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HomeMy WebLinkAboutGW1-2021-01619_Well Construction - GW1_20210323 WELL CONSTRUCTION RECO (GW-I) For iaiwat use onh �- L Well Coattaclor Idorma6oe L , S. RA,� yG . 14.WAMRZD?M Wen Coat®rI U _ M TO 3535 O s 6na s R R NCWeACmmrar CwdfiemmN®ber aoLffiCAsm(tw'»oobm'edweS ORL1N� '.'11R man Rrat awls za aleat>� urea® hers;ar- � R s in. 16 768 Hµ'y 268 W j6>ta� ba 1'� casnvcoax�vc ra:�la.ar _ > -^ 7 well Censtrac FamRN: in )yr Sao-.._ yRt� m mdatata mmaaa LL rl+taaap tre,rellmwaammtlevate(a�wC ! '7 R IL 57rh m �. 3.Well Use(tbaak well me): R R m Water Supply Wen: 17.SCBEHl;. adDM ITO ffiAKUM 9ArSCZ I MUMCIVIN I KAMMAt OAgrimhmal par;:�.wtn�au' R fL in oGm6 cummI(HestaWrbohng Supply) -A&.d=al Water Supply(mgle) R R ®- Omdustr-aVC�a�I OResidmtal Water Supply(sbmM) ,18.(azovt' - 9fragstma 11Wdls>IOO,000 CRD raox 70 xecwaeer SRppiy Wen: R R r OMmitamg ORecoycy R R r s Weh R R ' CAqu&Raehazpf OCuotmduatter Remediatim 0AgttiBa Storage and Recovery OSalinhy Bauaa F SANB/GRAVSLPA -' ^Y,:: �•••-. _ .,. I� DAgni5aTe4 DSmm%mnrD=nW R s 011apamnactial Tabmbgy ❑Snbsmeuz Comm R R OGmthummal(Closed loop) OT1mta -2a-D8.11*s LOU iedSmdakies8 OGeotlessuat 9kMWCoplmg Rearm) OOtba(edam under#21 Remadm) moat TO Aa>tan»N ait�rt _ e.W it - R 4.Date wen(s)completed: 3—1 L-24 Well ID# R '... tt d W �'+? .4 Sa.Wen Location 1 �1A� R Coh�r..yti,i, 1 d-str,.l,J (�sA� R s +ethq,'0wmw Name Pavan.lD®(ffapp$CaNm) 8 R r i Is fZ A R R Physsal Addm>a Cayt✓ ATzp . . R g' . W I ZI R631A8Es Cody Pacd kkvrmsc No(PAS SD.Lahtm&and loggitede fa depw/miaofemi a uds or deennal degeeea: (ifwen field om BV3=a n m»meat) 27-Certi uom y.- , .� 6.ls(sre)the wd4*. OPermaaem or OTemporary, U(e)p ' 'Wu`ur` r 1j ortersa Dam Sympurg d-jbrm./ r-,*d-row- 9&),rm leery mmv.ebdAeaoriane 7-19tidsarep.drm&n..i gwe&1 11Yes or M a ISAArCCO2C.0100m13AATACOZC.0100WcUCpunam Swr#w3rmddmamp gawbaeepalifdle.dWraxQtamreamifwaedm andemlobetk nmoe aide �drisrmadkabmrpveid la drz rePowv. - mpo a..dw 921>mst,is i t wane9&6aFoftlusfma 23.Sm diagram or addrboW wen demob: . S.For Gmpmbe/DPf or Clamed-Loop Geothermal Wens barmgthe smme You may use the bwk of this page to provide additimm %eh6 a info comtoGim,only l GW-lis needed. mdicite TOTAL NUMBER of wens (add'Sm Ovdm Rona&Ba4 You may also aMm:h mmmmal�ullct ifttsrmey d0ed. 24.SUBMITTAL 1NS'1RUMCINS 9.Totalwen depth below land surface: 160 0 (R) Submit this GW-1 whMm 30 s FormAaple we!<r&o aII dydagd (amg:e-3®200'mu'2�/00� days of wen mtlo per tkeSaBowog: 10.Static water level below mp of rases: �i (ft) Form An Wells Onp ml dbffi to Dmism d Water Rmac. tm (DWR; q,+ Indtsobow®,y..(. Ptocessiog Unit,1617 MSC,Raleigh,NC 27699-161'17 IL Borehole diameter: La l8 (m.) 24b.For Iaieetio®Welts Copy to DWR,Umlegmmd Jn)e-m Cmhd(Ric Pia 1636 MSC,Raleigh,NC 27699-1636 12.Welt emtrxtkamebod —ehd.., _T Geal�mlRe�a'iYeHeCOPYIDth the000rdqvam CLe�.1p�'•C"(rod pock m) wFWm ma FOR WATER SUPPLY WELLS CONLY: /( 24d.For Water Wells o�r_IW,0406 Copy tp DWR CCPCUr Lis.Yield(gp* LMaw of test� Petmrt Ptq�tmm,1011 At::K-t�l,r.0 i0» 1011 13e Db�n type�� Amount Faro GW-1 North CmDba Depammt MMmanaomGl Qoalhy-Dirisim of WaterResamom Ravmd 66201