GW1--02438_Well Construction - GW1_20240422

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WELL CONSTRUCTION RECORD ' • .
; Per[teem'tisePNLY:,-
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This Iona can be used for single tir tuultiple wells• . I .
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1.Well Contraitor Information:.
-It WATER ZONLS-Brian.Ewing • . ' '' . . ..• , . FROM.-.ft.: TO... ft. -1):pJic n),1 suptii
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. Well Cortniclot No .
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. . . : • .ft.• , `, I .
424 0-B . . •. : : ft " - . .
NC Well Contructer Coldly:alio:1i Thurber • • -. ,15.•OUTEHCASING'ffOrmulikusetlwells1011 LINER(irair Ileliblet-
PROM -TO ' DIANIETER:, ' IIIICKNESS• STATERIAIL- "
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SAEDACCO • • .ft,, 11. • 1 hu.
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:- Consuuti•Some
. • • . .' , 16.'INNER'CASING OR TUBING(geotherm•I cleted4o0p).•
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FROM TO IHANIETER. TUICKNESS ,,. MATERIAL.
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• 2.WO ConStruction Permit rt: . • • . .. . . 0 . :(I.: 8 *- ft.• 1" •,.0.11. SCH-4 0 'PVC•
.Lie 0.0.5-pptiocith,trqlpentlita.N.c.County.Srale;..Variarse.Nadal.rke.)'
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I in,'
:R.' rt., .• • •
3.Well (cited well use):' . . . 17:SCREEN - • • - .
-Water Supply Well: ,. ..- - . . — . , . -• • FROM- . :TO .•DIAMETER SIAM-SIZE THICKNESS' I SIATERIA L. . . 8 ..• IL .18. -ft; 1" .id,' .010 - SCH74 0 - PVC
DAgrieultemi. • -. diilmiidipahPublic- ,
• • M:. •ft. . it.
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°Geothermal aleatingiCooung Supply) DResideutial Water Supply(single) ' . .
Oludustrial/Conmtercial • , °Residential Water Supply(shatid)
'FROM- - TO.. '.MATERIAL' . ' ENEPLACESILNEMETTIOD&AMOUNT
Ellnigatio II-. .
' ft.•- • -lit, • . .
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Nou-Water Stipp lY Went. • • • r - -- • • . . .
t.
. • R.Monitoriog - ••pRecoyety ' ' - - - - -
• - -11. rt. - -
. • ' Injection-Well:- . . - •-. . . . . . . . .
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AquifcfRechirge •. • LlGimoidwigtr Rceiediatio:i• - ,-19.SANINGILSVEL•PACK(if unpile:Atte) . ,
' -.- - ' ' ' • FROM : • TO • "stAttaum. ESIPIACEMENT METII0II ' - • 7' . •-' • •
13 ArmiferStoragc anzl Reemety , 1:18alinitY nattier.
• 6 ft; 18 II. FILTER 'SAND. # 2
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. El Aquifer Test'. . . - . . EIStornmater Drunoge' . . • •
. . . . . . • -•ft. ' ft. •. • - , . •
• - .• CIESperimental Teclinoiog , , IDSubsidence Control. • . , . . •.. . • . „ ,
•. • •, : -‘7k DRILLING'LOG4tillaeh additiorial m heel If account • .
• °Geothermal(Closed Loop) •°Tracer. .' ' ' • -- . .FROM TO DESCRIPTION Rob r.hatIncw.martwk D ItGgAtin?iie.dea
FILL SILT AND SAND-
. EIGirmhermal tHeatinkabline Return) •130ther(explain under 421 Reniall,$) .° . ' -:ri-- 5 • . rt.
• • • - 5 --IL 10-, ".ft. SILTY:BAND
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4.Date Woo ConiPlicd: 3-28-24 • ..virit mf/TMW-3• • ••- • •• 10 ft: 18 rt. SILT CLAY,MOIST TO.WET. -. • •Well Location: • - .
._ft. • ft.
