GW1-2021-00257_Well Construction - GW1_20210125

WELL CONSTRUCTION RECORD wl,rn.ln .a oil r
IL.,mnnl cent bcn.ed I'll""'0' 1 nnlli Ile I'll'
L V,ell(ontractor Information:
IA.WATER ZONESVlr II Wilson 14) ULSI Met III\
rcdn-olnla to,\aln,: 45 0' 57 ft. wet
4473 ft. D.
�I'ls dl tlnuranur f'enlGcvuoll 4lna.c, 1.5.OUTER CASING for mufd-eased lvellsl OR LINER if• liable
FRO\I TII al\MFTFR TIIICR♦F i5 \I\1'V'ka U.
Parratt-Wolff, Inc.
16.INNER CASING OR TURING eolhrrmal closed-Ino
168-96-MW60-RW25 Most 0 U,, ,,I, TIIICE\E55 TfRI\I.
2.WA ell(instruction Pk,rnat rt: ft. 41 R. 2 Soh40 pVC
3.WW ell 1 Se(check well use): 17.SCREEN
\Winer Supply\\-ell: FROM to Im%%IFI'FR ' 'rol sl)If 1'111FA\E55 %I Mart,
-.:l enculwral CNhlnmlpal l'uhhc q1 n. 56 R. 2 'n .010 SCh40 pvc
-Ocolhcnnal ll lcabm.Ibuhnu supply I -Readenual Deter 5uppk l sm,lcl 0. rt. 2 in. .010 SCh40 pVC
-lndusvlu6C ommauul CReadenual Alma Supple(sharcdl IS.GROUT
FROM 10 '011FRIu, IMP1.0 T:M1]T\IF1IIOI k%101NT
-'Irrl_ahon 0 °' 37 r' Portland Cam Pour
Non-\Pater Supple AN ell:
z Wn,nlalnn_ cltecoycn 37 R 39 ft- Bentonite Ch Pour
Injection ell: D. R.
-�1ym lcr RYhurge Clliround%lte, Rem edlab"n 19.SAND/GR.AV A offli liable
FNfm TII '1s1 %] FVIPI.ACFMFNT VFI TIOD
-,1yuller Stul'alu and Recnen ❑Sullnit, Ratner
39 ft. 56 ft- #1 Fine Sand Pour
.Aylr Test ❑Sturm.,Lite, Dramage
❑. ft.
=RpenmcTiml Tcchnuloev L3.Suhsldomc Control
20.DRILLING LOG untankrin addi6ond sheefs if oeccaa
—
(ieothernml(C l osed loop) ell meet FROM TD DI S(RIM 10Cmlor.hnilne.csua.ruvkrce .etca
Geolheiial(HeabnJ( online Rctuml ❑Other Lesplar,under d-I Rclnarkel ft. ft.
12/11/20 2W-28 D. ft.
A. Dale WWellls)(ampleled: Well IDk
ft. ft.
5a.Well Location: fl. R.
Plantation Pipe Line Co 3571 ft ft
Pajo,OeoerCam, Hmdln 11)=nf:Wpbcublcl ft. ft.
2617 Quaker Landing Road, Greensboro, 27455 ft. ft.
PIll,"d sddmss.l'Ip and/l.
21.REMARKS
Guilford 7847837248
Cuonlc Palcel Id'ill fieau on 4. I'IV
5b.I nlfIrole and Longitude in deg,ee slunk noles/sea nit s or decimal degrees: 22 (ertifia. on:
36I1467281...iu .allielenll N -79.850615 Wv l
J , , k,
SIF•nah«ol(Fni sc A4dl Conlluetal Dmc
fi. Is(are)the%ell(,): ILPermakil l or ❑Temporan e, vvvane dn,loin.. I lw .d 11 rdou.e
n uh I?.! Ar I. I'll Will o.I%IA, 11 1 OOn,It III 1 un,lrmmin Fmmlerd,,urA dntlo
7. Is this a repair fit an existing M ell: -Iles or ZNu .,enaI/IIN rd hu,heen pr„1ld.j1,1 112,[1 ell net.
lI dv..I...........idi nw bl—,.I/I,.Lin""" ,au rn/urrneu.al wnl nplem,hr nenur"III"
,vhel.aide,- '1,......A, ,,u,m.......me n,,.A.I/ma,s,,,,l 23.Site diagram ur additional.sell derails:
You inn l the hack of iha pa In prnyIde additional .cell sic details l,, .sell
A.Number of Hells constructed: 1 cunsml'tioo delads You nm, alki,euech adds l I Toes It necessan
P - III-,nl.omnu,r„...er /ll, ii,IINLI .aL,h.peme u,nsfruemm. ,, ,...
,III I h,rn, I sFf MITT it],INS[I'C IICI
9 Total well depth below land surface: 56 I�� (ft.) 21a. Fur All Wells: Submit Ihn limn .whin 30 doss ,I nnnpla tun of Ivcll
1 ,nuhgl, uJl. l,l ill J,pdn / ", l aenlplr «'ol .,, Cutunl COTIARcl1011 to the lolln.ymW
III.Static wafer level below lop of casing: 45 (ft.) l/irisinn of WW'ale,Res........Information Processing L nit.
//n,nar/.na,,Ili ,e,o,e a„ I617 NlaiI Senice(enter,Raleigh,N(27699-1617
11.Borehole cliamcler. 8 1/4 (in I 24b. For Inicctin. AWe1I,ON1,1 In addwIII to send me the hoar,hl the address m
HOIIoW Stem Auger '-4aubose Lill" Suhmi a cups of"oh limn '.vthln 30 days of aanlpleunn ill'I'll[
12.Well construction method: Hollow to th m,e iollov.
I I. _ rolan_cable IIImCi pmh.cm I .
Ificisinn of\Water Resources.1'ndergrnunJ Injechan(antral Progrxnl,
FOR WW%I I R S1 ITI.W AWFLIS ONI A'. 1636 Mail Senice('enter.Raleigh,NC 27699-1636
13a.Wield(gpm) Method of test: 24c. For WWah•1 Supple S Iniecliun\Wells:
VI'll wbnut Inc cope of Ihu Ihnn mlhm 21l day s ofenmpleonn of
13b.Disinfection type. Antounb ..dl comtn¢tlon It (Ile toot he',dtlt depair,em of the county oboe
- umw uaal
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