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Home My WebLink About413526_Well Construction - GW1_20130528WELL CONSTRUCTION RECO F1t This form can be used for single or multiple wells For Internal Use ONLY: 1 ■ Well. Contractor Information: William J. Mabie Well Contractor Name 3137-A NC Well Contractor Certification Number AMEC E&I, Inc. Company Name 2. Well Construction Permit #: N/A List all applicable well construction permits (i.e. County, State, Variance, etc.) 3. aUse Well (checkuse): well Water Supply Well: ❑Agricultural ❑Geothermal (Heating/Cooling Supply) ❑ Industrial/ o 'mmerct al C ❑Irrigation ❑Municipal/Public ❑Residential Water Supply (single) ❑Residential Water Supply (shared) d) Non -Water Supply Well: OMonitoring ❑Recovery Injection Well: ❑Aquifer Recharge ❑Aquifer Storage and Recovery ❑Aquifer Test ❑Ex erimental Technology gY ❑Geothermal (Closed Loop) ❑Geothermal (Heating/Cooling Return) ❑ Groundwater Remediation ❑ Salinity Barrier ❑ Stormwater Drainage ❑ Subsidence Control ❑Tracer ❑Other (explain under #21 Remarks) 4. Date Well(s) Completed: 4/11/13 5a. Well Location: Brunswick Co. Landfill Well ID# TGW-2.1, 2.2, 2.3, 2.4 NA Facility/Owner Name Facility ID# (if applicable) Landfill Road, Bolivia, NC 28422 Physical Address, City, and Zip Brunswick County NA Parcel Identification No. (PIN) 5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) 34.04442054 N -78 ■ 26446145 W 6. Is (are) the well(s): ❑Permanent or Temporary 7. Is this a repair to an existing well: ❑Yes or ❑No 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. S. Number of wells constructed: For multiple injection or non -water supply wells ONLY with the same construction, you can submit one form. 4 9. Total well depth below land surface: 7 (ft.) For multiple wells list all depths if different (example- 3@200' and 2@100') 10. Static water level below top of casing: N/A Gas Mon . Well (ft.) If water level is above casing, use "+" 11. Borehole diameter: 3' S (in.) 12. Well construction method: Hand Auger (i.e. auger, rotary, cable, direct push, etc.) FOR WATER SUPPLY WELLS ONLY: 13a. Yield (gpm) Method of test: 13b. Disinfection type: Amount: FROM TO 41352B >fr:iyi:iv ii<i: i.4'ti: :•iY f'v:�' ?:'f�? t}:y:':::�i?i'i;:�:v'r'ii iii:4'}''^'v)i':i!ij'%ti:}i::!ii: tt�^:L�:{^n!:tt: `F-•::.:+.:>�`vvvii::r<.^!tikS G:i}v.:ii .. v:::?.::-:}:•i{i:•;•r:;.:..-.w:•!•i:•i:;'•:; �i:: :.•:}: rJ+4.,. ..: .,....:..:.-.,C,.... .. .. .. ...:..... .:.}$}:.i:.}}}}`: iKi n� i:J}:'•iii:{:: � : }.:v "J.Ji'?