GW1-2021-00806_Well Construction - GW1_20210215

WELL CONSTRUCTION RECORD For Winncl Use ONLY
Thu fro can b used for smgk sr h,le wells
1.Well Contractor Information:
Il WA
D.T. CHALMERS, JR. ni I,r,(RIP1110�
Well Contractor Name
4146A "
NC Well Contractor Certification Number x on .I du.rdaaw� m�
r�CATLIN Engineers and Scientists 0 n 4 n 2 vcCompany Name t[ rrr d' wells ORS.rNOAIL2.Wen Construction Permit 8: NSA n. n
List dl applicable wellpeanuts/re County, Jure, Ymiuraa,byedton,etc)
3.W'en l'se(check wen nse):
Water Supply Wen: FROM n, ui ua l I-r 1IOTsl� m
❑Agricultural ❑Municipal'Pubhc 40. 140_ 2 SM.010 Sch.40 PVC
❑Geothermal(Heating'Cooling Supply) ❑Residential Water Supply(single) r'-
❑InduanalCommercial ❑Residential Water Supply(shared) Faoht TO saasmu FaonwcErnrrr so:rtrooa AnaluNr
O Irrigation Oft. 0.5 o. Concrete Surface Pour
Non-Water Supply Well:
®Monitoring ❑Recovery 0"5 n. 2 n. Bent.Pellets Surface Pour
Injection Wen:
O Aquifer Recharge ❑Groundwater Remediation 19.SAND/GF AVEL PAG7c ra icable
O Aquifer Storage and Recovery ❑Salinity Banner Ix°al r" ucnmu
❑Aquifer Tea ❑Stommaler Drainage 2 n. 14 a Medium Sand Torpedo
❑Experimental Technology ❑Subsidence Control
fe es
❑Geothermal(Closed Loop) ❑Tracer rxonr To opsrwrnoNrai:,,
❑Geothermal(Heating/Cooling Return) ❑Other(explain under#21 Remarks) n. n.
4.Date Well(s)Completed: 01/19121 Well ION: MW-01 a' k e- O
Sa.Well Location:
Night Crossing INC. Offish Property 110
n. w
Facility/Owner Name Facility IDN(if applicable) lr�_
n.
361 Gillespie St.,FAYETIEMLLE,NC 29142
Physical Address Ciq',and 71p n n
CUMBERLAND
County Parcel Identification No.(PIN)
5b.Latitude and Longitude in degrees/minutesheconds or decimal degrees: 22 Certification:
(if troll field,one lot long is sufficient)
35.046338307 N -78.880251311 3qy 1/27/2021
!7`� 1— Sigmoe ofCatitied Well Contractor T Date
6.Is(are)the wen m(s): MPeranent or OTempoloq Br srgnmgrhu�{Turn./hrre(m rerq/svlwr rlu•ec•/l(s/vw(were/romrnareAm accnnkrnre coati
5 20L, 15AMACO2C 0100nr 15A M A('02C 02W We11 C.Ir.11oo.S1.n rls and f/w acnprvf
7.Is this a repairtasnexistmgwell: Oyes or ®NFEB 1 rhre remrelhua heenprm•iJrJ ro rAe xv/l oanr.
/(this rs a r"ir,Ill orb kwaon wefi crmsbmtmrm infor ovr rain esplam the arum of �y,
the repair under 21 remora sedron or on the buck ofthis�orm = )ii'Mte diagram or additional wen details:
(Gil You may,use the back of this page to provide additional well site details or well
8.Number of wens constructed: construction details. You may also attach additional pages if necessary
Far mu1riphc oyevtn.nr ran-urea supply welts ONLY with the same construction,Ynr
rim submit one form. SUBMITTAL INSTRUCTIONS
9.Total well depth below land surface: 14 (R.) 24a.For All Wens: Submit this form within 30 days of completion ofwell
Fru rmdliple welLc hsl dl depthv m di,fferent(cwmple-3/d OO'a l2��r 1(NI') construction to the following:
10.Static water level below top of casing: 4.62 (B.) Division of Water Resources,Information Processing Unit,
Ifuuter level rs alxnv roving use " 1617 Mail Service Center,Raleigh,NC 27699-1617
11.Borehole diameter: 6 (in,) 24b.For Infection Wells ONLY: In addition to sending the form to the
address in 24a above.also submit a copy of this form within 30 days of
12.Wen construction method: HSA completion of well construction to(he following:
fie,anger,narap,cnhle,direrr push,etc,) Division o(W'ater Resources,Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center,Raleigh,NC 27699-1636
13a.It (gpm) Method of test: 24c•For Water SvDDN&Infection Wells:
Also submit one cop)of this form within 30 days of completion of well
13b.Disinfection type: Amount: construction to the county health department of the county where constructed.
Adapted from Form GW-1 North Carolina Department of En.inamrem and Natural Resources-Division of Water Resources Revised 2-22-2016

WELL LOG J~ CATLIN
Englrxren.n4 Scientists
220222 SHEET 1 OF 1
PROJECT NO.: 220222 1 STATE: NC I COUNTY: CUMBERLAND Lowm: FAYETTEVILLE
PROJECT NAME: Odeh Property LOGGED BY: COREY FUTRAL WELL ID:
DRILLER: D.T. CHALMERS JR. MW-01
NORTHING: 471815 EAsnNG: 2035840 CREw: TREVOR MIZELLE
SYSTEM: NCSP NAD 83 USft BORING LOCATION: Prop.near Comer of Gil and T.O.C.ELEV.:
DRILL MACHINE: CME 45B TRACK METHOD: HSA 0 HOUR DTW: 4.6 TOTAL DEPTH: 14.0
START DATE: 1/19/21 END DATE: 1/19/21 24 HOUR DTW: 4.6 WELL DEPTH: 14.0
DEPTH BLOW COUNT OVA LAB o L SOIL AND ROCK WELL
o.5rt o.srt o.srt o.5rt (PPM) s G DEPTH DESCRIPTION DETAIL
0.0 LAND SURFACE 0.0
ISM)-Brown to gray,Silly F.SAND with rocks 0.0 — 0.6
i
a
S 2.0
5
N
3.0 3.0 &
�^ (SP)-U.gray with orange mottling,F.SAND
2
` 5 4 1.5 M(3) M •'. 40
(CH)-Gray with orange mottling,highly plastic CLAY.
Strong HCO
8.0
o
woB t 2 1.3 M-oi M
2 y
�N
12.0
1
3 3 12.7 M
4
14.0 14.0 14.0 14.0
BORING TERMINATED AT DEPTH 14.0 itin highly
plastic CLAY
Portland Cement Bentonite Pellets #2 Medium Sand