HomeMy WebLinkAboutGW1-2021-01272_Well Construction - GW1_20210209 "ELL CONSTRVCHONRECORD n
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Robert Miller a[s/t1FINly
N'clf Cowmcew Na.w IL n.
2675 ft. 11.
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DAoiwbpl 67• h. 72- fL 2• ALL0.30 SCH40 Pvc
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DindKKhUComnknlal n1le6idLiLIWLIw Supph IsteocdlnKm to MATLaIu. [MFIA(FML�T stetNopAAalocKT
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DAgm(er Recharge OGmundw;scr Renednaum If. RAWL►ACK
room To MA LST MR 1 e
❑.Acptrttt Stomgc and Rmmcn ❑$abrun Kamer 651 R. 72' IL Silica Band 20/30
❑Aquifer Test ❑Aormwmcr Drmrracc OL R.
❑Es7xnmcraal Tcthnolog% ❑Substdcnec('moot
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O(ROlhenrWl ICltnnf Loop DTvecr Flom TO Lts[TIIn" µ..6a,e..w.a•,�s ifn6,ar.
DCxoOanarl dicating(willat Return) OOthn 4npiain under 021 Reati ;t 0 It. 72• IL Orange silty send
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4.Dale N'r41ol Compkird: 1-15-2021 W+dp1DLDKM-2
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Fadwi O..=Manx Facdn IDa td appltcabkr
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1775 M Dixon Blvd , Shelby, MC, 28152 R. R
FIVMW Admca C*.and Zip AfO —
Cleveland Pive feet bentoni to seal from 60•to 65'
Cam/ Fismlldpbnradrn No INNI
Sh,La/dmdr•and la.ngitude in dr9mv,'mim teshe■Yrair deei"degrees:
(dwell Old ...LaIn n.WI'..x.al 21 Cmhrlo:
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7.h this a repair to an existing well: DYa sF 014W td " (+IRd 11u,mired h.bers p *,Iid to aY w/t oaa.rr
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moo:—I— SL'BMITI'ALINSTLCTIONS
1.Total edl depth belon 1a■d a■rfara 72• ID.1 24A For Ali Welk: Strbnal dus loin wnlun 10 dins of compkwm of well
For mulr;pL.r'rb:urn!l Jiyabur Jr/I.......vanpla)l2nin"'d a'Wl commrcttnn to the folbwirw
10.Static rater Inrl briuw hqr of casing: (ft.) Dri Won of W alrr Rrstmme%.Informatiaa Pnwm%ing 1 nil,
16l7Mail SeniCC(rarrr.Kalrigh.S(-2'ti'1.1.161'
11.Berehnk diameter:6• lit) 16b. Fur In ertion We] ONLY: '-, 0,N-on i„ of or. !I, 1, ,,, i.,it. .Kidiess in
]as:lbtne. alw subnut a cop.k of h, Dori ..nhoi ,1 da.s of nnopletkoi of well
11.Well comwrwcth.o t■eFY[dl Insd rotary ;otnitwom to tlx toilow usg
o c aupr.rases..ahlc.drra7 pnrh m:.l
Dhlsiue of N-arse Rewmran.l ndrrgmmnd In)rrtbe Caniml Program.
FOR WATER SUPPLY WELLS ONLY: 1656 Mail Sees icv(Carter.Kalrrgh,NC 2 VN-16d6
I3a YkW(nme) RklMd efUM ?be.For K am Seppia A lal"tfwo N ell.:
Al o ,ubum one :cps of Ilex. Iona widen L- d:wsef<omplivaw of
13h.Disinfection hpc Amis ar wdl uommicunn to the annex ficAlh depannxnl of flm camp wlere
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Form GW-1 Nonh CMhFA Dip■m■safEWLVNMn■And M■n■I Roaow�, Ln,nwn,.l w.nsi Reams R..ucd Toilusy�I•