{.?!.; !:•: iii::'1;�: � $ij? t :';i:�iY:i4iii:'h;':;: :yv DESCRIPTION ft. ft. N/A ft. ft. 14700106111,11111111 r:: ...:.. ..... FROM TO DIAMETER THICKNESS MATERIAL ft. ft. in. v.yx06111 nK F.v.. •} r.. 1. + ialltlfIBBMOBEEg FROM TO DIAMETER THICKNESS MATERIAL ft. ft. in. ft. ft. in. i:J ~i ;:v4ti4: } yv�}h.�ti:n•,vC-}.r4�4 y: :�iSi!)iniU.j�?+iti• tv: V �?� ii �'i: l•Ku{�il: +:itiiX}: >��vi'�i�ii•'.:$.Sv }J;i:Z\%Y��!i: n\.tii;;:>::>:.:{v{,`f\�'+:.if 1�j �?iin `�4i'�vyM1�t':•?i4.S�n{ •r.A : v�n.v n•.!t%• x. fi x.:/: v:1\" �:M,» n1v:.::>.,,, n.C,'A.` .3... }r.: :{},-'::j" ..x?: :t�>:>.',^•.: cr?{:,o{.., .:!7,:;+ ,+,!•:.: .:v... `ti:::: ...:>%• ?`i:.�:{ >}>•: �.,}-ri,, ;+,\.,{, 'r :i ;ice ..:n.} v • r::' ..?t:•:;.;.};::..`v:Y.?..,: ,yiy}.•�: •:ti.`•: ::.r•V . {.....J..-..s.. ::}. vR:,G:'r.{:.}:•xi:';;;;:;. FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL 3 ft. 7 ft. 2 in. 0.01 Sch 40 PVC ft. ft. in. w::.}:;;i.;.};:.:........::.:�::::.:,r...,}::J�:;?.:J::.):.:�:.tt.:t...:Y:t:{.:�.:.::.:.:tw}:.)}}Y'}tJ)}: Y:t::.):{{.........:..:.::;.:::.:::'.::4>.?T.}'.}:{:.}}::!{J::.:J::.}}:.�.:J'{:}}:.,,)}.::.Y{ ''r� , fir.,:. +•.f.> r�! .,«^ .,:,�:�: ; <::{.. .,>:}. .kA, �i:Q�'. :••>w n44 {. �::4}}ti{iti:: r.:. ...{. ,;�`i? vi%'v}•Y. ..:N!-: -•:::}+}:i v.�S^. } i2�::".•`4-„ :;;y;i}S.:}':v':i:i \::::`.:,v!:iti'v %�iO.....t v}iC9�... Y...v!rr...n::.:: n...n . FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT 0 ft. 1 ft. Portland I Hand Placed ft. ft. ft. ft. 110 FROM ^.k•ti:: {ti +,:�:•; :�r.:;yti`_`'rhrY ))>{>-'::�?;:.;�: ,.;...!`{;ii::>i: ti.:ti ': :<: �:;: t• »�{}:'ii`.: t{;•>w`, :fix{•:. „!-:;>}: :} i::'t::; ".: L' l::':.v`•i�v}:>: .,•}+ti':J14'•,S'yy:-'•:rr •.v• ..v.....:...:.:.:::: r..: �•.. :......:..: .. J..:....:n.•t::�.. ... . ..:xn• \::: :v... x4..:v t;>: , {:J:•.:.....ni...r.....i'>j!.:.................. f.!Sv ...................\ :>. TO MATERIAL EMPLACEMENT METHOD 2 ft. 7 ft. #2W.P. Hand Placed ft. ft. FROM TO `' =attach 4!• j^+i;; ti:.%iJ ?•iltyY:{;i•i; i��iih\�ihi; iiy,`:::2\�i:?:;{:., dv4i: '!{,Y��1ri J:tin\v: {l (y plc .�}: �'•:{i' i::4)r' ■Jfii:•' .hee.�t-r `* �:n1tt iil ` `• •ry•`.:`�i:^,v) •'.v:�;<'!g.:3:{> ..yfn•'7v`uiK':•'',:vti;:\•.v "-:if:+, :{ :'i`•�:v4:?{1 {}::ti:' i:•f•:: iri'?.{-i�rh::) in':5�;} :i:J` DESCRIPTION (color, hardness, soil/rock type, grain size, etc.) 0 ft. 7 ft. Brown to tan silty fine SAND ft. ft. ft. ft. ft. ft. ft. ft. ft. ft. M4Y It 4 ?013 ft. ft. ti� r .�.,... � �+~ , ::f::':.kl• ::ix}5:;: ; .ti? ):?:ii :J'r,.:-)• ,;..<, \:.:.$��•::•:3<i �:y:Y�i :.<- . �ii:?i5' .:\:; S. '. ^%i;:?<;+.� ::+-... , :::c.:.` {:;$t.. ,}�:��:?:. kip\�;}}\`;}{.v ..