GW1-2021-01252_Well Construction - GW1_20210209

\\ELI,CONSI'RUCl[ON RECORD P,1, "'Xt FNJ
Tins form inn It,usad IT,,cin Ico*nmllIpk,.c'Is
I.{{ell Con IFactor Inhmnmiom
14.N'ATLR ZfjNIS���'�
Dylan Fierst FROM i to I nitil"Rlrl loN
'•well Cnnr:y:10,N...... ft, ft,
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4507-A IL 'i fl. i '
NCN- I GI,Ir.¢nr4 n,._.,uo, rtcr ! IS.Ot TERCA51NC dnr nrdli-card wc0a OR LINER lih rllkahkl
FR(1\f Tonl\\IFTFR Tn1CR[F55 n11TF RI\l.
SAHDACCO Inc 0 ft. 10' 0. 1• in. SCH-40 PVC
l y N 16.INNERCA9IN( ORIURINGfXv.rh nil ckneJa rp) - _.
iNOV Tl) ul\NFTT0. Tlll(hir S6 T PILL.
t Wdl(t n.tmcfinn P.unitd 70002809 WH0301089 _ _ fl fl j n �—
MIT
sh.hI r.- 1.emu,
3 % dl Ex fcheck we11 uac). IL SGRC[N - - -
{Pater Suppir%%ell: FR1111 I To I mAnfFTI'R 11 OF
I_L\vrl;ullurul IJbS11ui.;iF<d:Pnbli:
se CHNv ls ll\CTFRIM
10 20 b. 1• tn .010 4H0 PV .
I lCembcnmd Illcimw Coollna Supph I IRcsiden6:d W'afcr Suttplc Igio-acl O. j ft.
I l lndustri;ll Commercial II RCcsidomai Wane Suppl, 15111rcd' 18.GROUT
i IO T 31 fTf0.1:V. iFalelnfUIIXT MFTIIOnx dflOF\l
❑lnc'abml ft. It.
NOm\{'atcr Supply{Yell: --
tf.
xM1lmliNnnG ❑Ramer,
Injection\{'ell: n. I ft.
I lAguifcr Rcchar,C fT(imutuhC;ncr P-nlcdiadOO 12H\D GIL4\'CLI A(.R litanpina6lci _ t _.... .
FRII\I ' 2 NLTER_ I0II/30 T\Ir\T MITrrtrtl
fl.Agni6;r ml;rp,c:u'.1Rmnrzn ❑5nlinih &Imcr g. ft. 20' ft. FILTER SAND 20/30 .
Cl Aquifer Test CIS;omwatcr Dmi mige b. fL ll
❑F.grmncnial Winelocl c1subsid_rcc(•nlaml
2n.RRILLING LOG 1v11aeh addiliunvl sheds if acen•an I
❑l',eotllen¢d(C'Iused Luupl ❑Tracer FROM I To nFSCRIrnoN....
❑G;otlwnlulfNe:RingCua,lirrt kcbuul ❑Otlxr leeplam mzler b11 Rcmar"i 0 (1. 20' D.
4.OAtc WCII(s)C.,nlplcta•d: 1/14/2021 {}dl lf)e TW-2 —
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5a.WYII I-AWAtiun: ft. ❑.
Cutter Family Properties, LLC ❑. � h.
F.loH,^(h,re,Wort Feubr. Ifs=tii arplcah c+
Dow Chemical - 6101 Orr Rd., Charlotte, NC, 28213 '-
ft tl ;
121.RI NL4RhN
Mecklenburg 09706202 Temporary 1• PVC well
Gonla, P.rt:d LLmATInnim,No PINI
5h.Latinidc and Iaingimde in dagnrosrminuu•siseennA+nr dttimRl degrees: n2,(cnifiealion:
d u.i:1'mIJ.nnc bn lnt�r.adl4 o:vl
N {{ D 1/15/2021
gib-o^of Cenlfied Well Can¢rtor Uam
6.b lire)the wcll(s): '.7Fcrnanent OF %"FenIIHMAq q, ,x••„�, f t ,.r:n r
I, OX .61 A( n II, - ,r,l""I ..0"'1 1
h this a m1mir to an cuminL'Atilt: 7Io Or XNO ..:.. .. ..:::.
r : . .. . v-.
23.Site diagram Or Ad ditiunsl III el l details:
Fa,a luat nse IIR buck of Ihis mite to prn,fd;:adddwnal %,It sae doills OF nett
X..Number-Id well:to mlmetcd; 1 eeus9uution del:nh. You ma, :11,au,ldl addiGen:d PelgcS It lItcVbsln.
,._ " SLUIMII"1'A��TLCTIONS
9.Total ndl depth bchm land vlrfaca'. 20 (fU) 24a. Fur All Wells: Sublml Ills ISnn m(hm ill d:ns OI'<xnnPl llou of lsell
::.•y! .nnsm¢IiantollaGTlWwing-
lu.StAtlCwater Inel 11CIUw 6g]of Casing: IN.) I)k ision of\{'titer Resources.Infornution Fmcessing l nit.
Ir 1617 Mail SlTrlee('enter.R:Jcigh.N('27699-1611
II.Borehole diameter.2.25• lictl '_4h. Fur Inhrllr n N%rd ON 1.1': b,adtfioon to sending fly four to(1a addfai en
'=aabw e. also 5nbmil a Cup, of Ihi ruuu nillon :it) dins of nnnfddiou of „ell
IL Nell nut,fnlClinn nmltlnd: DRIVEN :0115tnlCliun to tIW folloe ire.
tore,o:,hk direr W sf.eta,
Dis ision of W'alCr Rcsuu n'a•s.ltnA•rvnlnnA InjCtliun Cunlml Pnrgruu,
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R W1TI:R S(TFLY\FELLS ONLI'; 16311 Mail Service Center.Randgh,NC'Y'699-1636
Yield Iglrm/ Merhnd of ge t: 24c.Fur Wafer Suppb X Injectbm\Yrt\Iw stlbnul om <op, of Ibu fonu ,ill W Ja,s of Compleliml of
b.1)isinlha'[inn hpr. Amunn l: bell c.numcnan In the Munn health dep:nlmov of the scan wDcn•
eOMmcfcd
Form(,N-1 \onL Gp:mn'tntol(IPIn4tIILlli and 01,exn:cl\\.oa'TCLIFTIM Na,led:\uigu5t-y>I'