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Home My WebLink AboutGW1--02527_Well Construction - GW1_20240423 • • " . . - 1 . . . . . • . . . • 1 . . . . . . -- • . . • . ,),* • 1 '. . . . • . , • WELL CONSTRUCTION RECORD. .\.\ ' For internal Usc PRIN.:• " ( • . • r . This Parm can Wised for single or multiple wells- - • 1.Well Clintnietor InfOrmatiott: • \ • . • • i . . - • . . , - • • . . .74AVATERAINES •'. • ,,. .? .,. . , . Brian Ewing ' - ' - • • - - Flt01.• ' TO -" DESCRIPTION • • . " " ft; " -ft. ' I Wei toritaCtor Name ' -. .. . . .. • . ft. - ft. . • I. I 4 24 0-B - . " . • • ' . NC Well Contractor CcitilicationNUIthei . . •, .. . . •31.5.43UTERCASINGViiiiliPai-eifweils)OR LINERlni.lieiblel-, .. . • FROM • '10 ' DIAMETER ' Itut.ONESS NTATERIAL• • . . SAEDACCO • . ' • • , . ' 11.. . ff.' :' . .to.' .. . •* • Consputy :16:INNEllg55121i!riaar -d-lod ,“,'eltirie — ,. . . t;,fule-.. ' ' - .. • „ -FRoAr ' TO DIAMETER IITICKNESS. NIA'TERLAL •• • .'., 2.NWIl tonStrottitinTerlitit#:."- . : .. . : • • . .0 . • 'R. 15 ft. 2" . ,. ' 'itt. SCH-4 0 - • PVC -• ' - 1,•. . . • - 140,akapgiikabfe..I.Fe11 penidu ji...0.,County.S1aM,iiirfaare.kjediard 5c,1 . - • : "It. ft. • ' • in. . . 3.Well lise(cheek well uSe): • . " rk kREEN; . .. • • Water SuliftlyWelft . . • . • . , • • • •. FROM• TO - ,DrAMETlitt surrstri: TIIICKNS I MATERIAL . . • • • -- ••• '15 ft:: 2 5'• R. 2' Al., .0 010-.. . SCH-4 0 PVC . -., Cliigit,..^it' [Una, . • ilMOilidipaliFuldie: • Ili.ft. ft.:. •' - EIGeothenital(HeinineCoolits Supply) Ot*identill Water Supply(single)* . • - - • Clinch*litC6filutelciall * ; DRcslikatial.Wacc!•SOPP4..i.sluied). 'TUR401r1•49117r' MATERIAL •' EMPLA CEMENT ItlE7110D. AMOUNT • s - • . s s 1:11rritition . . ' . - '0 '' .,ft. 'li . • ft.• PORTLAND 'TREMIE . . . . . • ' • ?Inn-Water Supply Wolk-. • . . i ' •ft: ft.. . • . gailonitotipg - . . .01G:cow , . ' ,ry • . - Injection Well: - • • - - . - ,It.' .• ft; . , . . • . ElAnstifcrlleOarge . EIGtoundwatcr Rentediation • , v.19:SAND/GILINELPACK ft(inallieibtil';' - - -- ...-.---.----.. ,. -__.-.-- . • . . _ .TH051. • TO • MATEIUM. ‘ Eslolatf:EmENTAirritcui . ElAnnifer toragc-and Rc.covety . CISOlinity Ranier * ' 13 R. 2 5 . • ft.• FILTER SAND - # 2 • . I:Aquifer Test • " - - • 1:1Stomswatcr Eintints • • - . • . - ft. . • ft. . • . ., . . • . 0ExpiimentIl Tc'chnQtoV . EISuhsidence..Clitiliol . •- • - • ' 20: 1RILLINGLOGlaita0h:additionst shiiti if-necessary): -- - -•-. • - . • LICrentheratal(Clused Leap) • : ElTnicer ' • -FRONT. - TO nEscRIFTIoNtobr.luiralieti.tuit'oRktrt • EiGeothential aleatineiCoaliui Return). . 1:1011ter(explain under 421 Resuattis) 0 :ft. 5 IL FILL SILT CLAY . . . - , - • 5 • fr.. -15 • ft. MOIST-TO TO WET SILT/ CLAY • . ...• . . • - • • ' .t Date Well(4)Cainplete.d: 1-31-24 • -Nivdt InfeM0-113 01- .- ., • 15 ft. 2 5 •11; MOIST SILTY SAND • 5:s.WM LocatiOn: - • • .ft. ft. r--, 7-- --.7—,1 \.'..-•v.;- • ' v. . ...' ....--vv‘?' . .. 4 ,,-1 ,....., 1 ' • . ' .. .- -...,1- .Z......4: t., i • - • Chemours • • • •• ' • , . , ft. ft; -,, , .1 , , •• ' . ti!6iftly+Klatrii;Imin. ' • • Facdity I.Dtoppli4610„' ' . . . . .• - . 