�{,., �'.p � ; . t•:.. '.\•.,Rtt``.11 } �.,. , •:9.N`�'aio.:.•,++T�•. ..4.,G•i}':{! ri'`^: ::)F.;v ..v:.':::.v::: •: !v: n{,K>::{J :::,., J:4-\.hv.,x\J'•}:)::.. • nv:.,:....: i\\ t:: ::..•: }••'$ ,:: ::+..:..+.. "- ::;:,. :R•}x: '':i.: '.^r}:d. '::::If:;;r.;n •�',:. :%.J ::�'.. })tip':... • 22. Certip3. tion: Signature of Certifies •ntractor Date By signing this for P ereby cert( that the well(s) was (were) constructed in accordance with 15A 1 GAC 0.2C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a copy of this record has been provided to the well owner. 23. Site diagram or additional well details: You may use the back of this page to provide additional well site details or well construction details. You may also attach additional pages if necessary. SUBMITTAL INSTUCTIONS 24a. For All Wells: Submit thisf�'ihi construction to the following: Division of Water Qual 1617 Mail Service C In • ti2 o a 'er, Raleigh, NC 27699-161 24b. For Injection Wells: In additi to-sendir-rg°the- omrtcrthea idress in 24a above, also submit a copy of this form within 30 days of completion of well construction to the following: on of well Division of Water Quality, Underground Injection Control Program, 1636 Mail Service Center, Raleigh, NC 27699-1636 24c. For Water Supply & Injection Wells: In addition to sending the form to the addresses) above, also submit one copy of this form within 30 days of completion of well construction to the county health department of the county where constructed. Form GW-1 North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013 CC z 0 CO w 0 COMM 1, l / 1 (75 -41*: 1=1 // r 7 z J 0 g TEMPORARY GAS WELL ix Z w Et z a. M M CC W ~ J n' J Ow zw X . 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'" 1 .::::. -- ,e, F: • . <Y 0%.* ' T ' ....::,` 43; , , , , , ; Vi CO 0 • O. z°1-1 -771 CO cc a. occ a. g:1 411411000. co Lo Lo AMEC E&1, Inc. 5710 OLEANDER DR WILMINGTON, NC (910) 452-1185 GAS MONITORING WELL INSTALLATION RECORD JOB NAME Brunswick County Landfill BACKFILL MATERIAL Well Pack #2 JOB NUMBER 6550-12-0024 SLOT SIZE 0.10 inch WELL NUMBER TGW-2.1 SCREEN MATERIAL SCH-40 PVC INSTALL DATE 4/11/13 RISER MATERIAL SCH-40 PVC LOCATION See Site Map SCREEN DIAMETER 2.0" LATITUDE 34.0444205 RISER DIAMETER 2.0" LONGITUDE -78.26446145 BOREHOLE DIAMETER 3.0" AMEC REPRESENTATIVE K Charles -Smith LOCK BRAND Master DRILLING CONTRACTOR William Mabie NC3137A SIZE / MODEL NA DRILLING TECHNIQUE Hand Auger KEY CODE 0536 STICK UP CEMENT SEAL BENTONITE SEAL 2-IN SOLID RISER PIPE SAND PACK WELL SCREEN 3.0' 6.0' LOCKING OUTER PROTECTIVE