GW1--04899_Well Construction - GW1_20240828

WELL CONSTRUCTION RECORD For Internal Use ONLY:
This faro can be used for single or multiple wells
1.Well Contractor Information:
14.WATER N1S
Austin Fowler FROM TO DESCRIPTION
Well Contractor Name tr. R
4366A ft. ft
NC Well Contractor Certification Number 15.INNER CASING OR TUBING(aeothermal dosed-loop)
FROM TO DIAMEI ER TI IICKNESS V1.VTI RIAI.
CATLIN Engineers and Scientists 0 ft. 10 R 2 in. Sch.40 PVC
Company Name 16.OUTER CASING(for multi-case]wells)OR LINER(if applicable)
FROM II DI AA11 ll R I I IR ENI>} TI All RI AI
2.Well Construction Permit#: N/A
ft. ft.
List all applicable well permits(i.e.County,State, Variance,Injection,etc.) - -
ft. ft. f .
3.Well Use(check well use): 17.SCREEN
Water Supply Well: I ROAt lO D1_AAII FIR H HI I.Ill 1111(RNI.• Al A II RI AI
❑Agricultural ❑Municipal/Public 10 ft. 20 ft. 2 in. Slot 010 Sch.40 PVC
❑Geothermal(Heating/Cooling Supply) 0 Residential Water Supply(single) ft. ft. in.
❑Industrial/Commercial 0 Residential Water Supply(shared) 18.GROUT
I ROM TO AI AIIR,:AI I A1PI.All A11 NI A111111 II)A AAIO1 NI
❑Irrigation
ft. ft.
Non-Water Supply Well: -
®Monitoring ❑Recovery 1 ft. 8ft. Bent.Chips Surface Pour
Injection Well: ft. ft.
o Aquifer Recharge 0 Groundwater Remediation 19.SAND/GRAVEL PACK(if mattieablel
❑Aquifer Storage and Recovery 0 Salinity Barrier FROM TO MATERIAL EMPLACEMENT METHOD
❑AquiferTest ❑StormwaterDrainage 8 ft. 20 rt. #2 Medium Sand Surface Pour
❑Experimental Technology 0 Subsidence Control ft. fl.
20.DRILLING LOG(attach additional sheets )
❑Geothermal(Closed Loop) ❑Tracer I RO11 I t) DI Si(I M ION Icolor,hardness.x,a.ro s n N. c1,
❑Geothermal(Heating/Cooling Return) El Other(explain under#21 Remarks) ft. ft.
4.Date Well(s)Completed: 07/31/24 Dell ID#: PZ-D4 It f . se t O ft. rt. G
5a.Well Location: ft. ft. t pgAN
Duke Energy • tt Facility/Owner Name Facility lD#(if applicable) 116‘1
ft.
Duke Weatherspoon,Lumberton,NC 28358
Physical Address City,and Zip ft f 7-
21.REMARKS
ROBESON _
County Parcel Identification No.(PIN)
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification:
(if well field,one lat/long is sufficient) ,
34.589724 N -78.970001 w %�%��-�Z 8/20/2024
Signature of Certified Well Contractor Date
6.Is(are)the well(s): ®Permanent or ❑"femp traty By signing this form I hereby certify that the wells)was(were)constructed in accordance with
15A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a copy of
7.Is this a repair to an existing well: 0 Yes or ®No this record has been provided to the well owner.
If this is a repair,fill out known well construction information and explain the nature of
the repair under#21 remarks section or on the back of this form. 23.Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8.Number of wells constructed: 1 construction details. You may also attach additional pages if necessary.
For multiple injection or non-water supply wells ONLY with the same construction.you
can submit one form. SUBMITTAL INSTRUCTIONS
9.Total well depth below land surface: 20.0 (ft.) 24a.For All Wells: Submit this form within 30 days of completion of well
For multiple wells list all depths in different(example-3 .200'and 2@100) construction to the following:
10.Static water level below top of casing:_ 3.7 (ft.) Division of Water Resources,Information Processing Unit,
If water level is above casing,use 1617 Mail Service Center,Raleigh,NC 27699-1617
11.Borehole diameter: 4.25 (in.) 24b.For Infection Wells ONLY: In addition to sending the form to the
address in 24a above,also submit a copy of this form within 30 days of
12.Well construction method: HSA completion of well construction to the following:
(;.e.auger,rotary,cable.direct push etc.) Division of Water Resources,Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center,Raleigh,NC 27699-1636
13a.Yiek1(gpm) Method of test: 24c.For Water Sum*&Liectioa Web:
Also submit one copy of this form within 30 days of completion of well
13b.Disinfection Amount: construction to the county health department of the county where constructed.
type:_-
Adapted from Form GW-1 North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised 2-22-2016

ENVIRONMENTAL,CIVIL
WEI. L LOG GEOTECHNICAL WVm CATLIN
x on.Raiegh,Washnglon.
CharlestonEngineers and Scientists
224079 SHEET 1 OF 1
PROJECT NO.: 224079 STATE: NC COUNTY: ROBESON LOCATION: Lumberton
PROJECT: Duke Weatherspoon 1979 PZ Install LOGGED BY: Carolyn Smillie WELL ID:
DRILLER: Austin Fowler PZ-D4
NORTHING: 3829419 EASTING: 686175 CREW: Logan Hamilton _
SYSTEM: NCSP NAD 83 (m) DRILL MACHINE: CAT1303 CME-550 93%03/05/2024 T.O.C.ELEV.:
VERT.DATUM: NAVD88 (USft) METHOD: HSA 0 HOUR DTW: 3.7 TOTAL DEPTH: 20.0
START DATE: 7/31/24 END DATE: 7/31/24 24 HOUR DTW: NM WELL DEPTH: 20.0
DEPTH BLOW COUNT OVA LAB o L SOIL AND ROCK WELL
0.5ft 0.5ft 0.5ft 0.5ft (PPm) S G DEPTH DESCRIPTION DETAIL
2.9
0.0 Land Surface o.o
0.0 (SP)-Tan,fine to medium grained,well graded,SAND-
-
with comingled ASH. $Z
o
- D -
X.
3.0 ci
3.0 - - ,
(SP)-Orange,fine to medium grained,well graded, - a
SAND.
-- — w
��1
— 8.0
- L
— Sat. _1o.o —
N .:.
I — Li
- - ..
U ::
0,
17.0 - 17.0 - —
_ (SP)-Light gray,fine to medium grained,well graded, _ _ :
SAND. •
o - W —
o -
•
z 20.0 20.0 _20.0 20.0
re BORING TERMINATED AT DEPTH 20.0 ft
c - -
cc
z - -
I-
a - -
:3:.:'Bentonite Pellets 0#2 Medium Sand