GW1-2021-00626_Well Construction - GW1_20210326

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WELL CONSTRUCTION RECORD (GW-I) Fur Internal Use Onl}':
I.Kell Contractor Information:
Sean Cropsey 14.WATER ZONES
FItONI TO DESCRH'TION
U CII Cella l,ta,Nrr e
2485 A 60f` 80f° Limestone
t. fr.
V'\\ell Comm tnr(brnli", ]wn1"r 15.OUTER CASING for multi-cased wells OR LINER ifs livable
Applied Resource Management, PC "°" n nI " "`KNrs, is IAL
ft. ft. in.
(-ompom Nomc
EHWP-401-2021 16.INNER CASING oR n!RIAc eothermalclosed-too
2.VI ell Construction Perndt W: FROM TO DIAMETER AICKNI:SS M\TERIAI.
l"'allepp/nelhl, uel]eunrin,.o.mp.mu,.I.-. Iq(',tb urn,cl,ve. i<u rcmu.rrcJ ft. ft. in.
3.M ell Use(check well use): ft. 1
NWater Supply Wrell: 17.SCREEN
FROM T(1 DtlfilI'l'k SLOTSIZE TIII('KNEss aklia 11.
Agricultural C]Mtnlilipal:Public 0 fc R, M.
Gcothcrrtwl(Heating/(-oolme Supple) [DResidcntial Uincr Supply(single) 60 fI. $0 ft. 4 in _020 $Ch 40 PVC
Industrial/Cammercml [3Itesidennal U ate,Supl* (shwcd) IS.GROUT
bneatinn fRONI 10 )IAl'KRI:NI. IaNit!.N('r:M1.Nl Nt E1HOD&AMOI:NI'
Non-Water Supply W ell: Ort, 25 '' BentOnite Pour
3Monitonng ORe'o"M fc ft.
Injection Well:
,Neuter Recharge E]Groundvsoter Remedialion
19.SAND/GRAVEI,PACK titan icablc
Aquifer Storage and Recoccn QSaiiait,Burnet' moll TO MATERIAL ""'CEMENT METHOD
.Aquifer Tcst �Srorirsioci Dminagc 551i- 80"' #2 Pouf
I[vperimcntal Iechnolog, [3Subsidcacc Control ft. ft.
Geothermal(Closed loop) [3'1racer 20.DRILLING LOG octumb additional sheeesifneceew
DFs('RIPI'tt)N rnlor.LarJne ruck n c e,o(n.
Geolhermnl(Heating/Caaline ReDlm) Uther(esplain under!!21 Remarks) FRo v to ....nil0 ft. 10 fc
clay
4.Date Kell(s)Completed:03/11/2021 Well IBM 10it. 30 ft. Clay sand layers
5a.W ell Location: 30ft- 55 It. Sand Clay shells
Will Reeves 55ft 80f` Limestone
Fa,dm OancrNrae I anion Jr)=❑f apphcablcl R fr.
Pecan Grove Lot 17 f` f`
Pln,ical.\dies,.('it}'.end Zlp D. ft.
Pender 4214-42-7477 21.REMARKS
('Duna I'ercl 1&,ma"uianA'o. PINt
5b. I.adiude and l(ingihlde in degree%/nhinutes/seconds or decimal degrees:
tif,ccll field_one IaUlnng is ial icmal) 22.Cer lifieation:
34 24 31 N 77 37 30NN 1!yz1 03/11/2021
6. k(are)the well(s):1211'ermanenl or Q!Temporan S�g,nwrc of(cmacvl AN' II(lint mr Uam
laI e Ili.• lmm. I borvh, ..rnh IIIa1 rho nallr.l o ,r 1, 1, led 2"e of Jon..
7. Is this a repair to an existing well: 11'es or E✓ Ao 11IIh I•I sl':11 I0'.0100 , G,J v,=11'07r' also Nall I-„nm.1'r [ I wld,sa e
l/d Irrp,Ile fill II ku,1 In.I. u,nneltmrn/(rrnaI Irxl.Imn.Lrrnrure o/Me —,-, J; rJhal dmh, /1under.
spar.....0 21 delvodke,e.uon....m In, h,,,k o/del.,/„.,1
23.Site diagram or additional well details:
8.For Geoprobe/DPT of Closed-Loop Geothermal Wells hncing the same S ou m n use the buck tit tb¢page to prncide additional well site details or well
consuuction onk I GW-I is needed Indicate 101 Al_N1 MBLR ill wells amslruetion details YOU mav'also attach additional pules if necessarc.
drilled StBNII'I]AL INS'I R( CTIONS
9.1ulal well depth below land surface 80 (Pt) 24a. For NI Wells: Submit this torn sc,thin 30 dac' of completion fl hell
Lb .....Mlle ,dL.I'll all Aeprl ,I J be . - unp1, 3 as u...Ia R10 I ClmAR6'1101,to the follo""w
Ill.Static vote,'level below top(,teasing: 12 (ft.) Division of W'ate,Resources,Information Processing I nit,
It Ierel d..rhnde,.,r,I>•,I'll 1617 Mail Service Center,Raleugh,NC 27699-1617
11.Borehole diameter: 8 (ill.) 24b. For Injection Wells: In addition to sending the form to the address in 14a
Mud Rota aline also submit one cope of m f this for within 30 dans of completion of well
12.W'ell construction method: ry anu in] uon to the Ibllaoroc
.. alble,ditecl Pu..h.ac
1)isisinn of Water Resources,I.nderground Injection Control Program,
FOR W':%TER SI PPIA NN'El I ONLI': 1636 Nail Service('enter,Raleigh,NC 27699-1636
13a.)field(gpm) Method of test 24c. For Water Supply & hhiectfun AWelk: In addition to sending the haaa to
the address(es) ahovc also submit one cop,, of this Rlmh vothm 30 days of
13b.Disinfection h'pe: Amount completion of well construction w the county health depannhent of the lo(mty
where nulso ucted.
tom.G0s-I Noah Ca 0111IR Dcp:nvnem of line imnmcnad Vuablv-Di,ininn al'M liter R,.ources Iteh iseJ'-"?OIG