GW1-2021-01318_Well Construction - GW1_20210329

"ELL CONSTRICTION RECORD n,C.oal I .p I1vu
I I,lbrm wit it,u,,d I..r,lnul<...... „dls
I.\\ell Contractor Information:
Kevin White 16.WATER ZONES
FHII\I TU first RIM ION
\1;II C'eov1:IeI\mac fl. a
2973 ft. 0.
\t-U III(''111' 01u('annicau,n,\nmbn IS OUTER CASING finTd-e Aed ORUNER if able
rt0\I ' IE
r0 UI\MFTFH THI('KSFtiS M\TFm N,
Parratt-Wolff, Inc. ft.
16.INNER CASING OR TURD6G raW deed-1
FROM TO DI\METER TOKUNE95 M\TFRI\t.
2.\\ell Construction Permit#: 0 n. 59.5 ft' 2 Sch40 pve
,... dt.,pp0,ehle n ell pnu..!'' : wnnl. Is",. I bnum,.;111 lit,•,..n. n.
fl. fl. in.
3.W ell I-se(check well use): 17.SCREEN
\\afee Supph'N\'ell: FROM TO 1111MFTER SLAOSIIF 1 ❑mEK\1:4R 1 MATERI\I.
\,rcultural :.Munlclpal Puhl, 59.5 h 61.5 ft' 2 in 1 010 1 Sch40 I pvc
=(leothennel I Ileatm�G><�hn�Supplv'I -RcsNonuul Nmel Supph fllnl c7 ft. ft.
Indua,ah('rmo,ccnal ❑Residential Water Supplk (shared) U.GROUT
FROM TO \1 NIT Ft 41, rMPf_\CENIFNTMETHOT& \MOI'ST
trngauon 0 D. 54 b. Portland Cem Trelnie
Norl ater Supph,Well:
?1lonnun m• �Rcc o,cn
54 b 57 ft Bentonite Chi Trernie
Injection\\ell: n. h.
- \yuller Recharge DGround,cater Remediauon If.SANDIGRAVEL PACK K e
FROM TO MNTERHI. EMPL\CEME\TME7110U
-,Ay uller Storage and Recocen ❑Sahnu,Garner
57 D' 61.5 ft- #1 Sand Tremie
-Aywtcr Test ❑Slnnm,ater Dminagc
ft. ft.
=F%penmenml TeclmDlos, -]Subsidence Control
20.DRILLING LOG aWcY UESCRIPf DESCRIFT dohK
—(rcnlhcnnn (Closed lnopl CTracer FROM T(1 IfIS lmli avmness.I.Lis,11,Olin.gron ux.etc(
-G,othem,el(llcutol{CooIm_R,nal,f CUthcr(ccplamundc,`I Remarissl ft. ft.
12/18/20 AS-14 ft. ft.
J.Dale W411(sJ('omplrltJ: Well ID#
,a.NN ell location:
O. ft.
Colonial Pipeline Company rt ft
Ia,Ja.U,wc,AunI Iaa6n ID=u,apph I'leI ft.
14511 Huntersville-Concord Road, Huntersville, NC 28078 I
I'h.....I Ndd.... (is_m,d/Ip 21.REMARKS
Mecklenburg No cover
r,.nnl. pted aennr.-mrI\„ Irlo
,b.I.alitude and longitude in degrees/minutes/seconds or decimal degrees: 22 Certificalion:
1.1 dl field arc lalaang is wlti.Ienu
35.413007 N -80.804950
.11Cnalare at(r„16ed vau C"1111a� Dale
6. Is(are)the welbs): EL Permanent nr 7Tempor2n „,n,n•Jr„mrru .,.••,,,r„L.J�. . ,nLmn.M ,
EA N, 11 W, n',IP r ell,brn,nn w•n?mnJarJ,enJ lhel e
'.Isthis a repair loan evisdng well: ❑I'es or Z\o ..,o..... Jl Iho vdl,nnn..
Illln.1. repo,r.1,11oulo„ninn,11,ouvnnln...rgonna0on e„d evpl..... nen,re,.I,br
rpx,v under '1 ceme It, e,Dun w en me had'of I/.../tiro,. 23.Site diagram or additional well details:
You mac use the back of this page to pro,ide additional well site details o,well
S.Number of wells constructed: 1 aonxmcron details. Younm%also attach additional pages if necessar,
l..r.,..duple n,Ie,inn,or mu,...II,r•upph a dl,O N/A'n ub rh,,nine n.nsnudinn. um Len
,ohm.., I•vm Sl-1 ITiV INSTC(-TIONS
9. 1 ofal well depth below land surface: 61.5 Ift.) 24a. For All Wells: SLboaf this ti.rm within 30 dens of completion of,Nell
Far....duple ,11,lal ell Jop,h,N J,ll.renr mvmq.I'-3•¢'uu enJ P,i 1`0 1 t],nstinclmn to the Tllowomg
Hk Static water Iesrel below top of casing: Ill.) Oi fo cisimn of Water Resources.Inrmalion Processing I nit,
1 1 I„d m r,eh ,..e,ore ..., 1617 Mail Sen'ice Center.Raleigh,N('27699-1617
11.Borehole diameter: 2 (in.) 24b. For Iniection Wells ONIA In addnlon to wndmg the Il,rm to the address or
1/4 HSA '_laaho,e. .dso submit a cop% of this form ,athm 30 dos of completion of,still
12.M ell construction method: amstmclion¢,the following
u c :miler,roan.cahIL ifie,push.It, 1
Dicisinn of Wafer Resources.1-ndergrmunJ Injection Control Program,
FOR WATER M'PPI.I \NFLLS ON[1 0 1636%fail Senice Center,Raleigh,NC 27699-1636
Ida.N-field Igpnq Method of test: 24c. For Water Supply& Injection Wells
VIro suhma one cop, of this loan within 3U da,s of con,plenon It
136.Disinfection tall .Amount „ell cu,utrucuon to the county health depunlltcnt of the count, whete
- constructed -
brim,@-I R,n6(tuulou Uqv nna„at I. nnmwnl.nW Vamed RI,ow,,, ),,1 •n of N.lu Rc,aurce, R,,.,,d Auu,.,_'01]