GW1--05574_Well Construction - GW1_20240913

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RECORD
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WELL CONSTRUCTION R (GW-1) For Internal Use Only:
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1..Well'Contractor Information: . ; • ' '.. -
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,Eddie Thomas (Brian) ' • . !...14.WATEWZONES. - , . •'2 '-.
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. : • 'FROM, ; TO ', ,' DESCRIPTION '
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Well Contractor Name •' . .
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2581-A . . .
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NC Well Contractor Certification Number • •
15.OUTER CASING(for multi-cased.wells)OR LINER(if applicable)
Geologic Exploration Inc.. .FROM . • TO. - ; 'DIAMETER_ I:.' 'THICKNESS,' -MATERIAL
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CoritpanS,Natne ;,t ,
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. . . 16.INNER CASING OR TUBING(geothermal closed-loop)
- ' 2.Well Construction Permit#: . • • . , ,FROM ' -.' 'TO •-' ' . DIAMETER ' ' THICKNESS ',' -"MATERIAL . .
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. List all applicable welripnstruction permits(i.'e,01C,County State,'Variance,'etc') (Y0.• ' ft: 1 50.b -ft• ' 2 ' , .;'•;t.!: SCH 40 -:PVC
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3,Well Use(check well rise): , 179.o.,ft-•, 176.8 1‘.. 2 ...,1,_'": SCH 40 ' ; PVC , - , '. . ' •
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'Watei;StipPly Welt: ... -,,, , ' 17.SCREEN
., ; FROM--i 'TO '--.' DIAMETER. ....SLOT SIZE ' 'THICKNESS MATERIAL--,. • .'
I:Agricultural' ; . ':- clMuniciiial/Pul?lio , .
1500 ft' ; 170.0,ft,' 2 • •ill.,, 6.0o,incii 5617140 . PVC
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',.. '. • DGeOtiterrnal(Heatirig/Cooling Supply) DResidential Water Supply(single) , ;- -.;.-•ft. • ft.
. . OloduStrial/Comirieroial, OResidential Water Supply(shared) . ' •
Is.GROUT
blrrigation'., ;- :, .-- . °Wells>100,00.0,GPD' , . - .FROM • -!;TO'', i- MATERIAL .:,_ EMPLACEMENT METHOD&AMOUNT
. . Non Water Supply Well: . ,... .. .. .
0.0' •ft• '137 9 "-ft: Portland Bentonite Tremie
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ilivionitoring , '., - °Recovery . .' -' . ft. • . ft:
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Injection Well , -- '', ' -, , .... ;'- --• • . , •
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clAquitet-Reehgrie : - ; gGrbundwater Remediation - - • •
19.SAND/GRAVEL PACK(if applicable)
. ..' ClAqUifer Storage and Recovery OSalinity Barrier ' •FROM,- . • TO • -•-.' MATERIAL .:''. - EMPLACEMENT METHOD
,,i.i'.. ''• OAquifer Test .. '.'• ' OStorrnwater Drainage' 144.8 ,ft, 146.r.',ft'''. Secondary Filter Gravity/Pour !•-,. •;;, .; •
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- •. ' 145.7 1
DExperimental Technology °Subsidence Control '-' ',;ft'. 4
,,6:8 ,fi. Fiiii-iiigife i-(GP#2) Gravity/Pour
OGeotherthal(Closed Loop) OTracer .
20.DRILLING LOG(attach additional sheets if necessary), ... .
FROM-. :,70. .' , .. .DESCRIPTION(e-olor:ft.ardnesS,soil/rock type.grain size.etc.)- I ...,.
•' ''. • OGeothenhal(1-leating/COOling Return) ,',.ClOter(explain under'#21 Remarks) :
• -, - - d , ' ft•4':,!, ' ft,, Yello‘nd*Silty:Sand • • • .
•'"'t' ' ' '"""-:." •'1:- "-."' ' ' •07/09/2024 . DIA/-7 i •,, .,,;., ft:'...5-- ''; - fi: YellOW,RedSanCiY.,Silt,' ,,•;,.• •4.Date we0)Completed • • - . .. Well ID# ..• . = . -...
54.1717011 Location ,'B.- ; ft. 7. '',.. ft Red• Lean',Clay • ., ".. . . • ,
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Belews Creek Steam.Station. ' .-.-.. • '. 7.. ',. 1.,t., '.32...1.„,f,'.; Yellowlilicti‘itftrgY Silty Sand - ,,. ,. •., "'"I' ""•
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,..•, '- . -Facilii340iimerNanie' - .;'; : , . --- : . •FaCility IO#(if applicable) . -:3? • .!t*'-1 .175:8. .-ffr•i Rock .Gi-ieiSt/SchiSt " p ;7:7:.J ..,.-..:i I IT-
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3195;Pirie..H411,Road ,'Bele‘'n.is Creek, NC 27009 ft ft
i$,sic-ar,ksiciss-Ci!,,-,aiiciip - ''';;,-••' ' • •••' • ;; :: . • ,.s' ; ,i:t'...,_.' T., .t!'...•:, , .I, ..-!.! ''. r: :', '....•,. .._.,'•SEP 1„ 5 -Z024:••
. :•. Stokes .• ... .• , •••• , ,- • ;, • •, , • , .. - . •N 21.REMARKS. • • i '• ' . •.'• . '
-142:2CTI,Li!r-n
• , ;;; • - •••,. • . • • ' • ;- =- `I • • ... •f:BENTONIIIE',SEAb;•137.9 16144.01%.