1.i•' . ft, - : , / i D' .. ' 9 86 BUckle.Rd., Currie, NC,. 2 8435 - . . • - --- . . . .• ft. It. . • . . I ryfz,-----v..s•--.-:-i=:)•-•-•r.r.r.-..z!,,-• t J.-, . • . • •• -Volta Address.City and Zip -s2L:-RERIARKS ?,.. - • ' ' E.". ..74.:.',.."..-",: .. . - . . BENTONITE ,SEAL 11 TO 13 I, • Fender - • . • . county ,. . . .. ' -' 13.41-cel Idosairut'ation No,(PIN - ,ll . . 1. . . • " 5h,Latitude and.Lonkitudein tlegttes/minutesticesinds or&viola!detiv.es• ii.cirgifkati„,•, . • •- . . (ito.ell fichk ow:10160g iSsollielOil) • '. . • • 1 • - • .. . . O , • . ., . _.. - • - AY . ---BrianEwing . . • , . 2/2/2024 • • • - . Signature it 1C-atified'Well'Contractor Date . . • . 6.14(orepthe:woll(s} .i ziPerinattent or .EITemporary . ., .Ity.signbig. fu,mr,1 k'reby cerlify;rbar tlic ire14)Mil:'0.40.)-cim.rolter4 iir fir.T4irditace. • " • . . . .with/SA Nt,AC 07,C.0/Q0 or Met NCricct2c:.021111 tt Coiqtraction Stai4414aos4 that a - 7.;Is this a repair to an existingwell: OYesi- or IC No. - " tap pi-this'mit y f lia,tkvi beavided 0:.dia%all miter. " • . • if Ibis is ia'repair,fill 9i.074.iti well constrivioahifaraiathm cad tit•pitahl the natiire4rhe • • repair tirtiferdc21 rengikk serki;jin or an-gni bark.ofthii.farnt. 23:Site dimtratit or additional Well details: . - * "You 111#,use.the,back:Of this gage to provide-additional'well'site details or welt. -". ' " 8.Number.of Wells cOustnteted: 1 • cousuuetion details,'You iitay•aliO:Maeli additional pages if iteeessitrk . _ - FOinitiff/pp:DVed/1?)foiaoli-!Iiiree sbnify 1011s.ONLY.wlilt alt!saiile.c40-trurtiar..,yrait ow Nahnikeneprra, '- •SLIB111 ETTA!,INCTLICTIONS' •. • • • . • . - • • ' 9i.'Total welt below.land surface:, 2 5 •• • . 00 21a. Air Alt Wells:--5Ohntit this-flints.within 36 days of conortetititi•of Welt Air nadilpte iiielfsliir ail deObs if der4.4(exarapre-302110'aeu12@ 1614 t01i5litictiqnt the following:. i • . . . •• 10.Static Water level below lop Of easing:: . • • • • (ft.) DiviSitin of Water Rsourets,.Informaticln Processing Unit, • • - If Irma Ia..).it above va skt,z-am."+" • 1617 Mail Service!Center,Raleigh,NC-27699-1617 " • • . . . l'' C ' • - - . . EL Borehole diameter:8•28". • " .QM). . Mb.For Titiectioo:W4141 ONLY: ;In addition to.sending the fonn to the addiess•in- . . . 24O'aboe.e.also submit.a,-copy•Of dd.§foitti ‘rithiti 34 days.of completion of well • 12.Well construction method:BORED. . • . . COIISRUCti011 to the folloWine:. • . (Lc.auger...rotary,cable,direct push.etc..) . . . . . . . - •DivIsion.of Water Resou mes,11,Indergyound Injection Control Proprant• , •FOR WATER SUPPLY WELLS ON1Ar:'• . 1636 Malt$ervire,Feeteter.Raleigh,NC.276994636 . - ' I i •. . . . . . • • 14e.i.For.Water Supple Si-injeCtion Wells: 1.3a.Yield(gpin) ' Method of test: . • . ' Also'Snbatit one-copy of this.fottn within 39'days of etimOlpti9n of - 13h.Disinfeetion Tyne: • Amount: , . r well construction to the-county hcioltit department of the cont0 where• • • . •con.stMeted. I • - . . I ' Fonts GW-l. Nonit Carolina bcp•artrocru of Enettitillinit and is/aural Itcpaurees-qlvisloa of Water Eleiptro Revised August 2013.. • i- ' . . . I • . .