HomeMy WebLinkAboutGW1--03485_Well Construction - GW1_20240611 a
WELL CONSTRUCTION RECORD (GW-1) For internal Use Only:
I.Well Contractor Information:
Russeil Tayior 1a.WATEBZONEs
Mom : TO DESCRSPSION
2487-A
wWell7 A 85 , 90 = 1oq-ins, 139-114
'l�5 ` R' 14-50-4' 1114-to I
!IC Wall Coaasciot Catsiffcsdoa Numbs 15.OUTER CASIT G(Tor malel`ased welts)DRLII( Riau
Redden Brothers Well Drilling, Inc ; ROM ',TO I LUNETTE I_TRIMNESS ,K*UXat.
fr. ; ft 1 in. !.
CO y Name 16.DINER CASING OR TIRING creathermal eieeedaeess)
I.WIN Caasffaafoa Permit if; f o{0 a - P I FROM I TO _ ! nr,L.xETER I T�C:1043s MAT�tA1.
Gus eh'appftcoblc mil co+raorcrlon pazniu(r c U1G Carney.Start Variance,too) . ft. 1QGC f` /_ in. E P Vi,
3.Well use(check trail use): tp� " Z04 ft. (p •
'a 88 ■l fL
17.SCRs \
Water 3�piq Well:
Water FROM TO I Dint x ! SLOTS1 TfQClO I MATlatu
Agricola:el DMtlaicipa/?ubiic I ft. it.
Geatlserm�� it g Supply) Recidenaal Water St ppiy(single) i k, ft. a
IaduseiaWComme:dsl ids.r=1 Water Supply(sha c ) is.GROAT
leiestioa FROM ! TO JMJ.TERLIL t?L4GL1tlE T73/ fli013 fi ANIG
Noce--Water Supply Well: m tt j a.ge++a> °`+°a'°
Monitoring o3.e overy t rt. 1 O.
Action Well: ft. '
Acidic-Recharge 0Ctroundvratcr Rranedizcor.
19.SA.'D/GRAvU.PACK(if nealiceblel
Storage and Recovery oSalmity Barrier FROM 70 : >r arEtu u. I >aiftoh
tam Test 0Storstwater Drainage tI ft. I ft-
Experimental Technology 0Subsidence Control ! — ft.
Geothermal(Closed Loop) rum 10.DsZ.ILLLiG LOG famish addition:[sheets t asecuar7)
�i FROM Ta ' DESMUPTION talon.brdaai.mane*t t+e Role sue.r.
Geothermal Mea ingt/Cooling Recurs) f Other(explain u 3Zi Remarks) 1 �. i 1 P ' clay b 57n4
4.Date Well(s)Completed: 5�7�al 44 Well lilt-
/ rj 4 ft. IDf7 t yr,,e
ftt. I ft.
So.Well Location: '
limes Wrier 4 i'ljfj)7 melJ
Feelktty/Owe=Nesse l Fag:1i:y ID6(if apn::aski h t i ♦:+�I��;���7
/..7t fil 38 EIK.horn £Id L mkh.. ? / •`
ft. t
Pbyska:Adttrea.�y and Zip J I rt. ft. ; J U N 1 1 2024
�� (, 13 8N(a 8810 st,.— Q,rS—
/17400N CO Irr6ot en i'*rr aey ,g v
Cetmty Parcel idcauEeroer No.(?O) D'16Q�i�
SD.Latitude and longlimde in degrersiminatesiseconds or decimal degrees: '
(ifweU Sell one inflong is=IT:oleo:I 12.Certification:
.55° a8.3o9 ,( 083°075.e:247 W /?..e..eidiegfiJ j9/
Sigman a of Cmcified Well Contscm:
6.Is(are)the wen(s) Permanent or E:Temparary
3y signing:ids form,t hereby a tab-tiro( t•weirs',ass MTtr)coax:razed:a ono.:7.Is this a repair to an existing well: DYes orpN. „�+::54'�o'-C 9ZC.0100 or it4 ArilC 0 canon wet:Cecatrzctlart Srdm
stdr.IIthir tt a rope!:Jill out.!noonwrit casscuotion irrforma:for. apici:tar n¢:rrr of tiro :DPP of:H;aeon!itw bee pro:idrd ro the troll Dante.
repair otdrr f21 ern.cods sseriar or on the back of this lam- 23.Site diagram or additional well details:
8.For GeoprobelDPT or Closed-Loop Geothermal Wells'.avinethe same fc:way use le Dock of his page 0 provide additional well site deceits
aonstrnction.only l,GW-I s ceded. Indicate TOTAL NUMBER of v.-ellsn�eccnon devils. You may also attach additional pages if accessary.
drilled: / S.BV:r—Tad.,INSTRUCTIONS
9.Total well depth below n/�/�land surface: I00 (fs: Via. For All Wells: Sc .-nit:his fo::::within 30 days of cemplezion
For mrrinprr„►tls rat all depth,i-d t lesempir-3QS00'end gloo') coasruction to the foliowine
Ia.Static water level below top of casing: .2 S (ft) Ditlsioo of Water Resources,Information Processing Unit,
Jtvn er!owl is show casing,use- " 1617 31a0 Service Center,Raleigh,NC 176994611
li.Eorel oie CSaasoror: La (Ls.; rD. For Iniection Weisz- :n addition:a sending the for to the addtu
—Th above, also submit one copy of:Ilia firm a tin 30 days of co,oplation
12.Well construction meraad: (Lit,: � �� :oasis tvoon o he feilotvin5
(u mega4 rotvy,abk.4al4Ct 0113O.ae)
DiVisioa of Water Resources,Underground Injection Control Pros
Tea WATER SUPPLY WELLS ONLY: F 1636 Mail Service Center,Raleigh,NC 37699-1636
8 �,t[jlaj I y;e.For Water Suoaly&Injection Welts-. a addition to=Otis;the
.13a.Yield(gpra} tlerhad of rest i 30
, =e acdress(es} above. rdso submit one copy of :his forces within
L3b.Disinfection typo. i i ataotint: �Q i eo.—.piedoa a well coast-a:two to the county heahh department of th
1 y wnere cons-minted-
Form OW-. No r.:t ConCarol=Deoatt of r.:7o -e....:Q�;izy-Di_-"so-of Waicr Yaeu:eo R.-ued
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