County '. Parcel Identification No.(PIN) ' ;•'•', •- ; •' - ; - ; ' - ; ; • -•'' ' : .awc..•-mc...-:2-
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, - •• ••• '-. - • - Drilling Log Depths(Except Termination)Approximated to Nearest Foot • . -
,:;:. •r' ..,56.LatituCie,and longitude in degrees/mnuites/seconds'Ae decimal degrees: ,!, . - .- ‘-',... ; .,.:z., . -. . :.„',-. - ,,.• . :.-,.. .;• ::.:_-... ',,......" ..:-.. - • ..
•:' .:,.. . (if w:rell,field,one lit/long:is nitcieut) • -:: ,; ; • ,' 22fCerlificatinn: ' ' •-• -, !!' ' '
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36.2700'.-.'-'.,'-•.,:•..:-:• • 'N 80.0594 ''I ' •',-; :, H. •.• - :. : • ...., ' ...i.-,. .- -•':, 1- . .. , '. .:' • • :1',.' ".,-,',.-..: I. .. •
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6.Is(are)the well(s);-nrefilianent or ' DTeipporary Signature of Certified Well.CO•atra*t';. . 'ii • - . '• • .Date •'',...: : .-i',- : '..
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By signing this fork I hereby certifythatihd 1.well(s)was(were)constructed in accordance with,
7.Is this a repair to an existing well DYes .or elNo . ' 15;1 NCAC 02C.0100 or 15A NCAC 02C.6260 Well Construction Standards and that a copy
;'.. • If this*Is a repair fill Oui'lcnown well aoa.i.truction infbrination and explain the nature of the of this record has been provided to the well miner
repair under#21-reingili.s:section or on the back'of this Aini. • ,li
. ..., :23.Site diagram cir,addjtional well details:•., ' . - .
8 For Geoprobe/DPT 9rCloied,7Loop Geothermal Wells having the same ,Y61..i may use the back of this page ttl,provide additional well construction info
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construCtion,only 1,GWL1is needed, Indicate TOTAL NUMBER of wells ' (add'See-dvee in Remarks Box).You may also attach additional pages if necessary.
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24.SODMITTAL.INSTRUCTIONS. - •
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9.Total well depik below 175 8land surface:.. .; '-• •.. .' '
For multiple Wellsiis't all depilis if different(eyampld,3g300 and 2@l00'). Submit this GW-Lwithin 30 days of well coMpletion.per-tke following:
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, .,. ,. .,',141'..For All Wells Original form-;itol,Division of Water,-Resources (DWR), ,'--,::'•
10.Static water level below top of casing:.'; , , (ft) ' Information Processing Unit,1617 MSC Raleigh NC 21699-1617
if water level is above cas'ini:i4e".+" • ' • . .. • I, i•
. ... . ;ranaminal(0-40 ft) 24b.For Injection Wells: Copy to D:W12.,.Underground Injection Control(IUC)
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1 1.Borehole diarneter: 6.5 nominal(40-175.8 to (in.)
. . , • - , , ;Program,1636.1sASC;Raleigh,NC276994636, • , . _ . - • • ..
,. ' Down the Hole (DTH) Hammer ' -• l ' :.''''.:.- , -• , - i t - . • .
12.Well construction method: ; - , . 24c.For Water Supply and Open-Lo'op!Geothermal Return Wells:Copy to the
• '(i.e.;atjgcr,rdtary,.cable:-tlitect push etc.) : 1* : ' ' county environmental health department of the county where installed'
' FOR IYATER'stimy-virtiCs ONLY: 24d.For Watei Wells producing over 100.000 GPD: Copy to DWR,CCPCUA --
:.. Perinit-Program;1611'MSC;Raleigh,NC(27699,1611 • --
. 13a.Yield(gpm) . . . . Method of test: •
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• 13b.-Disinfection type: . , Arioqiint:. . • • •
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FOrmOCArl • ' -:-' - :-"'-''" ' :' ' 14Mth oar-olinaliM•tindrt i:IfEM-dianiiientf Otfality•-•Iiiiiiorillf Water kes•mikes• ' • ' - • '•"' ; Revised 6-6-20 fa-.-=' •
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