411905_Well Construction - GW1_20130304

NON RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION #: 4146A
1. WELL. CONTRACTOR:
D.T. Chalmers, Jr.
Well Contractor (Individual) Name
CATLIN Engineers and Scientists
Well Contractor Company Name
220 Old Dairy Road
Street Address
Wilmington North Carolina 28405
City or Town State Zip Code
( 910) - 452-5861
Area code - Phone number
2. WELL INFORMATION
WELL CONSTRUCTION PERMIT #: N/A
OTHER ASSOCIATED PERMIT # (if applicable): N/A
SITE WELL ID # (if applicable) USTTE/SW-MW 1 6
3. WELL USE (Check One Box): Monitoring Igl MunicipaVPublic ❑
IndustriaVCommercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation ❑ Other ❑ (list use).
DATE DRILLED: January 24, 2013
4. WELL LOCATION:
Rapid Refueler, New River MCAS,
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Jacksonville COUNTY: Orislow
TOPOGRAPHIC / LAND SETTING (check appropriate box)
❑Slope ❑Valley I%IFlat ❑Ridge ❑Other:
LATITUDE' 34.710553 DD
LONGITUDE' 77.448188 DD
Latitude/longitude source: IX] GPS ❑ Topo. map
(Location of well must be shown on a USGS topo map and
attached to this fomr if not using a CPS.)
5. FACILITY (Name of the business where the well is located.)
N/A N/A
Facility Name Facility ID # (if applicable)
Rapid Refueler, New River MCAS
Street Address
Jacksonville NC
City or Town State
Ms. Jenni Reed
Zip Code
Contact Name
Attn: BF/ EMD/ EQB/ 12 Post Lane
Mailing Address
Camp Lejeune NC
City or Town State
(910)- 451-5068
Area code - Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 18
28542-0004
Zip Code
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ISI
c. WATER LEVEL Below Top of Casing:. 11.20 FT.
(Use "+" if Above Top of Casing)
411905
d. TOP OF CASING IS 0.00 FT Above Land Surface*
• Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C.0118.
e. YIELD (gpm): WA METHOD OF TEST: WA
f. DISINFECTION: Type WA Amount: WA
g. WATER ZONES (depth):
Top
Top
Top
Bottom
Bottom
Bottom
7. CASING:
Depth
Top Bottom
Top Bottom
Top Bottom
Thickness/
Diameter Weight
Top 0 Bottom 8 Ft. 2 In. Sch. 40
Top Bottom Ft. in.
Top Bottom Ft. in.
8. GROUT:
Material
PVC
Depth Material Method
Top 0 Bottom 4 Ft.Portland Cement Tremie
Top 4 Bottom 6 Ft. Bent. Pellets Surface Pour
Top Bottom Ft.
9. SCREEN:
Depth
Top 8 Bottom
Top Bottom
Diameter Slot Size
18 Ft. 2 in. Slot.010in.
Ft. in. in.
Top Bottom Ft. in. in.
Material
PVC
10. SAND/GRAVEL PACK:
Depth Size Material
Top 6 Bottom 18 Ft. #2 Medium Torpedo Sand
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
SEE
ATTACHED
/
12. REMARKS:
RE(
FEB 2, ',, 2013
4ntormeL�oy Prncessalx3 t�
OtP.fO1BOG
I DD HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC ', WELLPONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD - S BEEN PROVIDED TO THE WELL OWNER.
Sleyt'� RE OFT RTIFIED WELL CIIhTRACT6R4"-- DA�E
'1
D.T. Chalmers, Jr. i I fll 201 ;I j
PRINTED NAME OF PERSON CONSTRUCT G �H LL it fl
Submit within 30 days of completion to: Division of Water Quality - Information Processing,
1617 Mail Service Center, Raleigh, NC 27699-1617, Phone No. [phone]
Modified from
Form GW-1 b

4 WELL
LOG
CATLIN
Engineers and Scientists
2"071
Wilmington, NC SHEET 1 OF 1
PROJECT NO.: 211071
STATE: NC
COUNTY: Onslow
LOCATION: Jacksonville
PROJECT NAME: JP-5 Stormwater
LOGGED BY: Corey Futral
WELL ID:
DRILLER: D.T. Chalmers, Jr.
USTTE/SW-
NORTHING: 3843674
EASTING: 275791
CREW: Josh O'Connell
MW1 6
SYSTEM: UTM NAD83 (m)
BORING LOCATION:
T.O.C. ELEV.: 22.6
DRILL MACHINE: CME-550
METHOD: H.S.A.
0 HOUR DTW: 11.2
TOTAL DEPTH: 18.0
START DATE: 01/24/13
FINISH DATE: 01/24/13
24 HOUR DTW: N/A
WELL DEPTH: 18.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB
o
s
L
°
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 22.6
0.0
0.0 _
-`'
0.6 (SM) - Dk. brown to black, Silty f. SAND 22.0
II 1 I 1 1 I -I--I I pi IILI 1 1 1 I 11 1 I 1 I 1 I 1 1 1 I I I
m w O
O
2" Slot .010 2' Sch. 40 PVC
Sch. 40 PVC
1lIl l]l]]]IIIIIIIIIIIIIIIIII!IIF4JIIIIIIIIIIIIII
a 0 A
s G C
-
3
4
7
10
0.2
M
m-',
\(TOPSOIL) w/roots. /
(SM) - Med. gray w/dk. brown, Silty f. SAND.
0.6
2'--„Uniform. Med. dense. 2
5.0 17.6
5.0
-
2
3
4
6
1.2
M
�/
/i
(SC/CL) - Med. gray tr. orange mottling, Sandy
✓/ 6.0 CLAY to Clayey SAND. Uniform. Loose/stiff. 16.6
_
(SM) - Lt. tan, Silty f. SAND tr. clay. Uniform.
Loose. 15.6
10.0 12.6
10.0
2
1
2
2
1.4
W
//
/ (SC/CL) - Black, Sandy/Silty CLAY to
Silty/Clayey SAND. Uniform. V. loose/soft.
plasticity. in Low P Y• 10s
15.0 7.6
15.0
-
2
2
3
3
1.7
Sat.
":::::
...:
(SP) - Lt. gray f. SAND. Uniform. Loose.
17.0 5.6
18.0
i -
-
Boring Terminated at Elevation 4.6 ft
in f. SAND.
l).
MAR 0 k
E.
2
2
C
Portland Cement
Bentonite Pellets
#2 Medium Sand