• • • r.:72, 77.-.''''',
•Former-Edge combe Genco Plant • • ft.' , . rt. , 5 i,i......4.•-•*IL,...i ;,,,--;:u ‘
• . . FacilityMivner:Nonic . . • • Facility #ID (if,applizabley .•. . ' . - - - - - - -
.. . • ft. ' • . ft.' :•• • •* ' • : • APR 2 42 711,-4 ' • - . -
• . 6358.Hattlebero.Rd., Battleboro, NC 27.80 9 , .Edgecoinbe . . :ft.
County, NC, 2780 9 . ' . : • Pity-Skid Address.City.and Zip• ;IL imlia,RE:,..,: • • . .
• ' ' 111:•‘;`;-7CV-:.'.••r il '•-•-•..:',12r4:::',1•:i'...;?,.1f. • . .
. .BENTONITE SEAL 4 .TO 6' - , • DWQ'.ISOC) •. . .
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- . coginly , . .Ntvgi Idooritalion No,(PIN) . ,. . . .
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5b.Littiliide and LiingitUde in rtegreciftninutet/sectinds rir decitnal ttetries I, ceriffitation:: . ,'• . ..; . •
nruen field,one jatiolig Is stitlickiii) '' •: . - • • - -
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. li:•__.__ - • • • • N'tf. Brian Ewing 4/3/2024
' . .• „ "• ' , ' t Signatme of CatifiedViell Contract(); ' Dam
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. . . 6.Is(are)the well(g) .OPerinattent. or X1Temilorruy
'By signbjg dris forra,'1:hem. by cerrey 1 1101 rhe wa(s)out(iirrej cangnrcreit Lt.acyardrawc
. . . • irklr(5A NCAC 02C.0100 or 15A NCACO2C.0200 Well Conitnierion Staislards and dish a
7.1s this a repair to any...tistieg well BOY0.-or EiNti • • - , •ro7y.of this wool has Neaprolidi.41 to-ire tirle Mrper. • .
11064x a erpo/r;fill air kaaiinivell raa.anvioa lirformaitan and eiplahr Ars,otarare of rise ., .
repair tauter 021 irrnarks Srciiin or an the back of this farm. . • ..23.Site RagraMor additional well details;
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• • ' •l'int may use the back of this page to'provide additional well site details or welt •. .
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• 8.Nutuherof wells constructed: • . • . . • . eousbuctiottdetaits, You may also attach.iddilion-ai pages if necessary. • •
'For sitaltipee Itteeciins or non-Iyarer iv*weils ONLY wIth'rat souse: consfroilion,,yoa eao ' • . . .. .
. .- submit roe faro. .• . . SeRbtiTTAV INSTI)CTIONS. I .• " • ' .
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9.Total well.depth below hind surface' 18 ' . . go 1.10..For AU Wells:. Submit hits•fatin within lb-d.ivs of compietion of well
For arahipleii,elislist all depths if diPireat((Armee-3€.200'and.20 1001 ' '. eonsinuction.to the following; i. .
10.Static water level below top of easing:- • : -019 Div iSitIll of Water ResoRres,Information OnteessIng Unit,
If warei1ewl is above(as*:use"+" . 1617 MailScrvice Center,Raleigh,NC 27699;1617 •
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• 11:Borehole ilianicfer;2?25 -(in.) • . 21b.For Infection Wells ONLY: In addition to sending the form to the.adtiressin
• . ' ' ' 24a ab6o.,also.submit a copy of this thrill within 30 days of.completion,of well
. 12.-Well construction Method-I DRIVEN • • . . conSiltuCtiOu to the following: ' ' , .
(Le:auger:rotary.table,diteit Visit.etc.). • . ' . - • ,
• ' ' - •Divisiou of Water Resources;Underground Otjection•ContrOl Program,
FOR WATER SUPPLY WELLS ONLY: - • 1636 hfail SerVice•Cdider,Raleigh;NC 27699-1636
. • 24e,•For Water Supply&Injection Wahl . . .
• 13a,Yield igirtn) - 'Method Of test: - • • • •
Also submit,one copy of'this famil.within 3b,days of Completion:of
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13b.Disinfeetiou type: Amount:• . , wet!construction to the ccumty 'department of'the.counti.where
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constructed.
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•roimOW-i . Noah Carolina El9of4iten1 of Etwitunnetit and Natural Resources-Dkvisloa of Waist wam'e . .lictised Augtet2013.
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