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Home My WebLink AboutWS0801053_GW-1_20200505WELL CONSTRUCTION RECORD (GW-1) 1. Well Contractor Information: Jonathan Kamionka Well Contractor Name 3465-A NC Well Contractor Certification Number Bill's Well Drilling Co Company Name 2. Well Construction Permit#: CU3340/WS0801053 List all applicable mell consmac0an permilr (.e. UIC. Contrary, Slate, Variance, etc) 3. Well Use (check well use): OAgriculmml OGeothermal (Heating/Cooling Supply) ❑ Industrial/Commercial Non -Water Supply Well: ❑Aquifer Recharge ❑Aquifer Storage and Recovery ❑Aquifer Test OExperimental Technology OGeothem al (Closed Loop) DGeothermal (Heating/Cooling 01tunicipal/Public ❑Residential Water Supply (single) ❑Residential Water Supply (shared) DGroundwmer Remediation OSalinity Barrier OStonnwater Drainage OSubsidence Control OTracer 4. Date Well(s) Completed: 4-22-2020 Well IDn 5a. Well Location: Goodson & Wells Farms, Inc. Thurman Herring Farm Facility/Owner Name Facility to# (ifapplicable) 359 White Flash Rd, Mt Olive, NC 28365 Physical Address, City, and Zip Dupling 35200137138 County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (ifwell field, are lablong is sufficient) 35.132851 N-77.923978 µ, 6. Is(are) the well(s): OPermanent or OTemporary 7. Is this a repair to an existing well: Oyes or ONo lfthis is a repair, fill out knoum well construction utformalton and explain the nalure ofthe repair under 921 remark section or on the back ofthis form. 8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same construction, only I GW-I is needed. Indicate TOTAL NUMBER of wells 9. Total well depth below land surface: 360 (R ) For multiple mells list all deplla Ifdii ferent (example- 3Q200' and 2@100) 10. Static water level below top of casing: 52•5 (ft.) Ifmater /eve/ is above casing, use "+^ it. Borehole diameter: 20 (in.) 12. Well construction method: Mud Rotary (i.e. auger, rotary, cable, direct pmb, etc.) For Internal Use Only: 14. WATER ZONES FROMA DESCRIPTION Sao -5 fLIS. OUING for mWti<asedwells) OR LINER ife licable FROM TO DLNfEI'ER THICRNExa MATERIAL 0 R. 152 n. 120 1n. 1 1 Steel 16. INNER CASING ORTUBING cot closed-too FROM TD DIAMETERhermel THICKNESS MAIL I/ ft. aos- in. 110 ins I SDR17 PVC a .0- ft. 355 O ft. 10 i"' I SDR17 IPVC 17. SCREEN FROM TO DIAMETER SLOTSIZE THICKNESS MATERIAL Ibp- R. I 49- ft 110 in' .032 1 Iss 300 o_ 355 ft' 10 In .032 1 Iss 18. GROUT FROM TO MATERIAL EMPLitCEMENTMETROD@AMOUNT 0 ft. 52 b- Cement grout Pumped 52 ft- 160 ft- Bentonite grout Pumped ft. ft. 19. SAND/GRAVEL PACK Ha Knhle FROM To MATERIAL EMPWCEMENTMETHOD 160 ft-no it• #2 gravel Poured 20. DRILLING LOG attach additional sheen if neensa FROM TO DESCRIPTION color hnednm,ace ck ninsiu.etc. ft. u- SEEATTACHED ft. ft. D. R. ft. D. ft. R. fr. ft. ft. R. 21. REMARKS 22. Certification: 4/22/2020 Signet re ofCertiSed Well Tuntractor Date Bysigning this form, l hereby certify that the avell(s) was (vere) co Irucled in accordance with 15A NCAC 02C.0100 or ISA NCAC 01C.0200 Well Construction Standards and that a copy ofthis record has been provided to the well oivner. 23. Site diagram or additional well details: You may use the back of this page to provide additional well construction info (add'See Overin Remarks Box). You may also attach additional pages if necessary. 24. SUBMITTAL INSTRUCTIONS Submit this GW-1 within 30 days of well completion per the following: 24a. For All Wells: Original form to Division of Water Resources (DWR), Information Processing Unit, 1617 MSC, Raleigh, NC 27699-1617 24b. For Injection Wells: Copy to DWR, Underground Injection Control (IUC) Program, 1636 MSC, Raleigh, NC 27699-1636 24c. For Water Supply and Open -Loop Geothermal Return Wells: Copy to the county environmental health department of the county where installed FOR WATER SUPPLY WELLS ONLY: 24d. For Water Wells producinE over 100.000 GPD: Copy to DWR, CCPCUA 13a. Yield Permri Program, 1611 MSC, Raleigh, NC 21699-1611 (gPm) 6OO Method of test: Pumped 13b. Disinfection type: HTH Amount; 4 Cups Form GW-I North Carolina Department ofEnviron nental Quality. Division of Water Resources Revised "-2018 BRES WELL DRILLING CO. 800 McArthur Road Fayetteville, North Carolina 28311 Office (910) 488-3740 office@billswelldrilling.com Date: 4/22/2020 www.billsweRdrilling.com Goodson & Wells Farms Drilling Log Lithology Thurman Herring Farm - White Flash Rd, Mt Olive, NC - Duplin County From To Formation Description 0 1 Topsoil 1 4 Tan Sandy Clay 4 8 Orange Sandy Clay 8 11 Red Sandy Clay 11 32 White Sand 32 45 Tan Sandy Clay w/fine tan sand streaks 45 47 Sandstone 47 52 Tan & White Sandy Clay 52 75 Orange Sandy Clay w/fine tan sand streaks 75 95 Orange Sandy Clay w/fine tan clay streaks 95 98 Gray clay 98 118 Gray & Orange Clay/sand streaks 118 128 Gray & Orange Clay 128 145 Gray Silty clay 145 158 Gray clay w/streaks of sand 158 165 Gray Clay 165 170 Gray Sand 170 192 "Tight" Sand w/streaks of clay 192 194 Clay 194 205 Sand w/streaks of clay 205 217 Hard Gray Clay 217 237 Hard dark gray clay 237 247 Gray Clay 247 248 Hard Spot 248 258 Fine Gray Sand 258 282 Fine & Medium Sand w/streaks of clay 282 290 Clay 290 298 Hard Clay w/streks of clay 298 312 Sand & Clay Streaks 312 317 Clay 317 360 Clay w/small streaks fine sand Jonathan Kamionka 3465-A