GW1-2021-00695_Well Construction - GW1_20210203

INELI,C'ONSTRUCTION RECORD FarU,,rrWII,ONI
Thee farm an,ti aced G.r o,l,,:+muhipk ,01,
I.AAdl Contractor Information;
14.WATER ZONES --�
Brian Ewing ER115�1 T�t(> n[51'RIIIIIIS
\Actl('onnmrot N:Nh O. I ft.
i
4240-B ft. ft.
I
N( \4ch(onlmnar(cnrficnnn Nnnbcr IS.OI--TER CASf.NC fur RwYi-eaMdwW10R
Yk
E FR .UM TO D15MFTFR TnLRNR 5T FMV
SAEDACCO In^ 0 fl. i 12' ft. 1.5" to. NA Steel
f pa.N,ow - ,. It-INNER CASING OR nISING ljrolkrr�tluced-1. J
FR051 t fU ht551[TER m_ TIII(ki@@ss N5T[RISC -
5 NNdlfnlntmetxtn Permrtd WI0300399 70002483 1�— ft. I.
f r,d , „";„ <,rxnr. e.0.�.-r,,,,,-I -tgerom,,,.,
3 W'dl l;r tcMel.�ellRcel. J�7.5('RUN
tamer Supply%itell: FRII51 To DI551rT1"A rlllT.1'/r 1Nnx VFSi NSTeRIaI.
I.I Agneultllral I,Municipal T'obbc 12' ft. 20' H. 1.5" ia. NA NA Steel
I ICrerolhemWl IHaatinKt'mAinc Suppl\I I IResidcntud Water Supple Isinglet n. ft. i•.
lhxlusuiah(7omnlcrcial IIRtNtdCoual R'atcf Supph lshl"'d) 11.GROUT
FROM TO %I%nmAi. -ENPLA[EMENT METHOD a A51OE 5T
Dlornimlion 11. ft. I
Non-Water Supple WdL ft. ff.
❑Nlonilonng ❑RmoScn _-L_-- -—
Injection Well: 19.SANff. ft,
--- 1 - - - -
ILANIdfcrRcchargc (I(imurdwalzr Rcnwdl:niun DlGRAVEL PA('K IR fkaYk)
YRIIN 10 In%TCRI%l INPrA1 tMVNT NITIFOU
f].47"ifcr Stnmgc atd Rsmcn Cl Salinin Dnmcr
❑.Aftmfcr Test ❑tiiommatcr DrlinTgc to. ! h.
❑Fxpertmcntal To_hnolol,n n.1wbcidcn:c Utomol
M.DRILU G LOG OmosizY aMi"Mal 11frel5 R Re onnr,f i
❑Cinolhemml Whined Luopl ❑Imcer FROM TO Df3("RIPTIONo.Iv.6.ranee,.,W,..i"Ir.a..:rr.tad i
❑GeutlamullHcaunerCbehne Rrluml ®CHhcr lea aln u[dcr 42 l Renmdksl 0 0. 20' n.
fl. i 11.
4.Date'A 010,1 Cumpleled; 1/15/21 Wdl IDaA16
It. n,
5a.AAdI[Awatilm_ n. n. —
Remediation Management Service Company f'. i ff.
F.x,ho Ch,ore Nlow Fa dos ID:,Rarplrabk+ fL l ft.
2650 Shenandoah Ave., Charlotte, NC, 28205 r-- —-----' --`---
fL I f6
Ptascal 5dlres,-Co,.:n.171p I1.REMARKS --
Mecklenburg 12710204 Temporary injection point through DPT tooling
Coma) lSrv,9 hbmtftCaDun Nu IPINI
Sh.Iammde and I.migimlk in fklpcestminuH•sis omk or decimal degrees: 22.('ertiOcation:
W oc 111iid.I'..hit In.N""FITYcm,
35.210533 N -80.801887 Brian Ewing 1/27/2021
' '-�i'-��I�:uturc of C'cmficd Kcll Cnntrclor [lafc
6.Le(ar)the%elllsl: 1-Pcrmancnt or K'Tkmlmran
ere, tlmO ::P.r..
neu .-n,I 9('.1('U'C '/liM,•., P.1Arifr
f' g4.,n,�S C.ngiwi n:... 4„I..J,-in,l rlaaa
-.Isthi%mmlizirmanesi5tingeell: DN" for KN'o r"�an,,.o,..r!n�:.11.1 t•,:.,
. .vY. NP ,I,... ,,, „—: n ..:, .......ry
n,L "I
,, , l n lard n T s,.,. . :,,.,OF If ar nd,ILI"'I. 23..Site diagram or additional well details:
,W min use(he back of lilt,pun to pfo,[dc addniotal"ell site delatls or dell
8.Number of Relis m1"Irueyed: 1 ceuslmuiuo detafil. You man alw altich addmoml pans if necc,,Ian
F.,.o.h,r•,,,�i,.,n,,, ,,,.�-,..,, „r,;.,•,�..06/.I �:rr�no .rmr rnn,miath.
. SUBNOT'f AL INS'11111101'S
9.Total Rdl depth belom land wrfan.—20 244 For :All Wells: Subrim (lo% font "nhln Itl dj, of contpknon of "cll
r,� .,,,,tre;.,, .. , ��, re„,,,uy,, ��, .�_„ r�,- n�•�r. .,,,,I n., construction In the folloullm
III.Static Natrr Inel he1u" rip of casing: ID.1 D!,noon of N%ACT Rmaircrs,Information Processing 1 nil.
n,,,go-.:,,,1,.,d.n, „I....; ,. - 1617NIAilSm'ice Center.Ralemgh,N( 2 7699-16 1 7
11.Burehuk diameter.,•5" On-) 24b. For htketion NA'PIIY ONIA: In addmon to seodout life font,to the:Iddu• ut
?taabo%r also slbool if cop) of lhis font, "idoo tm des of compk1tuu of "all
12,Ur115Vn5tNctum method: DRIVEN YrIY1mCllutl lu tlx:IVIIU,1111_C.
sarcr,m:m.a,61c.dine pssl,etc,
Die himn of Water RcwRrces.Underground InJenlnn Cunlml Pmgrun.
FOR AN'.ATER SCPPLN AA'FI.LS ONLY; 1636 Nlail Senice Center.Raleigh,NC'2 7699-16 36
\ For
4 alorS upph 5 Inj injection ON,
iecion A
Ila.1"idd IgPml - -_-. Metitnd of test. orm ,ithul 10 da,s of cmnplellon of
I3b.Disinfection hpe: Amount: %Act] constriction to the cmmn health department of the courn"here
co[mrictcd
fenu QAS-I Wnh(noh,uU\ptnneu[i,f fn.,ronns:n,nd�auvnl kcsnneee Un x.a,of N.ncr 9sxlrc6 R..o:d:A.gust IF,IF

7A-M1
January 28, 2021
Information Management
Division of Water Quality
1617 Mail Service Center
Raleigh. NC 27699-1617
Subject: Well Construction/Abandonment Records
Dear Information Management:
Enclosed are v cll construction/abandonment records for the following locations:
Location Job # Date
2650 Shenandoah Avenue; Charlotte . NC 13405 O1/27/21
Sincerely,
Karen Byer
SAEDACCO. Inc.
Enclosure(s)
9088 Northfield Dr. ♦ far'. Mill.SC 2010, • irdacao com • `i)O 919 0363 Pho^e 903 -AP 2180 ♦ Fax f8031148-2181
South Atlantic Environmental Drilling and Construction Co.