COVER DEPTH TO TOP OF BENTONITE SEAL 1.0' DEPTH TO TOP OF SAND 2.0' SCREEN LENGTH 3.0' TOTAL DEPTH OF BOREHOLE 6.0' AMEC E&I, Inc. 5710 OLEANDER DR WILMINGTON, NC (910) 452-1185 GAS MONITORING WELL INSTALLATION RECORD JOB NAME Brunswick County Landfill BACKFILL MATERIAL Well Pack #2 JOB NUMBER 6550-12-0024 SLOT SIZE 0.10 inch WELL NUMBER TGW-2.2 SCREEN MATERIAL SCH-40 PVC INSTALL DATE 4/11/13 RISER MATERIAL - SCH-40 PVC LOCATION See Site Map SCREEN DIAMETER 2.0" LATITUDE 34.0448339 RISER DIAMETER 2.0" LONGITUDE -78.26447092 BOREHOLE DIAMETER 3.0°' AMEC REPRESENTATIVE K Charles -Smith LOCK BRAND Master DRILLING CONTRACTOR William Mabie NC3137A SIZE / MODEL NA DRILLING TECHNIQUE Hand Auger KEY CODE 0536 STICK UP CEMENT SEAL BENTONITE SEAL 2-IN SOLID RISER PIPE SAND PACK WELL SCREEN 3.0° LOCKING OUTER PROTECTIVE COVER DEPTH TO TOP OF BENTONITE SEAL 1.0' DEPTH TO TOP OF SAND 2.0° SCREEN LENGTH 3.0' TOTAL DEPTH OF BOREHOLE 6.0' AMEC E&I, Inc. 5710 OLEANDER DR WILMINGTON, NC (910) 452-1185 GAS MONITORING WELL INSTALLATION RECORD JOB NAME Brunswick County Landfill BACKFILL MATERIAL Well Pack #2 JOB NUMBER 6550-12-0024 SLOT SIZE 0.10 inch WELL NUMBER TGW-2.3 SCREEN MATERIAL SCH-40 PVC INSTALL DATE 4/11/13 RISER MATERIAL SCH-40 PVC LOCATION See Site Map SCREEN DIAMETER 2.0" LATITUDE 34.0452191 RISER DIAMETER 2.0°' LONGITUDE -78.26454535 BOREHOLE DIAMETER 3.0" AMEC REPRESENTATIVE K Charles -Smith LOCK BRAND Master DRILLING CONTRACTOR William Mabie NC3137A SIZE/ MODEL NA DRILLING TECHNIQUE Hand Auger KEY CODE 0536 STICK UP CEMENT SEAL BENTONITE SEAL 2-IN SOLID RISER PIPE SAND PACK WELL SCREEN 3.0' LOCKING OUTER PROTECTIVE COVER DEPTH TO TOP OF BENTONITE SEAL 1.0' DEPTH TO TOP 2.0' SCREEN LENGTH 3.0' OF SAND TOTAL DEPTH OF BOREHOLE 6.0' AMEC E&I, Inc. 5710 OLEANDER DR WILMINGTON, NC (910) 452-1185 GAS MONITORING WELL INSTALLATION RECORD JOB NAME Brunswick County Landfill BACKFILL MATERIAL Well Pack #2 JOB NUMBER 6550-12-0024 SLOT SIZE 0.10 inch WELL NUMBER TGW-2.4 SCREEN MATERIAL SCH-40 PVC INSTALL DATE 4/11/13 RISER MATERIAL SCH-40 PVC LOCATION See Site Map SCREEN DIAMETER 2.0" LATITUDE 34.0461211 RISER DIAMETER 2.0" LONGITUDE -78.26308525 BOREHOLE DIAMETER 3.0" AMEC REPRESENTATIVE K Charles -Smith LOCK BRAND Master DRILLING CONTRACTOR William Mabie NC3137A SIZE / MODEL NA DRILLING TECHNIQUE Hand Auger KEY CODE 0536 STICK UP CEMENT SEAL BENTONITE SEAL 2-IN SOLID RISER PIPE SAND PACK WELL SCREEN LOCKING OUTER PROTECTIVE COVER 3.0' DEPTH TO TOP OF BENTONITE SEAL 1.0' DEPTH TO TOP OF SAND 2.0' SCREEN LENGTH 4.0' TOTAL DEPTH OF BOREHOLE 7.0'