411591_Well Construction - GW1_20130211

1. WELL CONTRACTOR:
Joe Zuncich
Well Contractor (Individual) Name
Applied Resource Manaaement. PC
Well Contractor Company Name
257 Transfer Station Road
Street Address
Hampstead NC 28443
City or Town State Zip Code
(910 ) 270-2919
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# NA
OTHER ASSOCIATED PERMIT/0 applicable) NA
SITE WELL ID #(if applicable) MWAOC-4
3. WELL USE (Check One Box) Monitoring Ei Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 1 /9/1,3
4. WELL LOCATION:
4971 Arendell Street
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Morehead Citv COUNTY Cartaret
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑ Valley elat ❑ Ridge ❑ Other
LATITUDE 34 044 ' 1.9100 "DMS OR DD
LONGITUDE 76 ° 47 27.6300 " DMS OR DD
Latitude/longitude source: W;GPS [Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
NA NA
Facility Name Facility ID# (if applicable)
4971 Arendell Street
Street Address
Morehead City NC
City or Town State Zip Code
Joe Zuncich. AoDlied Resource Mat. PC
Contact Name
P.O. Box 882
Mailing Address
Hampstead NC 28443
City or Town State Zip Code
( 910,i 270-2919
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 13
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO qI
c. WATER LEVEL Below Top of Casing: 3.81 FT.
(Use "+" if Above Top of Casing)
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3324A
d. TOP OF CASING IS 0 FT. Above Land Surface*
• *Top of casing terminated at/or below land surface may require
•
a variance in accordance with 15A NCAC 2C .0118.
n1'591
: e. YIELD (gpm): NA METHOD OF TEST NA
f. DISINFECTION: Type NA Amount NA
: g. WATER ZONES (depth):
Top 4' Bottom 13' Top Bottom
Top Bottom Top
Bottom
Top Bottom Top
Bottom
Thickness/
: 7. CASING: Depth Diameter Weight Material
Top 0 Bottom 3 Ft 2" SCH4( PVC
Top Bottom Ft
: Top Bottom Ft.
: 8. GROUT: Depth Material Method
Top 0.5 Bottom 1.5 Ft. Bentonite
Top 0.1 Bottom 0.5 Ft. Neat Cement
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
: Top 3 Bottom 13 Ft. 2" in. 0.010 in. PVC
: Top Bottom Ft in. in.
: Top Bottom Ft. in. in.
: 10. SAND/GRAVEL PACK:
Depth Size Material
Top 1.5 Bottom 13 Ft. Coarse Sand
Top Bottom Ft
Top Bottom Ft.
11. DRILLING LOG
: Top Bottom
•
•
7
/
/
•
•
•
•
•
•
•
•
•
•
•
/
/
/
12. REMARKS:
Formation Description
See attached boring logs.
TrA \r-\ arty
E-..
El:11.Jc
' nfo:•mation Procccc'sng Unit
DWQ/BOG
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
: 15A NCAC ELL CONSTRUCT! STANDARDS„, -AND THAT A COPY OF THIS
RECO % AS =EEN PRO E WELL OWNE
/'gt)-/.3
SIGNA ' E F CER I W LL CO RAC -TOR DATE
PR TED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - Information -Processing,
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]
Form GW-1 b
Rev. 2/09

MWAOC 4
Steel Manhole ---,
Ground Surface
1' Bentonite
A
1115'Sand
Locking Well Cap
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f
Concrete/Grout Crown
3' Riser
10' Screen
+ 13' Total Depth
Applied RReour e
Harnp reFd AIC2844
TITLE:
Type II Monitoring Well Asbuilt
JOB:
12098
SCALE:
Not to scale
DATE:
1/29/13
DRAWN BY:
EFC
WELL ID:
MWAOC4I

MWAOC-4
BORING LOG
NKC PROPERTIES
4971 ARENDELL STREET
MOREHEAD CITY, NORTH CAROLINA
DRILLED BY: D. Cummings
LOGGED BY: J. Zuncich
DATE: 1/9/13
Sample
Depth
Description
Water
Content
Blow Count
2'-4'
Medium gray, very fine grained sand. Organic
odor.
Low to
Moderate
Hydraulic
Push
5'-7'
Gray -brown, silty to fine grained sand with
minor clay lenses and tree root matter. No HC
odor.
High
Hydraulic
Push
10'-12'
Green -gray, silty clay with soft, loose texture
and low density. Organic odor.
High
Hydraulic
Push