411904_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 Contactor (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 5
3. WELL USE (Check One Box): Monitoring DM Municipal/Public ❑
IndustriaVCommercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation ❑ Other ❑ (list use).
DATE DRILLED: January 22, 2013
4. WELL LOCATION:
Rao id Refueler, New River MCAS,
(Street Name,Tlumbers, Community, Subdivision, Lot No., Parcel, Zip Cade)
CITY: Jacksonville COUNTY: Onslow
TOPOGRAPHIC / LAND SETTING (check appropriate box)
QSlope ❑Valley ElFlat CI Ridge ❑Other:
34.710676
LATITUDE:
LONGITUDE:
77.448442
DD
DD
Latitude/longitude source: ® GPS ❑ Topo. map
(Location of well must be shown on a USGS topo map and
attached to this form if not using a GPS.)
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
City or Town
Ms. Jenni Reed
NC
State
Zip Code
Contact Name
Attn: GF/ EMD/ EQB/ 12 Post Lane
Mailing Address
Camp Lejeune NC 28542-0004
City or Town State Zip Code
(910)- 451-5068
Area code - Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 18
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IX]
c. WATER LEVEL Below Top of Casing: 12.24 FT.
(Use "+" if Above Top of Casing)
411904
d. TOP OF CASING IC 0.00 FT Above Land Surface'
• Top of casing terminated at(or below land surface may require
e variance in accordance with 15A NCAC 2C.0118.
e. YIELD (gpm): WA METHOD OF TEST: N/A
f. DISINFECTION: Type WA Amount: WA
g. WATER ZONES (depth):
Top
Top
Top
Bottom
Bottom
Bottom
Top
Top
Top
Bottom
Bottom
Bottom
7. CASING: Depth Diameter Thickness/WeWeight Material
Top 0 Bottom 8 Ft. 2 in. Sch. 40 PVC
Top Bottom Ft. in.
Top Bottom Ft. in.
8. GROUT:
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 Diameter Slot Size Material
Top 8 Bottom 18 Ft. 2 in. Slot.010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
f0. 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:
13
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cto
I DO HEREBY CERTIFY THAT THIS W6_1. WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C. WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORVPIAS BEEN PROVIDED TO THE WELL OWNER. .....
S(ONA`TURE OF CERTIFIED WELL CONTRA ICVOR w DATE;;
D.T. Chalmers, Jr. 1 'd ___
PRINTED NAME OF PERSON CONSTRUCTINGTHE WELL
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

WELL
LOG
�CATLIN
Engineers and Scientists
2"0"
VJilminglon, 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: 3843688
EAS7lNG: 275768
CREW: Josh O'Connell
MW15
SYSTEM: UTM NAD83 (m)
BORING LOCATION:
T.O.C. ELEV.: 22.4
DRILL MACHINE: CME-550
METHOD: H.S.A.
g HOUR DTW: 12.2
TOTAL DEPTH: 18.0
START DATE: 01/22/13
FINISH DATE: 01/22/13
24 HOUR DTW: N/A
WELL DEPTH: 18.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB.
o
I
s
L
o
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 22.4
0.0
0.0
_
-:
o.s (SP) - Med. brown, f. SAND (TOPSOIL)21
I I 1 I 1 I I I 1 1 1 I 1 1 1 I 1 1 I I 1 1 1 I 1 I 1 I I I 1 I 1 1 I
W m p
O O 0
.010 2' Sch. 40 PVC
Sch. ch. 40 PVC
WHIIiininiinnnninFaiuiiiiiiiiiniuii
s m a
0 0 0
- 3
4
5
4
0.0
M
\w/grass at top.
-
(SM) - Med. brown and black, Silty f. SAND.
20.4
Uniform. Loose. 2
5.0 17.4
5.0
_
101i
5.5 (SM) - S.A.A. 16.9
-
1
2
3
2
9.7
M
:::
65 (SP) - Lt. gray, f. SAND. Loose. Uniform. 159
IVY!
7.0 (SC) - Med. to dk. gray, Clayey f. SAND. 15.4
Uniform.
10.0 12.4
10.0
1
2
1
1
1 4
W
f//i
110 (SC) -S.A.A. Dk. gray. V. loose. 11.4
_
/1!
(CL) - Dk. gray, Sandy CLAY. Uniform. V.
12.0, soft. Low plasticity. 10.4
15.0
15.0 7.4
-
2
4
4
4
3.3
Sat.
...:
Dk. gray, f. SAND. Uniform. Loose.
17.0 5.4
18.0
-
-
-
Boring Terminated at Elevation 4.4 ft
in f. SAND.
i,�,i. �sr
MAR Q.
{,
Portland Cement
Bentonite Pellets
42 Medium Sand