _• ' 0Aquifer Test . OStonnwater Drainage • . • • .' ft. •-• ft: ',. DExperimental Technology .0Subsiderice Control ft. ft, ! ' . . . °Geothermal(Closed Loop) ' °Tracer i • - .20 DRILLING LOG attach additional tbeett if necessary) : _... _....fucim • .-TO DESCRIPTION(color hen:dams,sollfrock type,grain size. °Geothermal(Heating/Cooling Return)• kidrIer(explain nailer#21 Remarks) ' it'. rvipei)golfeis rel 5-4,-;,,t*.eitt7 04.Date Well(s).Completed: '7' 23 Well ID# --• / P g- • ll, 2 S f!. 77) ;ft.. .4ciy ' - 1 5a.Well Location: • . ft. ft.. - . . r,,:,- . --- ,•••••-,6-„is-t: 1" , • ,413C- °We-11614r el veRl- ee-wer Scrw .5:;ie /Ye])0Vi 6 Vz/V9V ' .1:L - -1' - 11. 1. . Fat:fifty/Owner Name . FacilitY 1Dli(if opraicable) . ft. ft. : NOV a .S -2023. . . ....___ ft. ft. . ,. .2 i'2.7 zejeiwe /3/14,-3;.e 11-.3.0",Wile:), 2 Y.5'VZ Physical Address.City,and Zip . ft. . • • ft. 00-•011!CV:3 ON-510 CU - . 2.13 lelloy.78i8 . 21.REMARKS . ' • i. ,.,,.... , ' . . . Coiaity Parcei identification No.(PIN) Hea-tes'-'C411-44-• 44'ii"-A V&A"t,"E.IefrPtiC,11'60.--1:4)eti • ti-ee41&exc.hern'ai-i.c. e r.c,„,,,st,,,pe ;0,e e 5b.Latitude and longitude in degrees/minutes/s gee.6, f t i t ifieconds.or decimal degrees: (if well field,one lot/long is-sufficient) 22.Certificatin:e N " 77. 3 .Z'1 er 0 . . , .. . w 4,...d.,/,' d / .. . td ..-/e-, 23 . Signattire'of Certified Well Contrite** Date 6.Ware)the well(s): thrmanent •or ['Temporary . I. By signing this Arm,I hereby emit&that the well(s)was(were)constructed in accordance with 7.Is this a repair to an existing well: °Yes or Nil< ' 154 Afc,x pc.oloo oi 114 NCAC'02C.0200 Well.Cottstraction Standards and that a copy If this lea'vain fill out known well construction infoiMation and exfilain the nature of the of/his record has been provided to thi;well oime,. repair under 021 remarks.Fection or an Me hack of thLv fora,. . . ... 23.Site diagram or additional well details: You may use the back of this page to provide additional well conshuctiOn info 8.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same '(add'See Over'in Remarks Box).You may also attach additional pages if necessity. construction,only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells drilled: :I 24.SUBMITTAL INSTRUCTIONS 9,Total well depth below land surface': :, 2 7 ow • ,. . , , ,, Submit this GW-4 within 30.days of well completion per the following: . For multiple wells-list alldepths if&permit(example-3@200'and 24@l00) I 1: 10.Static water level below top of casing: le i ,.i '24a. For.All Wella: Original Om to Division of...Water Resources (DWR), .' (f.t4). Inforthation Processing Unit,16171,MSC;Raleigh,NC 27699-1617 If wat.er level is(Mat,e casing.use"+" • • , . I l • i 1 1 I ID .'' 24b.For Injection Wells:Copy IO WR,Underground Injection Conk)!(1UC) 11.Borehole diameter: 7' ' • on.) • ' , ,. , Program,1.636 MSC;'Raleigh,NC 27699-1636 . • . 1 . 1 '1. , . 1 1.2.Well construction method: Ro'td........5.444/,4. • !.., ' 24c.For Water Supply and Onen.,Loop Geothermal Return Wells;Copy to the ' (i.e.anger,rotary",cable;direct/ish,etc.) '• ' • '•1 . county environmental health department of the county where installed . • • - 1 FOR WATER SUPPLY WELLS ONLY: . I'1•1 ' 24d.For-Water Wells prOduchiglover 100;000 GPD: Copy to DWR,CCPCUA .... , t, , • i,: , ' Permit Program 1611MSC,Raleigh NC 27699-16.11'13a.Yield(gpm) . . Method of test: .._ . • ; i • l''I l , . 13b.Disinfection type: Aniount: .- . . 7: • . • Form OW-1 North Carolina Department of EnvirOnmental Quality-Division of Water Resources Revised 6-6-2018 . , 1 ,I ' I \ I ' - I I e I 0 TERRATi-IERM , ISTD Heater Boring Construction Detail Revision#: 0 Release date:_5/12/23_ • ' a arr..30+Z Caream, 'I ' I . I Approved by: SL , 1,---,,, ( \ Well ID HA-01 Date 1 7—1r 7,23 Oversight i2 PA'/Ild - Job#, R23-104 Driller A, thr,4141,;(1, if4tolerly/ , 1 ,c I Constructed A . (fill out if Design different) Notes 1/2"Thermocouple pipe? BEM= —Heater Stick-Up Height 30" a,ybe Thermocouple Length 28.71' --VEW Stick-Up Height 18" Iry Ground Surface 0.0' — ,,. Heater Can Conductive HT Grout— I.11;;›;.: ,,, ,, '''0 Angle from Horizontal 73° Schedule 80 21., kl Borehole Diameter 7.. g.:., t=i..m t:,ili 0`,. i 1----1-1;;;.r Top of MO Sand l' Top of Screen 3.5' x.cy Z--94.1! • Heater Can Length 29.5 ft "4: —- ••,,,, 5 Gal Buckets of Graphite 0.5 •42 . Heater Can Diameter 3 in 1 1 fP.' ( Bags of Silica 0.75 a Screen Length 10 ft t., ''.e.a Screen Dlamter 3 in k. 17.74 ,T1-2 At,',1. Bags of Cement 2.25 3 2,,,, 0, 1,•t. cviT,' Bottom of Screen 13.5' /5,5 Installation Method 1 , 'Direct Push , .:. 1 .t;1,4 1,, Bags of IMO Sand 7 3•,-,' ..,.., Sonic ' , Hollow Stern Auger 4. .z0& Gallons of Limestone , Mud Rotary' ' Other: .r.'fi ''4.if c't n v g• .4,4 Bottom of MO Sand 21' ‘ 001 44.,ir , .. . Bottom of Heater Can 27' , ;I;'''4 A-,,,,,-,'1,.• a Bottom of Borehole 27' a7' Post-Installation QC(to be performed 24hrs after installation) PID Log:Make/Model: 1)Confirm well Is free of grout Design Constructed lime: 3 ,10 Reading: a,0 PPM Depth to bottomlof well[ft bTOC: 7g c' Time: 4/.1,10 Reading: 0,0 PPM if greater than or equal to lft less than designed alert the office lime: B.) ,'a g Reading: 4. O PPM 2)Confirm grout plug reaches ground surface lime: Reading: PPM repeat daily until depth to grout is Oft. Time: . Reading: PPM Date, Depth to Grout[ft bgs] • Notes: . . Ca° 1 ..;,. . ., , I . , 1 1 ,, .